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Recurrent hilar cholangiocarcinoma

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
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
Kohei Fujikura, Takumi Fukumoto, Tetsuo Ajiki, Kyoko Otani, Maki Kanzawa, Masayuki Akita, Masahiro Kido, Yonson Ku, Tomoo Itoh, Yoh Zen
AIMS: This study was aimed to achieve a better definition of intraductal papillary neoplasms of the bile duct (IPNBs). METHODS AND RESULTS: Biliary tumours that showed predominantly intraductal papillary growth were provisionally classified into IPNBs (n=25) and papillary cholangiocarcinomas (n=27). IPNB was defined as a neoplasm that is confined to the epithelium or is regularly arranged in a high-papillary architecture along thin fibrovascular stalks, while the term "papillary cholangiocarcinoma" was used for tumours with more complex papillary structures (e...
July 13, 2016: Histopathology
Yong Keun Park, Jee Eun Choi, Woon Yong Jung, Sung Kyu Song, Jong In Lee, Chul-Woon Chung
BACKGROUND: Biliary strictures at the hilum of the liver arise from heterogeneous etiologies. The majority is malignant entities, but some may have benign etiologies. It is difficult to distinguish between malignant and benign biliary strictures preoperatively. It has been reported that 5~15 % of preoperative diagnoses of hilar cholangiocarcinoma turn out to be benign lesions or even other types of malignancies. Primary non-Hodgkin's lymphoma of the extrahepatic bile duct is very rare, with only a few cases reported as mucosa-associated lymphoid tissue (MALT) lymphoma arising from the hepatic duct bifurcation...
2016: World Journal of Surgical Oncology
Mee Joo Kang, Jin-Young Jang, Jihoon Chang, Yong Chan Shin, Dooho Lee, Hong Beom Kim, Sun-Whe Kim
BACKGROUND: Despite aggressive surgical resection, prognosis of patients with hilar cholangiocarcinoma is still unsatisfactory. There were limited data about actual long-term survival outcome. This study was designed to explore actual long-term survival outcome of hilar cholangiocarcinoma after surgical treatment, and to investigate the characteristics of patients with actual long-term survival. METHODS: The study cohort consisted of 403 consecutive patients with at least 5-year follow-up after surgical treatment for hilar cholangiocarcinoma at Seoul National University Hospital between 1991 and 2010...
October 2016: World Journal of Surgery
Yinzhe Xu, Hongguang Wang, Webin Ji, Maosheng Tang, Hao Li, Jianjun Leng, Xuan Meng, Jiahong Dong
BACKGROUND: Radical resection for hilar cholangiocarcinoma (HCa) is one of the most challenging abdominal procedures. Robotic-assisted approach is gaining popularity in hepatobiliary surgery but scarcely tried in the management of HCa. We herein report our initial experience of robotic radical resection for HCa. METHODS: Between May 2009 and October 2012, 10 patients underwent fully robotic-assisted radical resection for HCa in a single institute. The perioperative and long-term outcomes were analyzed and compared with a contemporaneous 32 patients undergoing traditional open surgery...
July 2016: Surgical Endoscopy
Georgi Atanasov, Hans-Michael Hau, Corinna Dietel, Christian Benzing, Felix Krenzien, Andreas Brandl, Julianna P Englisch, Georg Wiltberger, Katrin Schierle, Simon C Robson, Anja Reutzel-Selke, Sven Jonas, Andreas Pascher, Johann Pratschke, Moritz Schmelzle
BACKGROUND AND OBJECTIVES: Angiopoietins (Angs) play a pivotal role in angiogenesis and inflammation, and are associated with prognosis in malignancies. Monocyte express Ang-receptor TIE2 and correlate with prognosis in cancer. We aimed to investigate the prognostic value of Angs and TIE2-expressing monocytes (TEMs) in cholangiocarcinoma. METHODS: We analyzed surgically resected tumor specimens of hilar cholangiocarcinoma (n = 47) for distribution of Angs (Ang 1/Ang 2) and TEMs, as defined by co-expression of CD14 and Ang receptor TIE2...
July 2016: Journal of Surgical Oncology
Xiaolei Liu, Zhiying Yang, Haidong Tan, Liguo Liu, Yongliang Sun, Shuang Si, Li Xu, Wenying Zhou, Jia Huang
OBJECTIVE: To report five cases of isolated IgG4-related sclerosing cholangitis (IAC) and to summarize their clinical characteristics and the differential diagnosis. METHOD: The clinical data of five patients with isolated IAC were retrospectively analyzed, including laboratory tests, imaging examination and liver pathology. Their treatment and prognosis were also discussed. RESULTS: All five patients had no history of pancreatitis. All five patients presented with jaundice and three of them had fluctuant jaundice...
