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Cholangiocarcinoma And Surgery

Merel S Koedijk, Ben J M Heijmen, Bas Groot Koerkamp, Ferry A L M Eskens, Dave Sprengers, Jan-Werner Poley, Dik C van Gent, Luc J W van der Laan, Bronno van der Holt, François E J A Willemssen, Alejandra Méndez Romero
INTRODUCTION: For patients with perihilar cholangiocarcinoma (CCA), surgery is the only treatment modality that can result in cure. Unfortunately, in the majority of these patients, the tumours are found to be unresectable at presentation due to either local invasive tumour growth or the presence of distant metastases. For patients with unresectable CCA, palliative chemotherapy is the standard treatment yielding an estimated median overall survival (OS) of 12-15.2 months. There is no evidence from randomised trials to support the use of stereotactic body radiation therapy (SBRT) for CCA...
October 15, 2018: BMJ Open
Xu-Xiao Chen, Yue Yin, Jian-Wen Cheng, Ao Huang, Bo Hu, Xin Zhang, Yun-Fan Sun, Jian Wang, Yu-Peng Wang, Yuan Ji, Shuang-Jian Qiu, Jia Fan, Jian Zhou, Xin-Rong Yang
Current therapeutic options for intrahepatic cholangiocarcinoma (ICC) are very limited, which is largely attributed to poor understanding of molecular pathogenesis of ICC. Breast cancer type 1 susceptibility protein-associated protein-1 (BAP1) has been reported to be a broad-spectrum tumor suppressor in many tumor types, yet its role in ICC remains unknown. The aim of this study was to investigate the clinical implications and biological function of BAP1 in ICC. Our results showed that the messenger RNA and protein levels of BAP1 were significantly downregulated in ICC versus paired non-tumor tissues...
October 10, 2018: Cell Death & Disease
Volkan Öter, İlter Özer, Tahsin Dalgıç, Cemil Binarbaşı, Murat Ulaş, Erdal Birol Bostancı
BACKGROUND/AIMS: Hilar cholangiocarcinoma (HC) is a tumor that invades the confluence of the left and right hepatic bile ducts. Surgery is the definitive treatment but is also technically demanding. Here, we report our experience on 42 patients who underwent surgical resection for HC. The aim of the present study was to evaluate the margin status of resected specimens on frozen sections and the impact of R1 resection margin on survival. MATERIALS AND METHODS: A total of 42 patients with HC who underwent surgical resection in our clinic between January 2008 and January 2017 were included in the study...
October 9, 2018: Turkish Journal of Gastroenterology: the Official Journal of Turkish Society of Gastroenterology
Nicholas Bird, Adrian McKenna, Declan Dunne, Ben Francis, Stephen Fenwick, Graeme Poston, Robert Jones, Hassan Malik
AIMS: Cholangiocarcinoma is a rare cancer arising from the biliary tree. Case series indicate that 25-40% of all borderline resectable primary tumours are potentially resectable. The Memorial Sloane Kettering System (MSKCC) stratifies patients for resectability by longitudinal and radial extension of the hilar tumour. The Bismuth-Corlette system describes the longitudinal extension of the tumour within the biliary duct system. We sought to validate and, if possible, augment these two scores within an independent validation cohort...
September 11, 2018: European Journal of Surgical Oncology
Ning Zhang, Yatong Li, Mengyun Zhao, Xiaoyan Chang, Feng Tian, Qiang Qu, Xiaodong He
RATIONALE: Sarcomatous intrahepatic cholangiocarcinoma is a rare histological variant of cholangiocarcinoma (ICC). Previous medical literature has not mentioned the prevalence of this kind of disease, but a poorer prognosis than that of ordinary ICC was indicated. The diagnosis of the sarcomatous ICC is established on histopathological and immunohistochemical examinations. In this article, we present a new case of a patient with sarcomatous ICC who had no radiographic sign of intrahepatic tumor preoperatively...
September 2018: Medicine (Baltimore)
Hai-Ping Zhao, Zheng-Hua Zhang, Ai-Hong Zheng
The clinical significance of palliative interventional therapy in the management of patients with advanced hilar cholangiocarcinoma (HCCA; stages III-IV) has yet to be studied. The present work was aimed to compare the clinical outcomes of the patients treated with surgery or interventional therapy.A total of 90 patients with advanced HCCA, who admitted Fuyang First People's Hospital from May 2015 to February 2016, were enrolled. Forty-five of them were assigned to the experimental group receiving biliary drainage as the interventional therapy, and the remaining 45 patients were designated as the conventional group receiving radical/palliative surgery...
September 2018: Medicine (Baltimore)
Teruhisa Sakamoto, Yosuke Arai, Masaki Morimoto, Masataka Amisaki, Naruo Tokuyasu, Soichiro Honjo, Keigo Ashida, Hiroaki Saito, Shinsaku Yata, Yasufumi Ohuchi, Yoshiyuki Fujiwara
Portal vein stenosis, which results in serious clinical conditions such as gastrointestinal variceal bleeding and liver failure, is caused by hepatobiliary pancreatic cancer or major postoperative complications after hepatobiliary pancreatic surgery. In recent years, portal vein stenting under interventional radiology has been applied as a more useful treatment method for portal vein stenosis than invasive surgery. We herein report the successful use of a vascular stent for portal vein stenosis after pancreatoduodenectomy...
