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Cholangiocarcinoma AND unresectability

Benjamin Goeppert, Felicia Truckenmueller, Alessandro Ori, Valerie Fritz, Thomas Albrecht, Angelika Fraas, Dominique Scherer, Rosa González Silos, Carsten Sticht, Norbert Gretz, Arianeb Mehrabi, Melanie Bewerunge-Hudler, Stefan Pusch, Justo Lorenzo Bermejo, Peter Dietrich, Peter Schirmacher, Marcus Renner, Stephanie Roessler
Gallbladder carcinoma (GBC) is a biliary tract cancer with few treatment options and poor prognosis. Radical surgery is the only potentially curative treatment option but most patients diagnosed with GBC are unresectable. Thus, there is a great need for the development of new treatment options including targeted therapy. Here, we aimed at identifying deregulated miRNAs and affected pathways involved in GBC development and progression. We performed global miRNA profiling of 40 GBC and 8 normal gallbladder tissues and identified large differences with 30% of miRNAs being differentially expressed (false discovery rate: FDR < 0...
March 18, 2019: Scientific Reports
Tianyi Fang, Hao Wang, Yufu Wang, Xuan Lin, Yunfu Cui, Zhidong Wang
To explore the clinical significance of preoperative serum CEA, CA125, and CA19-9 levels in predicting the resectability of cholangiocarcinoma. Patients with cholangiocarcinoma diagnosed by radiologic examination and admitted to the Second Affiliated Hospital of Harbin Medical University from September 1, 2011, to November 30, 2017, were retrospectively included. The relationship between the preoperative serum CEA, CA125, and CA19-9 levels and the resectability of cholangiocarcinoma was analyzed by receiver operating characteristic (ROC) curve, as well as the best cut-off point...
2019: Disease Markers
Yun Nah Lee, Seok Jeong, Hyun Jong Choi, Jae Hee Cho, Young Koog Cheon, Se Woo Park, Yeon Suk Kim, Don Haeng Lee, Jong Ho Moon
BACKGROUND AND AIMS: Catheter-based endobiliary radiofrequency ablation (RFA) is an endoscopic local treatment for patients with malignant biliary stricture (MBS). However, excessive heating of the bile duct by the current RFA system can induce serious complications. Recently, a new RFA system with automatic temperature control was developed. In the present study, we examined the safety of the new RFA system in patients undergoing endobiliary RFA for extrahepatic MBS. METHODS: This prospective, multicenter study enrolled patients with unresectable or inoperable extrahepatic (>2 cm from the hilum) MBS...
March 12, 2019: Journal of Gastroenterology and Hepatology
Ross C D Buerlein, Andrew Y Wang
Most patients with perihilar cholangiocarcinoma present with surgically unresectable disease owing to the insidious nature of this malignancy. Relief of malignant perihilar biliary obstruction is a key aspect of cholangiocarcinoma. Although palliative stenting using uncovered metal stents has been advocated in patients with unresectable malignant perihilar biliary strictures, several endoscopic retrograde cholangiopancreatography-guided ablative modalities have emerged. Palliative photodynamic therapy, radiofrequency ablation, and intraluminal brachytherapy have been associated with improved stent patency and survival, although the ideal treatment approach remains unclear...
April 2019: Gastrointestinal Endoscopy Clinics of North America
Margaret M Romine, Jared White
Orthotopic liver transplantation (OLT) has many roles in biliary disease. OLT provides excellent results for patients with unresectable hilar cholangiocarcinoma. OLT prolongs survival in primary biliary cirrhosis not responsive to therapy and improves quality of life. OLT remains the durable option for patients with primary sclerosing cholangitis and complications of end-stage liver disease or recurrent cholangitis secondary to biliary obstruction. Indications for OLT after bile duct injury are chronic liver disease secondary to biliary cirrhosis and acute liver failure from associated vascular injury...
April 2019: Surgical Clinics of North America
Fabrice Caillol, Erwan Bories, Christophe Zemmour, Christian Pesenti, Jean Philippe Ratone, Marine Gilabert, Simon Launay, Marc Giovannini
Background and aim: More than 50% of the liver should be drained in case of unresectable hilar liver stenosis; however, it remains unclear if the use of several types of drainage (endoscopic retrograde cholangiography and pancreatography, percutaneous-biliary drainage, endoscopic ultrasound biliary drainage (EUS-BD)), allowing better drainage, has an impact on survival. The aim of our study was to evaluate the percentage of liver drained and its correlation on survival whatever the drainage technique used...
February 2019: United European Gastroenterology Journal
Francesco Auriemma, Luca De Luca, Mario Bianchetti, Alessandro Repici, Benedetto Mangiavillano
Malignant biliary strictures are usually linked to different types of tumors, mainly cholangiocarcinoma, pancreatic and hepatocellular carcinomas. Palliative measures are usually adopted in patients with nonresectable or borderline resectable biliary disease. Stent placement is a well-known and established treatment in patients with unresectable malignancy. Intraductal radiofrequency ablation (RFA) represents a procedure that involves the use of a biliary catheter device, via an endoscopic approach. Indications for biliary RFA described in literature are: Palliative treatment of malignant biliary strictures, avoiding stent occlusion, ablating ingrowth of blocked metal stents, prolonging stent patency, ablating residual adenomatous tissue after endoscopic ampullectomy...
