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perihilar cholangiocarcinoma

Yo-Ichi Yamashita, Huanlin Wang, Takeshi Kurihara, Eiji Tsujita, Akihiro Nishie, Katsunori Imai, Daisuke Hashimoto, Akira Chikamoto, Shinichi Aishima, Hideo Baba
BACKGROUND: The aim of this study was to evaluate the clinical significance of preoperative classification of intrahepatic cholangiocarcinoma (ICC) into perihilar and peripheral types using dynamic computed tomography (CT). PATIENTS AND METHODS: A retrospective cohort study was performed to analyze the differences in clinical characteristics between perihilar and peripheral ICC samples from patients between 1990-2014. RESULTS: A total of 87 patients were divided into three ICC subtypes; perihilar (n=34), peripheral (n=44), and unclassifiable ICC (n=9)...
December 2016: Anticancer Research
Naohisa Kuriyama, Shuji Isaji, Akihiro Tanemura, Yusuke Iizawa, Hiroyuki Kato, Yasuhiro Murata, Yoshinori Azumi, Masashi Kishiwada, Shugo Mizuno, Masanobu Usui, Hiroyuki Sakurai
In the most common surgical procedure for perihilar cholangiocarcinoma, the margin status of the proximal bile duct is determined at the final step. Our procedure, the transhepatic hilar approach, confirms a cancer-negative margin status of the proximal bile duct first. We first performed a partial hepatic parenchymal transection to expose the hilar plate, and then transected the proximal bile duct to confirm margin status. Then, divisions of the hepatic artery and portal vein of the future resected liver are performed, followed by the residual hepatic parenchymal transection...
November 28, 2016: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
N Bird, M Elmasry, R Jones, M Elniel, M Kelly, D Palmer, S Fenwick, G Poston, H Malik
BACKGROUND: Cholangiocarcinoma is a rare cancer with a poor prognosis. Radical surgical resection is the only option for curative treatment. Optimal determination of resectability is required so that patients can be stratified into operative or chemotherapeutic treatment cohorts in an accurate and time-efficient manner. Staging laparoscopy is utilized to determine the presence of radiologically occult disease that would preclude further surgical treatment. The aim of this study was to analyse the utility of staging laparoscopy in a contemporary cohort of patients with perihilar cholangiocarcinoma...
November 8, 2016: British Journal of Surgery
Chun-Yi Tsai, Nobuyuki Watanabe, Tomoki Ebata, Takashi Mizuno, Yuzuru Kamei, Masato Nagino
BACKGROUND: Curative hepatectomy with bile duct resection is the treatment for perihilar cholangiocarcinoma. A locally advanced tumor necessitates hepatectomy with simultaneous vascular resection, and reconstruction remains an obstacle for surgeons. Studies have focused on the variations of hepatic arteries. Nevertheless, the anatomical alignment of the portal veins, bile ducts, and hepatic arteries are equally critical in surgical planning of curative resection for advanced tumors. We have reported promising outcomes of hepatectomy with simultaneous resection and reconstruction of the hepatic artery...
November 16, 2016: World Journal of Surgical Oncology
Davendra P S Sohal, Shiva Shrotriya, Mohamed Abazeed, Michael Cruise, Alok Khorana
Biliary tract cancers (intrahepatic, perihilar and extrahepatic cholangiocarcinoma, and gallbladder and cystic duct cancers) are uncommon but highly lethal malignancies. Clinical presentation is often late, precluding curative surgical resection in most cases. For advanced disease, therapeutic options are limited to systemic chemotherapy, with suboptimal outcomes. An understanding of the molecular characteristics of biliary tract cancers may allow the clinical development of therapies targeting actionable alterations with the ultimate goal of improving clinical outcomes...