September 2018: Yonago Acta Medica
Koichiro Sakata, Daiki Kijima, Taizo Yamaguchi, Takashi Furuhashi, Toshihiko Abe, Haruki Iwamoto, Katsuhiko Morita
INTRODUCTION: Although curative resection is an outstanding prognostic factor of intrahepatic cholangiocarcinoma (ICC), certain segments remain unresectable. The standard therapy for initially unresectable ICC is uncertain. In this case report, we reported the feasibility of multimodal chemotherapy and curative resection. CASE: A 59-year-old Asian woman with back pain was referred to the hospital by her family physician regarding liver mass visible on ultrasonography...
September 15, 2018: International Journal of Surgery Case Reports
Ming-Yang Lee, Yi-Zhen Li, Kao-Jean Huang, Hui-Chi Huang, Ching-Yen Lin, Ying-Ray Lee
Cholangiocarcinoma (CCA) is one of the most serious of all cancers and a major public health problem. CCA is an extremely invasive cancer, and the survival rate for CCA patients is only 24 months after diagnosis. Although surgery and chemotherapy can extend the survival rate to 5 years, < 20-40% of CCA patients will survive this long; therefore, it is crucial to discover an effective chemotherapeutic agent for CCA. Indirubin-3'-oxime (I3O), a derivative of indirubin, has been shown to suppress cell proliferation and induce cell-cycle arrest and cell apoptosis in various human cancers...
September 27, 2018: European Journal of Pharmacology
Anuhya Kommalapati, Sri Harsha Tella, Gaurav Goyal, Mitesh Borad, Steven R Alberts, Lewis Roberts, Joleen M Hubbard, Lori Durgin, Sean Cleary, Amit Mahipal
BACKGROUND: To determine the association between the number of patients with intra-hepatic cholangiocarcinoma (IHCC) treated annually at a treatment facility (volume) and overall survival (outcome). METHODS: Patients with IHCC reported to the National Cancer Database (years 2004-2015) were included. We classified facilities by tertiles (T; mean IHCC patients treated/year): T1: <2.56; T2: 2.57-5.39 and T3: ≥5.40. Volume-outcome relationship was determined by using Cox regression adjusting for patient demographics, comorbidities, tumor characteristics, insurance type and therapy received...
September 25, 2018: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
Xinyu Li, Lei Huang, Xisheng Leng
OBJECTIVE: To investigate prognostic factors of  more than 10 years of survival for liver cancer patients after liver transplantation. METHODS: From May 2000 to May 2007, a total of 134 liver cancer patients who underwent liver transplantation in the Department of Hepatobiliary Surgery, Peking University People's Hospital, were continuously and retrospectively enrolled. The patients included 120 males and 14 females. There were 124 cases (92.5%) of primary hepatocellular carcinoma, 9 cases (6...
September 26, 2018: Journal of Cancer Research and Clinical Oncology
Yuichi Goto, Satoki Kojima, Yoriko Nomura, Daisuke Muroya, Syoichiro Arai, Hisamune Sakai, Ryuichi Kawahara, Toru Hisaka, Yoshito Akagi, Hiroyuki Tanaka, Koji Okuda
BACKGROUND: We experienced a rare case of benign arterial stricture of the right posterior hepatic artery (RPHA) caused by atherosclerosis in a patient with hilar cholangiocarcinoma. CASE PRESENTATION: A 75-year-old man was referred to our hospital for the detailed investigation of serum hepatobiliary enzyme elevation. The patient had a history of hypertension, type 2 diabetes mellitus, and an operative history of coronary artery bypass grafting 10 years before...
September 24, 2018: BMC Surgery
M Papamichail, K Marmagkiolis, M Pizanias, C Koutserimpas, N Heaton
BACKGROUND AND AIMS: Patients with liver tumors involving the inferior vena cava have a poor outcome without surgery. Liver resection en bloc with inferior vena cava resection and reconstruction is now performed in many centers. The purpose of this study is to investigate the safety and efficacy of inferior vena cava reconstruction during hepatic resection. MATERIALS AND METHODS: A review of 12 centers reporting 240 patients with combined hepatectomy and inferior vena cava resection and reconstruction for malignant tumors was performed...
September 24, 2018: Scandinavian Journal of Surgery: SJS
Nian-Mei Gong
PURPOSE: To retrospectively evaluate the role of intraoperative ultrasonography (IOUS) and contrast-enhanced IOUS (CE-IOUS) for the patients with hepatocellular carcinoma (HCC) undergoing hepatic resection (HR). METHODS: Twenty-one consecutive patients who had undergone HR for HCC were included in this study. The patients were subject to preoperative imaging modalities including preoperative ultrasonography (Pre-US) and preoperative contrast-enhanced ultrasonography (Pre-CEUS)...
