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https://www.readbyqxmd.com/read/28520651/laparoscopic-management-of-hepatocellular-carcinoma-a-critical-reappraisal
#1
David Fuks, Luca Aldrighetti, Long R Jiao, Go Wakabayashi, Paolo Limongelli
Following the introduction of the first laparoscopic liver resection, after ∼25 years, a critical reappraisal seems to be warranted. Liver resection represents the first choice for curing early hepatocellular carcinoma (HCC) allowing a curative chance also in selected patients with intermediate stage tumors. The criteria for liver resectability by laparoscopy remains the same for open surgery, which is oncological criteria (absence of extrahepatic tumor location; completely resectable R0 resection), anatomic (resectability of involved segment with its own blood surely and biliary drainage; absence of vascular invasion of portal or hepatic veins) and technical (possibility to leave in place a residual volume ≥40%)...
May 17, 2017: Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
https://www.readbyqxmd.com/read/28516570/proposal-of-size-based-surgical-indication-criteria-for-liver-hemangioma-based-on-a-nationwide-survey-in-japan
#2
Yoshihiro Sakamoto, Norihiro Kokudo, Takeyuki Watadani, Junji Shibahara, Masakazu Yamamoto, Hiroki Yamaue
BACKGROUND: Surgical indications for liver hemangioma remain unclear. METHODS: Of 510 patients undergoing surgical resection for liver hemangioma in 118 Japanese centers between 1998 and 2012, abdominal symptoms, diagnostic accuracy, and surgical outcomes were analyzed to propose size-based surgical indications. Patients were classified into four groups based on tumor size: Group A) ≤5 cm (n = 122, 24%), B) 5-10 cm (n = 164, 32%), C) 10-15 cm (n = 124, 24%), and D) >15 cm (n = 100, 20%)...
May 17, 2017: Journal of Hepato-biliary-pancreatic Sciences
https://www.readbyqxmd.com/read/28506055/clinical-features-and-outcomes-of-patients-with-hepatocellular-carcinoma-complicated-with-bile-duct-invasion
#3
Jihyun An, Kwang Sun Lee, Kang Mo Kim, Do Hyun Park, Sang Soo Lee, Danbi Lee, Ju Hyun Shim, Young-Suk Lim, Han Chu Lee, Young-Hwa Chung, Yung Sang Lee
Background/Aims: Little is known about the treatment or outcomes of hepatocellular carcinoma (HCC) complicated with bile duct invasion. Methods: A total of 247 consecutive HCC patients with bile duct invasion at initial diagnosis were retrospectively included. Results: The majority of patients had Barcelona Clinic Liver Cancer (BCLC) stage C HCC (66.8%). Portal vein tumor thrombosis was present in 166 (67.2%) patients. Median survival was 4...
May 16, 2017: Clinical and Molecular Hepatology
https://www.readbyqxmd.com/read/28503558/management-of-unresectable-intrahepatic-cholangiocarcinoma-how-do-we-decide-among-the-various-liver-directed-treatments
#4
REVIEW
Eugene J Koay, Bruno C Odisio, Milind Javle, Jean-Nicolas Vauthey, Christopher H Crane
Intrahepatic cholangiocarcinoma often causes death due to obstruction of the biliary system or interruption of the vascular supply of the liver. This fact emphasizes the critical need for local tumor control in this disease. Successful local tumor control has traditionally been achievable through surgical resection for the small proportion of patients with operable tumors. Technological advances in radiation oncology and in interventional radiology have enabled the delivery of ablative radiation doses or other cytotoxic therapies for tumors in the liver...
April 2017: Hepatobiliary Surgery and Nutrition
https://www.readbyqxmd.com/read/28503557/epidemiology-and-risk-factors-intrahepatic-cholangiocarcinoma
#5
REVIEW
Amar Gupta, Elijah Dixon
Intrahepatic cholangiocarcinoma (ICC) is a rare entity with a distinct clinical course and epidemiology from hilar and extrahepatic cholangiocarcinoma. ICC makes up 8-10% of cholangiocarcinomas and 10-20% of all primary liver tumors. There remains a considerable amount of geographic variation in the incidence of ICC worldwide; however, the overall incidence of this malignancy appears to be rising. Several risk factors have been identified, such as infectious causes (liver flukes, viral hepatitis), biliary tract disease [primary sclerosing cholangitis (PSC), hepaticolithiasis, biliary cystic diseases], metabolic syndrome, lifestyle choices (alcohol abuse, tobacco use), and cirrhosis...
