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Perihilar Cholangiocellular Carcinoma

Luciano Tarantino, Giuseppina Busto, Aurelio Nasto, Riccardo Aurelio Nasto, Paolo Tarantino, Raffaele Fristachi, Luigi Cacace, Sara Bortone
AIM: We evaluated feasibility, safety and efficacy of Electrochemotherapy (ECT) in a prospective series of patients with unresectable Perihilar-Cholangiocarcinoma (PHCCA). PATIENTS AND METHODS: Five patients with PHCCA underwent ECT. Three patients underwent percutaneous ECT of a single PHCCA nodule. One patient underwent resection of a nodule in the IV segment and intraoperative ECT of a large PHCCA in the VIII segment. Another patient underwent percutaneous ECT of a large PHCCA recurrence after left lobectomy and RF ablation of a synchronous metastasis in the VI segment...
October 2018: European Journal of Surgical Oncology
Arndt Vogel, Anna Saborowski
BACKGROUND: Cholangiocarcinomas (CCAs) are aggressive malignancies that display features of biliary differentiation. According to their anatomical location, CCAs are commonly classified as intrahepatic and extrahepatic tumors, the latter entity being further subdivided into perihilar CCAs, also termed as Klatskin tumors, and distal tumors. While a majority of CCAs occur sporadically, established risk factors such as liver fluke infestation or primary sclerosing cholangitis exist. SUMMARY: Due to lack of efficient early screening markers, CCAs are frequently diagnosed at an advanced stage when curative surgical resection is not an option...
2017: Digestion
Masayuki Nakano, Shun-Ichi Ariizumi, Masakazu Yamamoto
Cholangiocarcinoma, also referred to as cholangiocellular carcinoma (particularly in Japan), develops along the biliary tract. The tumor may be intra- or extrahepatic and have different features with specific treatments based on the site of origin. Guidelines for diagnosis and management of cholangiorcarcinoma, such as those proposed by EASL (European Association for the Study of the Liver)1 and the Mayo Clinic2 classify the tumor into intrahepatic, perihilar, and distal cholangiocarcinoma. There are three main macroscopic patterns of growth of cholangiocarcinoma: mass-forming, periductal-infiltrating and intraductal...
March 2017: Seminars in Diagnostic Pathology
L Zender, N P Malek
Cholangiocellular carcinoma (CCA) is the second most frequent primary liver carcinoma and is an aggressive tumor, which is mostly diagnosed in advanced stages. The overall survival is poor. Histpathological analysis of tumor biopsies or cytological analysis of biliary brushings can be used to confirm the diagnosis. A differentiation is made between distal, perihilar and intrahepatic CCA. The anatomical position determines the diagnostic and therapeutic strategy. Before diagnostic or therapeutic measures are undertaken it is essential to resolve biliary obstruction via endoscopic stenting or percutaneous biliary drainage...
December 2016: Der Internist
Tadashi Tsukamoto, Akishige Kanazawa, Sadatoshi Shimizu, Masayuki Sakae, Shigeaki Kurihara, Tetsuzo Tashima, Sota Deguchi, Wataru Goto, Masaya Kotsuka, Akira Ishikawa, Mami Yoshii, Takayoshi Nakajima, Yukihiro Mori, Go Ohira, Akiko Tachimori, Yutaka Tamamori, Atsushi Yamamoto, Toru Inoue, Yoshito Yamashita, Yukio Nishiguchi
The stenting strategy for portal vein stenosis in cases with unresectable hilar malignancies reduces portal hypertension and maintains portal vein blood flow. This not only improves quality of life, but also leads to aggressive therapy with anticancer agents. A 65-year-old woman presented with painless jaundice 8 months after left hemihepatectomy with lymph node dissection for intrahepatic cholangiocellular carcinoma. Seven months after biliary stenting for bile duct stenosis, progressing pancytopenia and ascites were noted...
November 2014: Gan to Kagaku Ryoho. Cancer & Chemotherapy
Felix Momm, Eva Schubert, Karl Henne, Norbert Hodapp, Hermann Frommhold, Jan Harder, Anca-Ligia Grosu, Gerhild Becker
BACKGROUND AND PURPOSE: In spite of various efforts perihilar cholangiocellular carcinoma (Klatskin tumour) has still a bad prognosis. The treatment of patients with inoperable Klatskin tumours by stereotactic fractionated radiotherapy (SFRT) was analysed retrospectively. PATIENTS, METHODS AND MATERIALS: In our department 13 patients were treated for Klatskin tumours by SFRT (32-56 Gy, 3 x 4 Gy/week) from 1998 to 2008. The treatment technique was developed from stereotactic body frame radiotherapy to image guided (IGRT) stereotactic radiotherapy with control of patient positioning by cone beam computer tomography (CBCT)...
April 2010: Radiotherapy and Oncology: Journal of the European Society for Therapeutic Radiology and Oncology
Massimo Malago, Andrea Frilling, Jun Li, Hauke Lang, Christoph E Broelsch
The surgical treatment of perihilar cholangiocellular carcinoma (CCC) is challenging due to the adjacency of the tumor to the hilar vessels, major hepatic veins, bile ducts, and the inferior vena cava. Additionally, the tumour frequently infiltrates the parenchyma of the caudate lobe or/and invades its bile ducts. CONSENSUS STATEMENTS: Negative margin caudate hepatectomy is rarely feasible. Isolated partial or complete caudate lobe resection is an oncologically inadequate procedure. Extended hepatectomies in combination with caudate lobectomy can provide prolonged survival, even in patients with advanced CCC...
2008: HPB: the Official Journal of the International Hepato Pancreato Biliary Association
Gabriele I Kirchner, Jens J W Tischendorf, Jörg Bleck, Siegfried Wagner, Martin Caselitz, Juergen Klempnauer, Michael P Manns, Michael Gebel
OBJECTIVE: Enlarged perihilar lymph nodes have been described in patients with primary sclerosing cholangitis (PSC). The aim of the study was to determine the clinical relevance of perihilar lymph nodes in PSC patients with and without cholangiocellular carcinoma (CCC). MATERIAL AND METHODS: The status of perihilar lymph nodes was investigated in 117 patients with PSC using "high-end" ultrasound. Thirty-five of the 117 PSC patients had histologically proven CCC...
2008: Scandinavian Journal of Gastroenterology
S Kubicka
Risk factors for cholangiocellular and gallbladder carcinomas are bile stones and chronic inflammation of the biliary system. Gallbladder cancer and intrahepatic cholangiocellular carcinomas can be diagnosed with a high sensitivity by ultrasonography, CT and MRI, while the most sensitive diagnostic methods for perihilar or distal cholangiocellular carcinomas are ERC or MRC. The only curative option for patients with gallbladder- or bile duct cancer is surgical resection. Outside clinical studies there is currently no indication for neoadjuvant or adjuvant chemotherapy or radiochemotherapy...
May 2004: Zeitschrift Für Gastroenterologie
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