September 19, 2018: Clinical Hemorheology and Microcirculation
Toshifumi Wakai, Jun Sakata, Tomohiro Katada, Yuki Hirose, Daiki Soma, Pankaj Prasoon, Kohei Miura, Takashi Kobayashi
Recent advances in dimensional imaging, surgical technique, and perioperative patient care have resulted in increased rates of complete resection with histopathologically negative margins and improved surgical outcomes in patients with extrahepatic cholangiocarcinoma. However, achieving cancer-free resection margins at ductal stumps in surgery for this disease remains challenging because of longitudinal extension, which is one of the hallmarks of extrahepatic cholangiocarcinoma. When the ductal resection margins are shown to be positive on examination of frozen sections, discrimination between carcinoma in situ and invasive carcinoma is clinically important because residual carcinoma in situ may lead to late local recurrence whereas residual invasive carcinoma is associated with early local recurrence...
September 2018: Annals of gastroenterological surgery
Yusuke Kumamoto, Takashi Kaizu, Hiroshi Tajima, Nobuyuki Nishizawa, Shigenori Ei, Kazuharu Igarashi, Masahiko Watanabe
Systemic inflammatory-, immunological- and nutritional-based indices, such as the neutrophil-to-lymphocyte ratio (NLR), the prognostic nutritional index (PNI) and the Glasgow prognostic score (GPS), are drawing considerable research attention to predict the long-term prognosis of many types of cancer. Recently, these parameters have also been reported to be useful in predicting postoperative morbidity in several fields, including colorectal and otolaryngological cancer. However, while distal cholangiocarcinoma exhibits a high morbidity rate, its risk factors of morbidity have not yet been established...
October 2018: Molecular and Clinical Oncology
Jordan M Cloyd, Laura Prakash, Jean-Nicolas Vauthey, Thomas A Aloia, Yun Shin Chun, Ching-Wei Tzeng, Michel P Kim, Jeffrey E Lee, Matthew H G Katz
BACKGROUND: Although increasingly administered to patients with pancreatic ductal adenocarcinoma, the role of preoperative therapy for patients with distal cholangiocarcinoma is undefined. METHODS: All patients with distal cholangiocarcinoma who underwent pancreatoduodenectomy between 1999 and 2014 were retrospectively reviewed. Differences in clinicopathologic characteristics and overall survival (OS) were compared between patients who underwent surgery de novo and those who received preoperative therapy...
September 6, 2018: American Journal of Surgery
Adianto Nugroho, Kwang-Woong Lee, Kyung-Bun Lee, Hyo-Shin Kim, Hyeyoung Kim, Nam-Joon Yi, Kyung-Suk Suh
The incidence of combined hepatocellular carcinoma-cholangiocarcinoma (cHCC-CC) in a single patient accounts for only 0.4 to 14% of all primary liver cancer. However, the prognosis of its intrahepatic cholangiocarcinoma (ICC) component is poor. We experienced a unique case of a sequentially developed cHCC-CC with adrenal metastasis as the primary presentation and a hidden primary hepatocellular carcinoma. A 65-year-old female with a history of jaundice and abdominal discomfort was diagnosed with S4 ICC measuring 5 cm in diameter, and characterized histologically as papillary adenocarcinoma with intraductal growth, but without any evidence of malignant hepatocyte...
August 2018: Annals of Hepato-Biliary-Pancreatic Surgery
Darren Chua, Albert Low, Yexin Koh, Brian Goh, Peng Chung Cheow, Juinn Har Kam, Jin Yao Teo, Ek Khoon Tan, Alexander Chung, London Lucien Ooi, Chung Yip Chan, Ser Yee Lee
Backgrounds/Aims: Hilar cholangiocarcinomas (HCCAs) are tumors that involve the biliary confluence; at present, radical surgery offers the only chance of long-term survival, but this can be challenging given the complexity of the hilar anatomy. Blumgart and Jarnagin described a preoperative staging system that incorporates the effect of local tumor extent and its impact on adjacent structures and that has been demonstrated to correlate better with actual surgical resectability. The primary aim of this study is to describe the correlation between preoperative Blumgart-Jarnagin staging and its correlation with surgical resectability...
August 2018: Annals of Hepato-Biliary-Pancreatic Surgery
Chaobin He, Yu Zhang, Yunda Song, Jun Wang, Kaili Xing, Xiaojun Lin, Shengping Li
Background: There are few diagnostic tools that can be used to determine which patient with intrahepatic cholangiocarcinoma (ICC) can benefit from surgery actually, highlighting that the need for new preoperative stratification strategies. The aim of this study was to investigate the predictive values of preoperative biomarkers in survival analyses for patients with ICC after surgical resection. Methods: A total of 285 patients with ICC were retrospectively reviewed. Receiver operating charateristics (ROC) curves were used to evaluate the predictive effects of preoperative carbohydrate antigen 19-9 (CA19-9) with different cutoff values and carcinoembryonic antigen (CEA) in patients with ICC...
2018: Journal of Cancer
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