April 2017: Hepatobiliary Surgery and Nutrition
https://www.readbyqxmd.com/read/28500686/factors-predicting-the-overall-response-and-overall-survival-in-hepatocellular-carcinoma-patients-undergoing-balloon-occluded-transcatheter-arterial-chemoembolization-b-tace-a-retrospective-cohort-study
#6
Takeshi Hatanaka, Hirotaka Arai, Mitsuhiko Shibasaki, Hiroki Tojima, Daichi Takizawa, Mitsuo Toyoda, Hisashi Takayama, Takehiko Abe, Ken Sato, Satoru Kakizaki, Masanobu Yamada
AIM: This study aimed to investigate the factors predicting the overall response and overall survival in hepatocellular carcinoma (HCC) patients undergoing balloon-occluded transcatheter arterial chemoembolization (B-TACE). METHODS: Sixty-six patients treated with B-TACE at a tertiary referral hospital between January 2011 and August 2015 were included in this retrospective cohort study. RESULTS: The overall response was classified as complete response (CR), partial response (PR), stable disease (SD), and progressive disease (PD) in 35 (53...
May 12, 2017: Hepatology Research: the Official Journal of the Japan Society of Hepatology
https://www.readbyqxmd.com/read/28492356/high-frequency-irreversible-electroporation-safety-and-efficacy-of-next-generation-irreversible-electroporation-adjacent-to-critical-hepatic-structures
#7
Imran A Siddiqui, Russell C Kirks, Eduardo L Latouche, Matthew R DeWitt, Jacob H Swet, Erin H Baker, Dionisios Vrochides, David A Iannitti, Rafael V Davalos, Iain H McKillop
Irreversible electroporation (IRE) is a nonthermal ablation modality employed to induce in situ tissue-cell death. This study sought to evaluate the efficacy of a novel high-frequency IRE (H-FIRE) system to perform hepatic ablations across, or adjacent to, critical vascular and biliary structures. Using ultrasound guidance H-FIRE electrodes were placed across, or adjacent to, portal pedicels, hepatic veins, or the gall bladder in a porcine model. H-FIRE pulses were delivered (2250 V, 2-5-2 pulse configuration) in the absence of cardiac synchronization or intraoperative paralytics...
June 2017: Surgical Innovation
https://www.readbyqxmd.com/read/28490979/dose-to-organ-at-risk-and-dose-prescription-in-liver-sbrt
#8
REVIEW
Rives Michel, Izar Françoise, Parent Laure, Modesto Anouchka, Portier Guillaume, Kirzin Sylvain
Stereotactic body radiation therapy (SBRT) is delivered in a curative intent to many primary and secondary tumors. Concerning liver metastasis, SBRT can be safely delivered using one to five fractions. An excellent local control is obtained with doses from 20 to 60 Gy. For primary hepatic tumors, results are also good, but the risk of hepatic toxicity related to liver pre-existent pathology must be taken into account. Radiation induced liver disease (RILD) is not frequent in its classical presentation, but modifications of liver enzymes are often observed...
March 2017: Reports of Practical Oncology and Radiotherapy
https://www.readbyqxmd.com/read/28487467/overall-survival-and-clinical-characteristics-of-brca-associated-cholangiocarcinoma-a-multicenter-retrospective-study
#9
Talia Golan, Maria Raitses-Gurevich, Robin K Kelley, Andrea G Bocobo, Ayelet Borgida, Rachna T Shroff, Spring Holter, Steven Gallinger, Daniel H Ahn, Dan Aderka, Jain Apurva, Tanois Bekaii-Saab, Eitan Friedman, Milind Javle
BACKGROUND: Biliary tract malignancies, in particular cholangiocarcinomas (CCA), are rare tumors that carry a poor prognosis. BRCA2 mutation carriers have an increased risk of developing CCA with a reported relative risk of ∼5 according to the Breast Cancer Linkage Consortium. In addition to this risk, there are potential therapeutic implications in those harboring somatic and/or germline (GL) BRCA mutations. Therefore, it is important to define the clinical characteristics of GL/somatic BRCA1/2 variants in CCA patients...
May 9, 2017: Oncologist
https://www.readbyqxmd.com/read/28485658/multicystic-biliary-hamartoma-with-extremely-elevated-ca19-9-a-case-report
#10
Takeshi Morinaga, Imai Katsunori, Yo-Ichi Yamashita, Takanobu Yamao, Takayoshi Kaida, Shigeki Nakagawa, Daisuke Hashimoto, Akira Chikamoto, Shinji Sumiyoshi, Yoshiki Mikami, Hideo Baba
Multicystic biliary hamartoma (MCBH) is a rare cystic disease of the liver. We herein report a case of MCBH associated with extremely elevated levels of serum carbohydrate antigen (CA) 19-9. A 53-year-old man was referred to our hospital because of extremely elevated CA19-9 levels (more than 12,000 U/mL). Enhanced abdominal computed tomography and magnetic resonance imaging (MRI) revealed a multicystic tumor with a calcified wall in the left lobe of the liver, although no apparent intracystic nodule was detected...