March 15, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
Yuki Hirose, Jun Sakata, Kizuki Yuza, Daiki Soma, Natsuru Sudo, Hirosuke Ishikawa, Kumiko Tatsuda, Kohei Miura, Kazuyasu Takizawa, Kabuto Takano, Masayuki Nagahashi, Takashi Kobayashi, Hitoshi Kameyama, Shin-ichi Kosugi, Toshifumi Wakai
A 46-year-old woman underwent right hemihepatectomy, cholecystectomy, and sampling of the hilar lymph nodes for combined hepatocellular and cholangiocarcinoma. She received oral S-1 after hepatectomy. However, her serum level of carcinoembryonic antigen gradually increased, and solitary paraaortic lymph node recurrence was detected on positron emission tomography-computed tomography 12 months after hepatectomy. The patient underwent paraaortic lymph node dissection. Histologic examination revealed solitary paraaortic lymph node metastasis composed of hepatocellular carcinoma...
November 2015: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Hiroyuki Kanomata, Yasuji Seyama, Keigo Tani, Toru Tanizawa, Masahiro Warabi, Minekazu Murayama, Toru Asano, Masamichi Takahashi, Yujiro Matsuoka, Yukio Miyamoto, Nobutaka Umekita
A 67-year-old man with elevated hepatobiliary enzymes was referred to our hospital for further examination. Computed tomography indicated hilar cholangiocarcinoma of Bismuth type Ⅳ and revealed invasion of the right hepatic artery and the left portal vein. We diagnosed locally advanced unresectable hilar cholangiocarcinoma, and performed 5 courses of chemotherapy with gemcitabine plus S-1. After chemotherapy, the tumor was significantly reduced in size and vascular invasions were alleviated, so we decided to perform surgical resection...
November 2015: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Shuguang Wang, Feng Tian, Xin Zhao, Dajiang Li, Yu He, Zhihua Li, Jian Chen
The aim of the study is to evaluate the therapeutic effect of a new surgical procedure, dumbbell-form resection (DFR), for hilar cholangiocarcinoma (HCCA) with severe jaundice. In DFR, liver segments I, IVb, and partial V above the right hepatic pedicle are resected.Hemihepatectomy is recognized as the preferred procedure; however, its application is limited in HCCAs with severe jaundice.Thirty-eight HCCA patients with severe jaundice receiving DFR and 70 receiving hemihepatectomy from January 2008 to January 2013 were included...
January 2016: Medicine (Baltimore)
Vasileios Tatsis, Evaggelia Peponi, Georgios Papadopoulos, Periklis Tsekeris, Michael Fatouros, Georgios Glantzounis
INTRODUCTION: A rare case of hemorrhagic gastritis induced by radiation is presented, which was resistant to conservative treatment and required subtotal gastrectomy. PRESENTATION OF CASE: A 56-year-old male was initially undergone right hepatectomy, resection of the extrahepatic biliary tree, hilar lymph node dissection and hepatico-jejunostomy due to advanced hilar cholangiocarcinoma. Because of the extent of the disease, chemo-radiotherapy was administered. The patient received a total radiotherapy dose of 57...
2016: International Journal of Surgery Case Reports
Jie Zhou, Weiwen Shen, Xiaojing He, Jing Qian, Shiyuan Liu, Guanzhen Yu
Prdx1 is an important member of peroxiredoxins (Prdxs) regulating various cellular signaling and differentiation. Prdx1 confers an aggressive survival phenotype of cancer cells and drug-resistance, yet its role in hilar cholangiocarcinoma is not fully investigated. In present study, we detected the expression profile of Prdx1 in 88 hilar cholangiocarcinoma by tissue arrays and immunohistochemistry. Prdx1 level was down-regulated by specific Prdx1-shRNA in vitro and the possible mechanism was investigated. Overexpression of Prdx1 was observed in 53 of 88 cases (60...
2015: International Journal of Clinical and Experimental Pathology
Guanzhen Yu, Wenlong Yu, Guangzhi Jin, Dongyun Xu, Ying Chen, Tian Xia, Allan Yu, Wenzheng Fang, Xiaoli Zhang, Zhaosheng Li, Keping Xie
BACKGROUND: The therapeutic and prognostic value of the glycolytic enzymes hexokinase, phosphofructokinase, and pyruvate kinase (PK) has been implicated in a variety of cancers, while their roles in treatment of and prognosis for hilar cholangiocarcinoma (HC) remain unclear. In this study, we determined the expression of PKM2 in and its impact on biology and clinical outcome of human HC. METHODS: The regulation and function of PKM2 in HC pathogenesis was evaluated using human tissues, molecular and cell biology, and animal models, and its prognostic significance was determined according to its impact on patient survival...
