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perihilar cholangiocarcinoma

Sara Kammerer, Tobias Meister, Heiner Wolters, Matthias Lessing, Anna Hüsing, Dirk Domagk, Martin Floer, Christian Wilms, Hartmut Schmidt, Norbert Senninger, Gabriele Köhler, Hauke Sebastian Heinzow
Background: Perihilar cholangiocarcinomas are often considered incurable. Late diagnosis is common. Advanced disease therefore frequently causes questioning of curative surgical outcome. Aim: This study aimed to develop a prediction model of curative surgery in patients suffering from perihilar cholangiocarcinomas based on preoperative endosonography and computer tomography. Methods: A cohort of 81 patients (median age 67 (54-75) years, 62% male) with perihilar cholangiocarcinoma was retrospectively analyzed...
March 2018: United European Gastroenterology Journal
Meryl C Nath, Michael S Torbenson, Lori A Erickson
No abstract text is available yet for this article.
March 2018: Mayo Clinic Proceedings
Ibrahim Nassour, Ali A Mokdad, Matthew R Porembka, Michael A Choti, Patricio M Polanco, John C Mansour, Rebecca M Minter, Sam C Wang, Adam C Yopp
BACKGROUND: There are limited well-controlled studies that conclusively demonstrate a benefit of adjuvant therapy in resected perihilar cholangiocarcinoma. Most studies include all biliary tract tumors as one entity despite the heterogeneity of these diseases. METHODS: We identified patients with resected perihilar cholangiocarcinoma from the National Cancer Database between 2006 and 2013. Patients who received adjuvant therapy (AT) were compared to an observation (OB) cohort by propensity score matching...
February 27, 2018: Annals of Surgical Oncology
Benjamin P T Loveday, Jennifer J Knox, Laura A Dawson, Ur Metser, Anthony Brade, Anne M Horgan, Steven Gallinger, Paul D Greig, Carol-Anne Moulton
BACKGROUND AND OBJECTIVES: Neoadjuvant chemoradiation and liver transplantation may be offered for unresectable perihilar cholangiocarcinoma (pCCA). This study aimed to determine the dropout rate and survival of patients who entered a national tri-modality protocol. METHOD: Patients enrolled Jan 2009-Aug 2015 were included. Enrolment criteria: ≤65 years, brush biopsy-proven unresectable pCCA <3.5 cm diameter. Conformal radiotherapy was given concurrently with Capecitabine...
February 2018: Journal of Surgical Oncology
H P Neeff, P A Holzner, M Menzel, P Bronsert, A Klock, S A Lang, S Fichtner-Feigl, U T Hopt, F Makowiec
BACKGROUND: The incidence of intrahepatic cholangiocarcinoma (ICC) is increasing worldwide. Surgical resection is the only curative treatment option. AIM OF THE STUDY: This study analyzed the prognostic factors after resection of ICC. MATERIAL AND METHODS: A total of 84 patients were surgically treated under potentially curative intent. Perihilar and distal cholangiocarcinomas were excluded. The 5‑year survival was analyzed with respect to tumor stage (TNM), number of lesions, complete surgical resection (R0), peritoneal carcinosis and postoperative complications...
February 20, 2018: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
Andrew Y Wang, Patrick S Yachimski
Endoscopic ultrasound (EUS) and endoscopic retrograde cholangiopancreatography (ERCP) are the mainstays of interventional endoscopic practice. EUS occupies a central role in the diagnosis of pancreatobiliary neoplasms and offers a platform for a wide range of direct tumor therapies. Initial steps have demonstrated the feasibility of such applications in animal models and pilot studies. Larger clinical trials and incorporation of EUS-based therapies into cooperative cancer studies might demonstrate an impact in the clinical prognosis of patients with pancreatic cancer...
February 16, 2018: Gastroenterology
Jeroen L A van Vugt, Marcia P Gaspersz, Jaynee Vugts, Stefan Buettner, Stef Levolger, Ron W F de Bruin, Wojciech G Polak, Jeroen de Jonge, François E J A Willemssen, Bas Groot Koerkamp, Jan N M IJzermans
BACKGROUND: Low skeletal muscle mass is associated with increased postoperative morbidity and worse survival following resection for perihilar cholangiocarcinoma (PHC). We investigated the predictive value of skeletal muscle mass and density for overall survival (OS) of all patients with suspected PHC, regardless of treatment. METHODS: Baseline characteristics and parameters regarding disease and treatment were collected from all patients with PHC from 2002 to 2014...