May 9, 2017: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/28485270/a-review-of-the-scaffold-protein-menin-and-its-role-in-hepatobiliary-pathology
#11
Laurent Ehrlich, Chad Hall, Fanyin Meng, Terry Lairmore, Gianfranco Alpini, Shannon Glaser
Multiple endocrine neoplasia type I (MEN1) is a familial cancer syndrome with neuroendocrine tumorigenesis of the parathyroid glands, pituitary gland, and pancreatic islet cells. The MEN1 gene codes for the canonical tumor suppressor protein, menin. Its protein structure has recently been crystallized, and it has been investigated in a multitude of other tissues. In this review, we summarize recent advancements in understanding the structure of the menin protein and its function as a scaffold protein in histone modification and epigenetic gene regulation...
April 28, 2017: Gene Expression
https://www.readbyqxmd.com/read/28480071/targeted-therapy-in-biliary-tract-cancers-current-limitations-and-potentials-in-the-future
#12
REVIEW
Selley Sahu, Weijing Sun
Biliary tract cancers (BTC)/Cholangiocarcinoma (CCA) is an aggressive biliary tract epithelial malignancy from varying locations within the biliary tree with cholangiocyte depreciation., including intrahepatic cholangiocarcinoma (iCCA) (iCCA), extrahepatic cholangiocarcinoma (eCCA) and gallbladder carcinoma (GBC). The disease is largely heterogeneous in etiology, epidemiology, and molecular profile. There are limited treatment options and low survival rates for those patients with advanced or metastatic disease...
April 2017: Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/28480068/biliary-cancer-intrahepatic-cholangiocarcinoma-vs-extrahepatic-cholangiocarcinoma-vs-gallbladder-cancers-classification-and-therapeutic-implications
#13
REVIEW
Daniel H Ahn, Tanios Bekaii-Saab
Biliary cancers (BCs) are a diverse group of tumors that arise from the bile duct epithelium and are divided into cholangiocarcinomas of the intrahepatic and extrahepatic cholangiocarcinoma (EHCC) and cancer of the gallbladder. Despite improvements in treatment and diagnosis, BCs are often diagnosed at an advanced stage and associated with poor prognosis and limited treatment options. Recent discoveries have allowed us to have a better understanding of the genomic diversity in BC, and identify genes that are likely contributing to its pathogenesis, proliferation and treatment resistance...
April 2017: Journal of Gastrointestinal Oncology
https://www.readbyqxmd.com/read/28479376/extracellular-vesicles-in-bile-as-markers-of-malignant-biliary-stenoses
#14
Valeria Severino, Jean-Marc Dumonceau, Myriam Delhaye, Solange Moll, Isabelle Annessi-Ramseyer, Xavier Robin, Jean-Louis Frossard, Annarita Farina
BACKGROUND & AIMS: Algorithms for diagnosis of malignant common bile duct (CBD) stenoses are complex and lack accuracy. Malignant tumors secrete large numbers of extracellular vesicles (EVs) into surrounding fluids; EVs might therefore serve as biomarkers for diagnosis. We investigated whether concentrations of EVs in bile could discriminate malignant from nonmalignant CBD stenoses. METHODS: We collected bile and blood samples from 50 patients undergoing therapeutic endoscopic retrograde cholangiopancreatography at university hospitals in Europe for CBD stenosis of malignant (pancreatic cancer, n=20 or cholangiocarcinoma, n=5) or nonmalignant (chronic pancreatitis [CP], n=15) origin...
May 4, 2017: Gastroenterology
https://www.readbyqxmd.com/read/28473850/endoscopic-ultrasound-guided-biliary-drainage-using-self-expandable-metal-stent-for-malignant-biliary-obstruction
#15
Lei Lu, Xiaowei Tang, Hangbin Jin, Jianfeng Yang, Xiaofeng Zhang
Purpose. Endoscopic ultrasound-guided biliary drainage (EUS-BD) has been increasingly reported worldwide. However, studies concerning EUS-BD from Mainland China are sporadic. This study aims to investigate the feasibility, efficacy, and safety of EUS-BD using SEMS in a single center from Mainland China. Methods. Between November 2011 and August 2015, 24 patients underwent EUS-BD using a standardized algorithm. Results. Three patients underwent rendezvous technique (RV), 4 underwent hepaticogastrostomy (HGS), and 17 underwent choledochoduodenostomy (CDS)...
