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Recurrant cholangiocarcinoma

Kenneth Eng Ling Kwan, Vishalkumar G Shelat, Cher Heng Tan
Recurrent pyogenic cholangitis (RPC) is an infective process involving the biliary tree typified by pigmented intraductal calculi with dilatation of the intra- and extrahepatic biliary tree. Previously endemic to South-east Asia, RPC can now be seen in Western countries with the increasing access to international travel and immigration. Affected patients are often plagued by recurrent bouts of cholangitis, and commonly suffer from complications such as abscess formation and biliary strictures. In severe cases, cirrhosis with portal hypertension may develop...
October 21, 2016: Abdominal Radiology
Zi-Ying Lin, Zhen-Xing Liang, Pei-Lin Zhuang, Jie-Wei Chen, Yun Cao, Li-Xu Yan, Jing-Ping Yun, Dan Xie, Mu-Yan Cai
BACKGROUND: Serum C-reactive protein (CRP), an acute inflammatory response biomarker, has been recognized as an indicator of malignant disease progression. However, the prognostic significance of CRP levels collected before tumor removal in intrahepatic cholangiocarcinoma requires further investigation. METHODS: We sampled the CRP levels in 140 patients with intrahepatic cholangiocarcinoma who underwent hepatectomies with regional lymphadenectomies between 2006 and 2013...
October 12, 2016: BMC Cancer
Kenichi Komaya, Tomoki Ebata, Yukihiro Yokoyama, Tsuyoshi Igami, Gen Sugawara, Takashi Mizuno, Junpei Yamaguchi, Masato Nagino
BACKGROUND: Percutaneous transhepatic biliary drainage is an established biliary drainage method but is associated with a potential risk of seeding metastasis. The aim of this retrospective study was to evaluate whether percutaneous transhepatic biliary drainage really increases seeding metastasis and worsens the postoperative survival in patients with resectable perihilar cholangiocarcinoma. METHODS: Patients who underwent resection for perihilar cholangiocarcinoma after percutaneous transhepatic biliary drainage or endoscopic biliary drainage were retrospectively reviewed...
October 3, 2016: Surgery
Le Li, Guang-Quan Zhang, Hua Chen, Zhong-Jie Zhao, Hong-Ze Chen, Huan Liu, Gang Wang, Yue-Hui Jia, Shang-Ha Pan, Rui Kong, Yong-Wei Wang, Bei Sun
Long intergenic non-protein coding RNA, p53 induced transcript (Linc-pint) is a long noncoding RNA (lncRNA) that regulates tumor cell viability and proliferation. We used qRT-PCR and RNA FISH analysis to evaluate Linc-pint levels in the plasma and tumor tissues of pancreatic cancer (PCa) patients. Our data demonstrate that Linc-pint expression is lower in plasma samples from PCa patients than from healthy individuals, and indicate that plasma Linc-pint levels are more sensitive than CA19-9 for detecting PCa...
September 30, 2016: Oncotarget
Mark K Doherty, Jennifer J Knox
Surgical resection remains the most important treatment for patients with biliary tract cancer (BTC), but despite radical surgical techniques many patients ultimately develop recurrent disease. BTC encompasses several distinct disease entities-intrahepatic, perihilar and distal bile duct cholangiocarcinoma as well as gallbladder cancer. These tumors are histologically similar, but have different etiologies and recent information regarding their genomic footprint has questioned their biological similarity. Surgical approaches are also necessarily varied based on the site of the tumor...
September 5, 2016: Chinese Clinical Oncology
Michel Rayar, Giovanni Battista Levi Sandri, Pauline Houssel-Debry, Christophe Camus, Laurent Sulpice, Karim Boudjema
Treatment of intrahepatic cholangiocarcinoma remains a major challenge. For an unresectable lesion without extrahepatic spread, liver transplantation could be a potential solution but it is still associated with poor oncologic results owing to the absence of effective neoadjuvant treatment. We report the case of a young man with locally advanced intrahepatic cholangiocarcinoma presenting with multiple intrahepatic metastases and vascular structure involvement. The lesion was significantly downstaged by a multimodal therapy including intra-arterial Yttrium-90 radioembolization, systemic chemotherapy and external radiotherapy, allowing liver transplantation...