February 16, 2019: World Journal of Gastrointestinal Endoscopy
Benjamin W Johnson, G Paul Wright
The practice of hepatic surgery has become increasingly complex as additional therapeutic options emerge to treat both primary and metastatic tumors of the liver. Liver-directed therapy options include selective internal radiation therapy (SIRT), stereotactic body radiation therapy, chemoembolization, bland embolization, hepatic artery infusion chemotherapy (HAIC), and ablative techniques such as microwave or radiofrequency ablation. Hepatocellular carcinoma has been treated with many of these therapies for palliation of symptoms, definitive treatment, and as a bridge to transplantation...
March 2019: American Journal of Surgery
O Strobel, M W Büchler
No abstract text is available yet for this article.
February 13, 2019: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
Matthew C Hernandez, John R Bergquist, Jennifer L Leiting, Tommy Ivanics, Lin Yang, Rory L Smoot, David M Nagorney, Mark J Truty
BACKGROUND: Patient-derived xenografts (PDX) are clinically relevant human cancer models that can be used to guide individualized medicine. We aimed to generate PDX models from clinically obtained biopsy specimens (surgical or image-guided) hypothesizing that low volume biopsy specimens could provide sufficient viable tissue to successfully engraft PDX models from patients with unresectable or metastatic disease. MATERIALS AND METHODS: We maintain a prospective high volume gastrointestinal malignancy PDX program...
February 12, 2019: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Marcia P Gaspersz, Stefan Buettner, Jeroen L A van Vugt, Jeroen de Jonge, Wojciech G Polak, Michail Doukas, Jan N M Ijzermans, Bas Groot Koerkamp, François E J A Willemssen
BACKGROUND: The aim was to compare the prognostic accuracy of cross-sectional imaging of the 7th and 8th editions of the American Joint Committee on Cancer(AJCC) staging system for perihilar cholangiocarcinoma(PHC). METHODS: All patients with PHC between 2002 and 2014 were included. Imaging at the time of presentation was reassessed and clinical tumor-node-metastasis (cTNM) stage was determined according to the 7th and 8th editions of the AJCC staging system. Comparison of the prognostic accuracy was performed using the concordance index (c-index)...
February 12, 2019: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Jun Wang, Halmurat Obulkasim, Xiaoping Zou, Baorui Liu, Yafu Wu, Xingyu Wu, Yitao Ding
Hilar cholangiocarcinoma is a highly malignant tumor and is currently treated by surgical resection or liver transplantation; however, these treatments result in poor patient prognosis accompanied with high recurrence and low patient mortality rates. Neoadjuvant therapy with liver transplantation is a novel treatment that exhibits promising clinical application, with a reported 5-year survival rate of 82%. However, transplantation centers conducting research into this treatment are limited due to its length and complexity...
February 2019: Oncology Letters
Takuya Sakamoto, Yutaka Takeda, Yoshiaki Ohmura, Yoshiteru Katsura, Ryota Mori, Yohei Nose, Kenji Kawai, Kohei Murakami, Atsushi Naito, Junichi Inatome, Yoshinori Kagawa, Toru Masuzawa, Atsushi Takeno, Chiyomi Egawa, Kohei Murata
Gemcitabine and cisplatin combination therapy(GC therapy)is now considered a highly effective regimen for patients with unresectable and metastatic biliary tract cancer. We performed GC therapy for 18 patients between January 2014 and April 2018. The median age of the patients was 67.5 years, and 13 patients were men. Fifteen patients had a performance status (PS)score of 0, and 3 patients had a PS score of 1. Nine patients had distal cholangiocarcinoma, 3 had intrahepatic cholangiocarcinoma, 3 had duodenum papilla cancer, and 3 had gallbladder cancer...
December 2018: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Silvia Bisello, Matteo Renzulli, Milly Buwenge, Lucia Calculli, Giuseppina Sallustio, Gabriella Macchia, Francesco Deodato, Giancarlo Mattiucci, Silvia Cammelli, Alessandra Arcelli, Lucia Giaccherini, Francesco Cellini, Giovanni Brandi, Sara Guerri, Savino Cilla, Rita Golfieri, Lorenzo Fuccio, Alessio G Morganti, Alessandra Guido
Radiotherapy (RT) is a treatment option for advanced biliary tract cancer (BTC), often combined with sequential and/or concurrent chemotherapy. The use of modern RT techniques requires accurate clinical target volume (CTV) definition and delineation. However, guidelines for CTV delineation in BTC are lacking. Therefore, the aim of this study was to propose a computer tomography (CT) atlas for CTV definition of BTC. We previously proposed guidelines to define the nodal CTV (CTV-N) in BTC. In this study, based on a literature analysis, we defined the margins to be added to the gross tumor volume (GTV; subclinical and microscopic disease) to define the primary tumor CTV (CTV-T)...