November 2016: Critical Reviews in Oncology/hematology
Xiaodong Wang, Jungang Hu, Guang Cao, Xu Zhu, Yong Cui, Xinqiang Ji, Xuan Li, Renjie Yang, Hui Chen, Haifeng Xu, Peng Liu, Jian Li, Jie Li, Chunyi Hao, Baocai Xing, Lin Shen
Purpose To evaluate the efficacy and safety of hepatic arterial infusion (HAI) of oxaliplatin and 5-fluorouracil for advanced perihilar cholangiocarcinoma (PCC) in this prospective phase II study. Materials and Methods The protocol was approved by the local ethics committee, and all patients gave informed consent. Patients with nonresectable PCC were included in a prospective, open phase II study investigating HAI through interventionally implanted port catheters. HAI consisted of infusions of oxaliplatin 40 mg/m(2) for 2 hours, followed by 5-fluorouracil 800 mg/m(2) for 22 hours on days 1-3 every 3-4 weeks...
November 7, 2016: Radiology
Ruud Weijer, Séverine Clavier, Esther A Zaal, Maud M E Pijls, Robert T van Kooten, Klaas Vermaas, René Leen, Aldo Jongejan, Perry D Moerland, Antoine H C van Kampen, André B P van Kuilenburg, Celia R Berkers, Simone Lemeer, Michal Heger
Photodynamic therapy (PDT) is an established palliative treatment for perihilar cholangiocarcinoma that is clinically promising. However, tumors tend to regrow after PDT, which may result from the PDT-induced activation of survival pathways in sublethally afflicted tumor cells. In this study, tumor-comprising cells (i.e., vascular endothelial cells, macrophages, perihilar cholangiocarcinoma cells, and EGFR-overexpressing epidermoid cancer cells) were treated with the photosensitizer zinc phthalocyanine that was encapsulated in cationic liposomes (ZPCLs)...
November 1, 2016: Cellular and Molecular Life Sciences: CMLS
Han Liu, Xi Cen, Tao Suo, Xueya Cai, Xuewen Yuan, Sheng Shen, Houbao Liu, Yue Li
BACKGROUND: This population-based study examined surgical outcomes and hospital and post-acute care resource use after operations of cholangiocarcinoma during 2005-2012. STUDY DESIGN: Using New York State hospital claims, we identified subjects with intrahepatic tumor who underwent hepatectomy only (n = 2089), subjects with perihilar tumor who underwent hepatectomy and biliary-enteric anastomosis (BEA; n = 389) or BEA only (n = 3721), and subjects with distal cholangiocarcinoma undergoing pancreatectomy or pancreaticoduodenectomy (n = 228)...
October 26, 2016: World Journal of Surgery
Hitomi Hoshino, Makoto Ohta, Makoto Ito, Kenji Uchimura, Yasuhiro Sakai, Takeshi Uehara, Shulin Low, Mana Fukushima, Motohiro Kobayashi
Intrahepatic cholangiocarcinoma (ICC) is the second most common primary liver neoplasm, followed by hepatocellular carcinoma. ICC can be further subclassified as (i) perihilar and (ii) peripheral types, the latter histologically resembling small-sized intrahepatic bile ducts, such as interlobular bile ducts, cholangioles/ductules and the canals of Hering. Cholangiolocellular carcinoma (CoCC), now classified by the World Health Organization as a subtype of combined hepatocellular-cholangiocarcinoma, is currently regarded as a subtype of peripheral-type ICC...
October 17, 2016: Laboratory Investigation; a Journal of Technical Methods and Pathology
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
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...
October 2016: Chinese Clinical Oncology
Nobuyuki Watanabe, Tomoki Ebata, Yukihiro Yokoyama, Tsuyoshi Igami, Gen Sugawara, Takashi Mizuno, Junpei Yamaguchi, Masato Nagino
BACKGROUND: No authors have reported on the anatomic features of the independent right posterior portal vein variant and its relevance to left hepatic trisectionectomy. The purpose of this study was to review vasculobiliary systems according to portal vein anatomy, to clarify the anatomic features of the right posterior portal vein variant, and to discuss its operative implications for left hepatic trisectionectomy. METHODS: In a radiologic study, the 3-dimensional anatomy of the portal vein, hepatic artery, and bile duct were studied in 200 patients who underwent computed tomography...
September 27, 2016: Surgery
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
Taku Aoki, Keiichi Kubota
No abstract text is available yet for this article.