2017: Gastroenterology Research and Practice
https://www.readbyqxmd.com/read/28470400/comparative-radiological-pathological-study-of-biliary-intraductal-tubulopapillary-neoplasm-and-biliary-intraductal-papillary-mucinous-neoplasm
#16
Chia-Hung Wu, Yi-Chen Yeh, Yu-Chuan Tsuei, Li-Kuo Huang, Chia-I Lin, Chien-An Liu, Hsiou-Shan Tseng, Yi-You Chiou, Nai-Chi Chiu
PURPOSE: Biliary tract intraductal tubulopapillary neoplasms (BT-ITPNs) and intraductal papillary mucinous neoplasms (BT-IPMNs) are rare and poorly described. Herein, we examined the magnetic resonance imaging (MRI) features of BT-ITPNs and BT-IPMNs and correlated them with key gross and microscopic pathological findings. METHODS: We retrospectively identified five patients with definitive pathological findings of BT-ITPN and available diagnostic MRI findings. Key MRI features were correlated to the gross and microscopic pathology and compared to those of BT-IPMNs (19 patients)...
May 3, 2017: Abdominal Radiology
https://www.readbyqxmd.com/read/28468559/pediatric-mesenchymal-hamartomas-of-the-liver-can-show-both-foregut-and-hindgut-phenotype
#17
Hao Wu, William Ferguson, Eumenia Castro, Milton Finegold, Kalyani Patel
Cystic epithelium in mesenchymal hamartoma (MH) is typically biliary type. Mucinous differentiation of the epithelium and increased hepatocellular component may pose a diagnostic challenge. We studied MH in 7 children (6 M, 1 F; age 4 months to 8 years, median 1 year). Resected tumors varied from 3.0 to 17.0 cm. All tumors showed biliary epithelium in the cystic component with strong and diffuse reactivity for CK7 and CK19. Expression of CK20 and CDX2 was additionally seen in 2 tumors, rare/focal in 1, and diffuse with mucinous differentiation in the other...
January 1, 2017: Pediatric and Developmental Pathology
https://www.readbyqxmd.com/read/28465631/biliary-tract-cancer-stem-cells-translational-options-and-challenges
#18
REVIEW
Christian Mayr, Matthias Ocker, Markus Ritter, Martin Pichler, Daniel Neureiter, Tobias Kiesslich
Management of biliary tract cancer remains challenging. Tumors show high recurrence rates and therapeutic resistance, leading to dismal prognosis and short survival. The cancer stem cell model states that a tumor is a heterogeneous conglomerate of cells, in which a certain subpopulation of cells - the cancer stem cells - possesses stem cell properties. Cancer stem cells have high clinical relevance due to their potential contributions to development, progression and aggressiveness as well as recurrence and metastasis of malignant tumors...
April 14, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28465630/pathogenesis-and-clinical-spectrum-of-primary-sclerosing-cholangitis
#19
REVIEW
Neelam G Gidwaney, Swati Pawa, Kiron M Das
Primary sclerosing cholangitis (PSC) is a disease of the biliary tract, which has been documented in the literature since 1867. This disease has a strong predilection for affecting men and can be seen in individuals as young as 2 years of age. PSC has a strong associated with inflammatory bowel disease, more commonly with ulcerative colitis, and is also part of the clinical spectrum of IgG4-related diseases. Small-duct PSC, a variant of PSC, also has an association with inflammatory bowel disease. The exact pathogenesis of PSC is not well understood at present, however, is likely a combination of a genetic predisposition with alteration of the molecular structure of the gut...
April 14, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/28461144/disease-free-survival-following-resection-in-non-ductal-periampullary-cancers-a-retrospective-multicenter-analysis
#20
Stéphane Bourgouin, Jacques Ewald, Julien Mancini, Vincent Moutardier, Jean-Robert Delpero, Yves-Patrice Le Treut
BACKGROUND: Predictors of recurrence following pancreaticoduodenectomy are well described for ductal periampullary cancers but lack reliability for non-ductal tumors. The purpose of this study is to analyze the disease-free survival (DFS) and to define the predictors of recurrence following resection for ampullary (AC), bile duct (BDC) and duodenal cancers (DC). MATERIALS AND METHODS: Clinico-pathological data of patients operated on between 2001 and 2011 were retrospectively reviewed...
April 28, 2017: International Journal of Surgery
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