February 2019: Oncology Letters
Maria R Baimas-George, David M Levi, Lon B Eskind, Russell C Kirks, Michael Passeri, Mark Lessne, Dimitrios Kardassis, Stuart Salmon, David A Iannitti, Dionisios Vrochides
Incorporation of liver transplant techniques in hepatopancreaticobiliary surgery has created an opportunity for the resection of locally advanced hepatic tumors formerly considered unresectable. A 73-year-old woman presented with cholangiocarcinoma involving inferior vena cava, all three hepatic veins, and right anterior portal pedicle, initially deemed nonoperative. This case demonstrates the first combined application of associating liver partition and portal vein ligation for staged hepatectomy and ex vivo resection to perform an R0...
January 15, 2019: Journal of Surgical Oncology
Maria Angeles Gonzalez-Carmona, Maximilian Bolch, Christian Jansen, Annabelle Vogt, Matthias Sampels, Raphael U Mohr, Katrin van Beekum, Robert Mahn, Michael Praktiknjo, Jacob Nattermann, Jonel Trebicka, Vittorio Branchi, Hanno Matthaei, Steffen Manekeller, Jörg C Kalff, Christian P Strassburg, Tobias J Weismüller
BACKGROUND: Chemotherapy with gemcitabine and cisplatin is the current standard for patients with unresectable cholangiocarcinoma. Local photodynamic therapy has also demonstrated benefit in patients with extrahepatic cholangiocarcinoma. AIM: To evaluate the benefit of photodynamic therapy in combination with systemic chemotherapy in advanced extrahepatic cholangiocarcinoma. METHODS: Three hundred and fifty-three patients diagnosed with cholangiocarcinoma between 2004 and 2016 were treated at the University Hospital of Bonn, Germany...
January 13, 2019: Alimentary Pharmacology & Therapeutics
Jia-Wei Feng, Xing-Hai Yang, Bao-Qiang Wu, Yong Jiang, Zhen Qu
Cholangiocarcinomas are heterogeneous biliary tract tumors that cause devastating disease. Perihilar cholangiocarcinoma (PHC) is the most common type of biliary tract cancer and are associated with a high mortality. Diagnoses of PHC depend on the results of its clinical presentation, serum biomarkers and imaging techniques. Pre-operative managements including pre-operative biliary drainage (PBD) and portal vein embolization (PVE) could reduce mortality. The best chance of long-term survival and potential cure is surgical resection with negative surgical margin...
December 21, 2018: Gastroenterología y Hepatología
Li-Ye Wang, Shuai Gong, Li-Ping Gao, Li-Xia Hou, Wei He
RATIONALE: Intrahepatic cholangiocarcinoma (ICC) originates from the secondary branch of the bile duct and the intrahepatic bile duct epithelial cells, and is a rare pathological type of primary liver cancer. Recently, apatinib has been successfully used for a variety of malignancies. PATIENT CONCERNS: A 23-year-old female was noted with intermittent right upper abdominal distension, abdominal pain, and vomiting after eating for more than 1 month. The enhanced CT scan revealed multiple intrahepatic lesions, portal vein and right branch tumor emboli were present...
December 2018: Medicine (Baltimore)
Ryusei Matsuyama, Daisuke Morioka, Ryutaro Mori, Yasuhiro Yabushita, Seigo Hiratani, Yohei Ota, Takafumi Kumamoto, Itaru Endo
BACKGROUND: The concept of "borderline resectable" was recently introduced to the field of surgery for pancreatic cancer, and surgical outcomes for this disease with extremely dismal prognosis have improved since the introduction of this concept. However, no such concept has yet been introduced to the field of surgery for hilar cholangiocarcinoma (HCca). AIM: To determine a definition and criteria for "borderline resectable" in the field of surgery for HCca...
April 2019: World Journal of Surgery
Daniel R Waisberg, Rafael S Pinheiro, Lucas S Nacif, Vinicius Rocha-Santos, Rodrigo B Martino, Rubens M Arantes, Liliana Ducatti, Quirino Lai, Wellington Andraus, Luiz C D'Albuquerque
Intrahepatic cholangiocarcinoma (ICC) is the second most prevalent primary liver neoplasm after hepatocellular carcinoma (HCC), corresponding to 10% to 15% of cases. Pathologies that cause chronic biliary inflammation and bile stasis are known predisposing factors for development of ICC. The incidence and cancer-related mortality of ICC is increasing worldwide. Most patients remain asymptomatic until advance stage, commonly presenting with a liver mass incidentally diagnosed. The only potentially curative treatment available for ICC is surgical resection...
2018: Translational Gastroenterology and Hepatology
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