September 2016: Journal of Gastrointestinal and Liver Diseases: JGLD
Wen-Jie Ma, Anuj Shrestha, Fu-Yu Li
Mantel et al. showed that the use of intraoperative frozen section analysis of the proximal bile ducts has a limited contribution in obtaining secondary R0 resections and final resection status had no impact on recurrence rate in hilar cholangiocarcinoma. However, the accuracy, sensitivity, and specificity of intraoperative frozen section analysis were determined by the specific pathologic features of the tumor and the different experienced pathologists in different pathology laboratories. It has been demonstrated that tumor-free resection margin (R0) is the most prognostic factor for survival, as well as the only factor that can be modified by the surgeons...
September 29, 2016: Cancer Medicine
Eliza W Beal, Lai Wei, Cecilia G Ethun, Sylvester M Black, Mary Dillhoff, Ahmed Salem, Sharon M Weber, Thuy Tran, George Poultsides, Andre Y Son, Ioannis Hatzaras, Linda Jin, Ryan C Fields, Stefan Buettner, Timothy M Pawlik, Charles Scoggins, Robert C G Martin, Chelsea A Isom, Kamron Idrees, Harveshp D Mogal, Perry Shen, Shishir K Maithel, Carl R Schmidt
BACKGROUND: Gallbladder and extrahepatic biliary malignancies are aggressive tumors with high risk of recurrence and death. We hypothesize that elevated preoperative Neutrophil-Lymphocyte Ratios (NLR) are associated with poor prognosis among patients undergoing resection of gallbladder or extrahepatic biliary cancers. METHODS: Patients who underwent complete surgical resection between 2000-2014 were identified from 10 academic centers (n=525). Overall (OS) and recurrence-free survival (RFS) were analyzed by stratifying patients with normal (<5) versus elevated (>5) NLR...
September 24, 2016: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
Anne Tr Noll, Thorsten Cramer, Steven Wm Olde Damink, Frank G Schaap
Cholangiocarcinoma (CCA) is a relatively rare malignancy of the intra- or extra-hepatic bile ducts that is classified according to its anatomical localization as intrahepatic, perihilar or distal. Overall, CCA has a dismal prognosis due to typical presentation at an advanced irresectable stage, lack of effective non-surgical treatments, and a high rate of disease recurrence. CCA frequently arises on a background of chronic liver inflammation and cholestasis. Chronic inflammation is accompanied by enhanced cell turnover with generation of additional inflammatory stimuli, and a microenvironment rich in pro-inflammatory mediators and proliferative factors that enable accumulation of mutations, transformation and expansion of mutated cells...
September 18, 2016: World Journal of Hepatology
A Doussot, C Lim, C Gómez Gavara, D Fuks, O Farges, J M Regimbeau, D Azoulay
BACKGROUND: The impact of morbidity on long-term outcomes following liver resection for intrahepatic cholangiocarcinoma is currently unclear. METHODS: This was a retrospective analysis of all consecutive patients who underwent liver resection for intrahepatic cholangiocarcinoma with curative intent in 24 university hospitals between 1989 and 2009. Severe morbidity was defined as any complication of Dindo-Clavien grade III or IV. Patients with severe morbidity were compared with those without in terms of demographics, pathology, management, morbidity, overall survival, disease-free survival and time to recurrence...