September 2016: Nihon Shokakibyo Gakkai Zasshi, the Japanese Journal of Gastro-enterology
Robert J S Coelen, Anthony T Ruys, Jimme K Wiggers, Chung Y Nio, Joanne Verheij, Dirk J Gouma, Marc G H Besselink, Olivier R C Busch, Thomas M van Gulik
BACKGROUND: Nearly half of patients with perihilar cholangiocarcinoma (PHC) have incurable tumors at laparotomy. Staging laparoscopy (SL) potentially detects metastases or locally advanced disease, thereby avoiding unnecessary laparotomy. However, the diagnostic yield of SL has decreased with improved imaging in recent years. OBJECTIVE: The aim of this study was to identify predictors for detecting metastasized or locally advanced PHC at SL and to develop a risk score to select patients who may benefit most from this procedure...
September 1, 2016: Annals of Surgical Oncology
Robert J S Coelen, Pim B Olthof, Susan van Dieren, Marc G H Besselink, Olivier R C Busch, Thomas M van Gulik
Importance: Resection of perihilar cholangiocarcinoma (PHC) is high-risk surgery, with reported operative mortality up to 17%. Therefore, preoperative risk assessment is needed to identify high-risk patients and anticipate postoperative adverse outcomes. Objective: To provide external validation of the Estimation of Physiologic Ability and Surgical Stress (E-PASS) risk model in a Western PHC cohort. Design, Setting, and Participants: The E-PASS variables were obtained from a database that included 156 consecutive patients who underwent resection for suspected PHC between January 1, 2000, and December 31, 2015, at the Academic Medical Center, Amsterdam, the Netherlands...
August 31, 2016: JAMA Surgery
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
Masataka Okuno, Tomoki Ebata, Yukihiro Yokoyama, Tsuyoshi Igami, Gen Sugawara, Takashi Mizuno, Junpei Yamaguchi, Masato Nagino
BACKGROUND: Inflammation-based prognostic scores are useful prognostic indicators for several types of cancer. The aim of this study was to evaluate whether the scores predict survival impact in unresectable perihilar cholangiocarcinoma. METHODS: The modified Glasgow Prognostic Score (mGPS), Neutrophil Lymphocyte Ratio (NLR), Platelet Lymphocyte Ratio, and Prognostic Nutritional Index, were retrospectively assessed in 219 patients with unresectable perihilar cholangiocarcinoma...
October 2016: Journal of Hepato-biliary-pancreatic Sciences
Dirk Walter, Eva Herrmann, Ria Winkelmann, Jörg G Albert, Juliane Liese, Andreas Schnitzbauer, Stefan Zeuzem, Martin-Leo Hansmann, Jan Peveling-Oberhag, Sylvia Hartmann
BACKGROUND AND AIMS: CD15 is expressed by various cancer types; among these are intrahepatic and perihilar cholangiocarcinoma (CCA). The aim of this study was to elucidate CD15 expression in distal CCA as well as in dysplastic biliary tissue and to determine its prognostic significance. METHODS AND RESULTS: Tissue samples from patients with intrahepatic (iCCA, n = 22), perihilar (pCCA, n = 7) and distal CCA (dCCA, n = 15), who underwent surgical resection in the period from 2010 to 2015 were evaluated for CD15 expression...
July 21, 2016: Histopathology
Stefan Buettner, Jeroen L A van Vugt, Faiz Gani, Bas Groot Koerkamp, Georgios Antonios Margonis, Cecilia G Ethun, George Poultsides, Thuy Tran, Kamran Idrees, Chelsea A Isom, Ryan C Fields, Bradley Krasnick, Sharon M Weber, Ahmed Salem, Robert C G Martin, Charles Scoggins, Perry Shen, Harveshp D Mogal, Carl Schmidt, Eliza Beal, Ioannis Hatzaras, Rivfka Shenoy, Shishir K Maithel, Alfredo Guglielmi, Jan N M IJzermans, Timothy M Pawlik
INTRODUCTION: Although widely used, the 7th edition American Joint Committee on Cancer (AJCC) staging system for perihilar cholangiocarcinoma (PHC) may be limited. Disease-specific nomograms have been proposed as a better means to predict long-term survival for individual patients. We sought to externally validate a recently proposed nomogram by Memorial Sloan Kettering Cancer Center (MSKCC) for PHC, as well as identify factors to improve the prediction of prognosis for patients with PHC...
October 2016: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
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