February 16, 2018: Digestive Surgery
Takeshi Kawamura, Takehiro Noji, Keisuke Okamura, Kimitaka Tanaka, Yoshitsugu Nakanishi, Toshimichi Asano, Yuma Ebihara, Yo Kurashima, Toru Nakamura, Soichi Murakami, Takahiro Tsuchikawa, Toshiaki Shichinohe, Satoshi Hirano
BACKGROUND: Post-hepatectomy liver failure (PHLF) is a serious complication after major hepatectomy with extrahepatic bile duct resection (Hx with EBDR) that may cause severe morbidity and even death. The purpose of this study was to compare several criteria systems as predictors of PHLF-related mortality following Hx with EBDR for perihilar cholangiocarcinoma (PHCC). METHODS: The study cohort consisted of 222 patients who underwent Hx with EBDR for PHCC. We compared several criteria systems, including previously established criteria (the International Study Group of Liver Surgery (ISGLS) criterion; and the "50-50" criterion), and our institution's novel systems "Max T-Bili" defined as total bilirubin (T-Bili) >7...
February 8, 2018: Digestive Surgery
Takahisa Ogawa, Kei Ito, Shinsuke Koshita, Yoshihide Kanno, Kaori Masu, Hiroaki Kusunose, Toshitaka Sakai, Toji Murabayashi, Sho Hasegawa, Yutaka Noda
Background and study aims:  Evaluation of longitudinal tumor extent is indispensable for curative surgical treatment of extrahepatic cholangiocarcinoma. The aim of this study was to evaluate the usefulness and feasibility of cholangioscopic-guided mapping biopsy using a newly developed peroral digital cholangioscope, SpyGlass DS (SpyDS), for preoperative evaluation of extrahepatic cholangiocarcinoma. Patients and methods:  Thirteen patients (mean age, 75 years; male 10, female 3) with extrahepatic cholangiocarcinoma who underwent cholangioscopic-guided mapping biopsy using SpyDS for preoperative evaluation were included in this study...
February 2018: Endoscopy International Open
Kazuhiko Hashimoto, Kei Adachi, Ryouji Nonaka, Jeong-Ho Moon, Yujiro Fujie, Shoichiro Fujita, Keiko Kojima, Jun Hanai, Shingi Imaoka, Tadashi Ohnishi
The patient was a 79-year-old woman, who had undergone pancreaticoduodenectomy(PD)for lower bile duct carcinoma in our hospital(pT3N0H0P0M0, fStage III ). Four years 6 months after the initial operation, abdominal CT revealed left bile duct expansion and hilar bile duct thickening. Therefore, based on the diagnosis of perihilar cholangiocarcinoma originating from the left hilar duct, we performed left lobectomy with caudate lobectomy and biliary tract reconstruction. The surgical specimen showed a tumor in the left hilar bile duct...
November 2017: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Halmurat Obulkasim, Xiaolei Shi, Jun Wang, Jun Li, Bo Dai, Pengwen Wu, Shuai Wang, Xun Wang, Yitao Ding
Cancer-associated fibroblasts (CAFs) exhibit various phenotypes and serve an important role in tumor progression. However, research on podoplanin expression in CAFs is limited, and its role in the cholangiocarcinoma microenvironment remains unclear. The present study analyzed the clinical and pathological records of 42 patients diagnosed with perihilar cholangiocarcinoma (pCCA) in The Affiliated Drum Tower Hospital of Nanjing University Medical School (Nanjing, China). Immunohistochemical staining was performed to evaluate the expression of podoplanin in CAFs in order to determine its association with clinicopathological parameters and survival rate...
January 2018: Oncology Letters
F Rassam, E Roos, K P van Lienden, J E van Hooft, H J Klümpen, G van Tienhoven, R J Bennink, M R Engelbrecht, A Schoorlemmer, U H W Beuers, J Verheij, M G Besselink, O R Busch, T M van Gulik
AIM: Perihilar cholangiocarcinoma (PHC) is a challenging disease and requires aggressive surgical treatment in order to achieve curation. The assessment and work-up of patients with presumed PHC is multidisciplinary, complex and requires extensive experience. The aim of this paper is to review current aspects of diagnosis, preoperative work-up and extended resection in patients with PHC from the perspective of our own institutional experience with this complex tumor. METHODS: We provided a review of applied modalities in the diagnosis and work-up of PHC according to current literature...
January 19, 2018: Langenbeck's Archives of Surgery
Kenichi Komaya, Tomoki Ebata, Yukihiro Yokoyama, Tsuyoshi Igami, Gen Sugawara, Takashi Mizuno, Junpei Yamaguchi, Masato Nagino
BACKGROUND: Although several studies have been conducted on the patterns of recurrence in resected perihilar cholangiocarcinoma, they have many limitations. The aim of this study was to investigate recurrence after resection and to evaluate prognostic factors on the time to recurrence and recurrence-free survival. METHODS: Consecutive patients who underwent curative-intent resection of perihilar cholangiocarcinoma between 2001 and 2012 were reviewed retrospectively...