September 15, 2016: British Journal of Surgery
Venkata S Katabathina, Christine O Menias, Varaha S Tammisetti, Meghan G Lubner, Ania Kielar, Akram Shaaban, Joseph Mansour, Venkateshwar R Surabhi, Amy K Hara
Life expectancies for solid organ recipients as well as graft survival rates for these patients have improved over the years because of advanced immunosuppressive therapies; however, with chronic use of these drugs, posttransplant malignancy has become one of the leading causes of morbidity for them. The risk of carcinogenesis in transplant recipients is significantly higher than for the general population and cancers tend to manifest at an advanced stage. Posttransplant malignancies are thought to develop by three mechanisms: de novo development, donor-related transmission, and recurrence of a recipient's pretransplant malignancy...
September 2016: Radiographics: a Review Publication of the Radiological Society of North America, Inc
Chul-Soo Ahn, Shin Hwang, Young-Joo Lee, Ki-Hun Kim, Deok-Bog Moon, Tae-Yong Ha, Gi-Won Song, Sung-Gyu Lee
BACKGROUND: Hepatitis B virus (HBV)-associated intrahepatic cholangiocarcinoma (ICC) was reported to have a favourable prognosis. We investigated the clinicopathological features of patients with HBV-associated ICC and compared post-resection survival outcomes of ICC patients with and without hepatitis B surface antigen (HBsAg) to assess the prognostic impact of HBV infection. METHODS: A single-institution cohort of 292 patients who underwent macroscopic curative resection for ICC were divided into HBV (n = 37) and non-HBV (n = 255) groups...
September 6, 2016: ANZ Journal of Surgery
Benjamin Goeppert, Christina Ernst, Constance Baer, Stephanie Roessler, Marcus Renner, Arianeb Mehrabi, Mohammadreza Hafezi, Anita Pathil, Arne Warth, Albrecht Stenzinger, Wilko Weichert, Marion Bähr, Rainer Will, Peter Schirmacher, Christoph Plass, Dieter Weichenhan
Cholangiocarcinoma (CC) is a rare malignancy of the extrahepatic or intrahepatic biliary tract with an outstanding poor prognosis. Non-surgical therapeutic regimens result in minimally improved survival of CC patients. Global genomic analyses identified a few recurrently mutated genes, some of them in genes involved in epigenetic patterning. In a previous study, we demonstrated global DNA methylation changes in CC, indicating major contribution of epigenetic alterations to cholangiocarcinogenesis. Here, we aimed at the identification and characterization of CC-related, differentially methylated regions (DMRs) in potential microRNA promoters and of genes targeted by identified microRNAs...
September 3, 2016: Epigenetics: Official Journal of the DNA Methylation Society
Mishal Mendiratta-Lala, Hakmin Park, Nik Kolicaj, Vivek Mendiratta, Deep Bassi
PURPOSE: Liver transplant guidelines for diagnosing hepatocellular carcinoma (HCC) do not mandate pathologic confirmation; instead, 'classic' imaging features alone are deemed satisfactory. Intrahepatic peripheral mass forming cholangiocarcinoma (IHPMCC) is a relative contraindication for transplantation due to high rate of recurrence and poor prognosis. This study examines the imaging findings of IHPMCC, to aid in the identification and differentiation from potentially confounding cases of HCC...
September 3, 2016: Abdominal Radiology
Hyeong Min Park, Sung Pil Yun, Eung Chang Lee, Seung Duk Lee, Sung-Sik Han, Seoung Hoon Kim, Sang-Jae Park
BACKGROUND: This study aimed to analyze the postoperative outcomes for patients with recurrent intrahepatic cholangiocarcinoma (ICC) and to determine the prognostic factors. In addition, this study investigated the effects of various treatment methods for patients with recurrent ICC. METHODS: This retrospective study analyzed the postoperative outcomes and prognostic factors of recurrent ICC that occurred for 81 of 128 patients who underwent hepatic resection for ICC between April 2001 and April 2013...