2015: Molecular Cancer
Andrej Wagner, Marcus Wiedmann, Andrea Tannapfel, Christian Mayr, Tobias Kiesslich, Gernot W Wolkersdörfer, Frieder Berr, Johann Hauss, Helmut Witzigmann
Hilar cholangiocarcinoma (CC) is non-resectable in the majority of patients often due to intrahepatic extension along bile duct branches/segments, and even after complete resection (R0) recurrence can be as high as 70%. Photodynamic therapy (PDT) is an established palliative local tumor ablative treatment for non-resectable hilar CC. We report the long-term outcome of curative resection (R0) performed after neoadjuvant PDT for downsizing of tumor margins in seven patients (median age 59 years) with initially non-resectable hilar CC...
2015: International Journal of Molecular Sciences
Yang Yu, Yan Chen, Jianxia Ma, Xiaofeng Yu, Guanzhen Yu, Zhaoshen Li
Secreted protein acidic and rich in cysteines-like protein 1 (SPARCL1) has been implicated in tumor initiation, formation, and progression of various cancers, yet its role in hilar cholangiocarcinoma remains largely uncharacterized. In the present study, tissue microarrays containing resected hilar cholangiocarcinoma specimens from 92 patients were used to evaluate the expression of SPARCL1 protein by immunohistochemistry (IHC). In vitro assays were used to determine the effect of SPARCL1 overexpression on cell growth and migration...
March 2016: Tumour Biology: the Journal of the International Society for Oncodevelopmental Biology and Medicine
Qi Sun, Fanni Li, Fengkai Sun, Jun Niu
Interleukin-8 (IL-8), matrix metalloproteinase-9 (MMP-9) and neovascularization have been implicated to be associated with biological processes, especially cancer progression. However, few studies have investigated the role of IL-8 in human hilar cholangiocarcinoma. In this study we detected the expression of IL-8 combined with MMP-9 and microvessel density (MVD) in hilar cholangiocarcinoma to evaluate their clinicopathological significance and prognostic value. A total of 62 patients with hilar cholangiocarcinoma who underwent curative surgery were enrolled in this study...
2015: International Journal of Clinical and Experimental Pathology
D Chirita, M Calita, M Grasu, R Dumitru, I Gramaticu, A Croitoru, M Ionescu, T Dumitrascu
Resection represents the single hope for long-term survival in a patient diagnosed with a hilar cholangiocarcinoma (Klatskin tumor). However, the largest part of these patients develops a recurrent disease. Second metachronous periampullary cancers after a curative-intent surgery for a Klatskin tumor represent an exceptional pathology, and the management of these patients was poorly documented. Hereby, it is presented a 32-year-old patient with bile duct resection, left hemi-hepatectomy and loco-regional lymph nodes dissection, for a type IIIB Bismuth-Corlette Klatskin tumor, which, furthermore, 6 years later, underwent a pancreaticoduodenectomy for a metachronous carcinoma of the ampulla of Vater...
July 2015: Chirurgia
Do Hyun Park
Only 20-30% of patients with hilar cholangiocarcinoma (CC) are candidates for potentially curative resection. However, even after curative (R0) resection, these patients have a disease recurrence rate of up to 76%. The prognosis of hilar cholangiocarcinoma (CC) is limited by tumor spread along the biliary tree leading to obstructive jaundice, cholangitis, and liver failure. Therefore, palliative biliary drainage may be a major goal for patients with hilar CC. Endoscopic retrograde cholangiopancreatography (ERCP) with stent placement is an established method for palliation of patients with malignant biliary obstruction...
September 2015: Journal of Hepato-biliary-pancreatic Sciences
John C Mansour, Thomas A Aloia, Christopher H Crane, Julie K Heimbach, Masato Nagino, Jean-Nicolas Vauthey
An American Hepato-Pancreato-Biliary Association (AHPBA)-sponsored consensus meeting of expert panellists met on 15 January 2014 to review current evidence on the management of hilar cholangiocarcinoma in order to establish practice guidelines and to agree consensus statements. It was established that the treatment of patients with hilar cholangiocarcinoma requires a coordinated, multidisciplinary approach to optimize the chances for both durable survival and effective palliation. An adequate diagnostic and staging work-up includes high-quality cross-sectional imaging; however, pathologic confirmation is not required prior to resection or initiation of a liver transplant trimodal treatment protocol...
August 2015: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
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