January 11, 2018: Surgery
Maria Consiglia Bragazzi, Lorenzo Ridola, Samira Safarikia, Sabina Di Matteo, Daniele Costantini, Lorenzo Nevi, Vincenzo Cardinale
Cholangiocarcinoma (CCA) is a heterogeneous group of malignancies that may develop at any level of the biliary tree. CCA is currently classified into intrahepatic (iCCA), perihilar (pCCA) and distal (dCCA) on the basis of its anatomical location. Notably, although these three CCA subtypes have common features, they also have important inter- and intra-tumor differences that can affect their pathogenesis and outcome. A unique feature of CCA is that it manifests in the hepatic parenchyma or large intrahepatic and extrahepatic bile ducts, furnished by two distinct stem cell niches: the canals of Hering and the peribiliary glands, respectively...
January 2018: Annals of Gastroenterology: Quarterly Publication of the Hellenic Society of Gastroenterology
Jun Sakata, Tomoki Ebata, Toshifumi Wakai
Surgical resection that leaves no residual carcinoma offers the only chance of long-term survival for patients with perihilar cholangiocarcinoma. Numerous attempts have been made to improve and expand the use of surgical procedures for this disease, and surgical outcomes are now improving. Here, we describe the contributions of Eastern and Western surgeons to advances in surgical resection for perihilar cholangiocarcinoma by reviewing the landmark achievements of those who pioneered these surgical procedures...
January 12, 2018: Journal of Hepato-biliary-pancreatic Sciences
Rajat Garg, Uqba Khan, Ahmed AlRajjal, Zyad Kafri
Cholangiocarcinoma (CCA) is a very aggressive and lethal tumor, which arises from the epithelial cells of bile ducts. CCA comprises about 3% of all gastrointestinal malignancies and its incidence is on the rise in the recent years. Anatomically, it is classified into intrahepatic, perihilar, or extrahepatic (distal) CCA. There are a number of risk factors associated with CCA including primary sclerosing cholangitis, fibropolycystic liver disease, parasitic infection, viral hepatitis, chronic liver disease, and genetic disorders like Lynch syndrome...
September 2017: Case Reports in Gastroenterology
Jordan M Cloyd, Yun Shin Chun, Naruhiko Ikoma, Jean Nicolas Vauthey, Tlhomas A Aloia, Amanda Cuddy, Miguel A Rodriguez-Bigas, Y Nancy You
PURPOSE: Patients with Lynch syndrome (LS) have a significantly elevated lifetime risk of developing biliary tract cancers (BTCs) compared to the general population. However, few studies have characterized the clinical characteristics, genetic features, or long-term outcomes of mismatch-repair deficient (dMMR) cholangiocarcinomas associated with LS. METHODS: A retrospective review of a prospectively maintained Familial High-Risk GI Cancer Clinic database identified all patients with BTCs evaluated from 2006 to 2016 who carried germline mutations in MLH1, MSH2, MSH6, or PMS2...
December 14, 2017: Journal of Gastrointestinal Cancer
Chun-Yi Tsai, Motoi Nojiri, Yukihiro Yokoyama, Tomoki Ebata, Takashi Mizuno, Masato Nagino
BACKGROUND: Portal vein embolization is essential for patients with biliary cancer who undergo extended hepatectomy to induce hypertrophy of the future remnant liver. Over 830 patients have undergone the portal vein embolization at our institution since 1990. Non-alcoholic fatty liver disease is an entity of hepatic disease characterized by fat deposition in hepatocytes. It has a higher prevalence among persons with morbid obesity, type 2 diabetes, and hyperlipidemia. Neither the mechanism of hepatic hypertrophy after portal vein embolization nor the pathophysiology of non-alcoholic fatty liver disease has been fully elucidated...
December 6, 2017: BMC Gastroenterology
Masato Nagino
No abstract text is available yet for this article.
December 4, 2017: Annals of Surgery
Wen-Jun Jia, Shi-Quan Sun, Luo-Shun Huang, Qiao-Li Tang, Yu-Dong Qiu, Liang Mao
The aim of the present study was to investigate the role of triglyceride metabolism in the effect of obstructive cholestasis on liver regeneration following 50% partial hepatectomy (PH). Obstructive cholestatic rat models were achieved via ligation of the common bile duct (BDL). Following comparisons between hepatic pathological alterations with patients with perihilar cholangiocarcinoma, rats in the 7 day post‑BDL group were selected as the BDL model for subsequent experiments. Liver weight restoration, proliferating cell nuclear antigen labeling index, cytokine and growth factor expression levels, and hepatic triglyceride content were evaluated to analyze liver regeneration post‑PH within BDL and control group rats...
January 2018: Molecular Medicine Reports
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