August 31, 2016: Annals of Surgical Oncology
Byoung Hyuck Kim, Kyubo Kim, Eui Kyu Chie, Jeanny Kwon, Jin-Young Jang, Sun Whe Kim, Do-Youn Oh, Yung-Jue Bang
Purpose: This study was conducted to evaluate the long-term outcome in patients undergoing pancreaticoduodenectomy (PD) followed by adjuvant chemoradiotherapy for distal cholangiocarcinoma (DCC) in a high-volume center and to identify the prognostic impact of clinicopathologic factors. Materials and Methods: A total of 132 consecutive patients who met the inclusion criteria were retrieved from the institutional database from Jan 1995 to Sep 2009. All patients received adjuvant treatments at a median of 45 days after the surgery...
August 23, 2016: Cancer Research and Treatment: Official Journal of Korean Cancer Association
Seungha Hwang, Tae Jun Song, Seol So, Min Kyung Jeon, Eun Hye Oh, Byoung Soo Kwon, Sujong An, Myung Hwan Kim
Primary biliary mucosa-associated lymphoid tissue (MALT) lymphoma is extremely rare. We report a case of primary biliary MALT lymphoma with obstructive jaundice diagnosed by endoscopic biopsy, without surgical intervention. Obstructive jaundice was relieved by endoscopic drainage and endoscopic biopsy was done simultaneously during endoscopic retrograde cholangiopancreatography. Unnecessary surgical intervention can be avoided after pathological confirmation of lymphoma. The patient received radiotherapy, and is alive without any evidence of recurrence or biliary obstruction...
August 25, 2016: Korean Journal of Gastroenterology, Taehan Sohwagi Hakhoe Chi
Kyueng-Whan Min, Dong-Hoon Kim, Byoung Kwan Son, Eun-Kyung Kim, Sang Bong Ahn, Seong Hwan Kim, Yun Ju Jo, Young Sook Park, Jinwon Seo, Young Ha Oh, Sukjoong Oh, Ho Young Kim, Mi Jung Kwon, Soo Kee Min, Hye-Rim Park, Ji-Young Choe, Jang Yong Jeon, Hong Il Ha, Jung Woo Lee
BACKGROUND: AJCC staging system is unreliable for predicting survival in distal bile duct (DBD) cancer patients, due to inter-observer variation. Measured depth of invasion (DOI) is suggested to be more accurate to predict patients' clinical outcome in extra-hepatic cholangiocarcinomas, but its significance in DBD cancer and cutoff values are still debatable. This study aimed to identify the optimal cutoff value of DOI in relation to prognosis in DBD cancer patients. METHODS: Data of 179 patients with DBD adenocarcinoma treated in three institutions were investigated...
August 22, 2016: World Journal of Surgery
Junwen Hu, Rongfa Yuan, Changwen Huang, Jianghua Shao, Shubing Zou, Kai Wang
BACKGROUND: Synchronous development of primary hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (ICC) in different sites of the liver have rarely been reported before. The purpose of this study is to investigate the clinicopathological characteristics of synchronous double cancer of HCC and ICC. CASE PRESENTATION: A 56-year-old Chinese man without obvious liver cirrhosis was preoperation diagnosed with multiple HCC in segments VI (SVI) and VII (SVII) by the abdominal computed tomography (CT) and contrast-enhanced ultrasonography (CEUS)...
August 17, 2016: World Journal of Surgical Oncology
Tetsuo Tsukahara, Tomoki Ebata, Yoshie Shimoyama, Yukihiro Yokoyama, Tsuyoshi Igami, Gen Sugawara, Takashi Mizuno, Masato Nagino
OBJECTIVE: The aim of the study was to evaluate whether carcinoma in situ (CIS) residue at the ductal stump affects the survival of patients undergoing resection for extrahepatic cholangiocarcinoma. BACKGROUND: Positive ductal margin with CIS has been treated as a tumor-free margin from a prognostic viewpoint because several studies have reported that residual CIS foci at the ductal stump do not affect survival after resection. METHODS: Patients who underwent resection for extrahepatic cholangiocarcinoma were retrospectively reviewed...
August 5, 2016: Annals of Surgery
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