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Cholangiocarcinoma And Surgery

Chen-Ta Chi, Gar-Yang Chau, Rheun-Chuan Lee, Yen-Ying Chen, Hao-Jan Lei, Ming-Chih Hou, Yee Chao, Yi-Hsiang Huang
BACKGROUND/PURPOSE: Combined hepatocellular-cholangiocarcinoma (cHCC-CCA) is a rare primary liver cancer. Preoperative diagnosis of cHCC-CCA is difficult, and outcome of cHCC-CCA is obscured. Our study aimed to investigate the clinicopathological and radiological features of cHCC-CCA and compare their outcomes with hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (ICC). METHODS: From August 2010 to December 2017, 891 patients undergoing liver tumor resection in Taipei Veterans General Hospital, including 30 patients with pathology-proven cHCC-CCA, 819 HCC, and 42 ICC were retrospectively reviewed...
March 12, 2019: Journal of the Formosan Medical Association
Hai-Jie Hu, Yan-Wen Jin, Anuj Shrestha, Wen-Jie Ma, Jun-Ke Wang, Fei Liu, Ya-Yun Zhu, Rong-Xing Zhou, Parbatraj Regmi, Nan-Sheng Cheng, Fu-Yu Li
Prediction of early postoperative recurrence is of great significance for follow-up treatment. However, there are few studies available that focus on high-risk factors of early postoperative recurrence or even the definition the exact time of early recurrence for hilar cholangiocarcinoma. Thus, we aimed to examine the optimal cut-off value for defining the early in patients with R0 resection of hilar cholangiocarcinoma and to investigate prognostic factors associated with early recurrence. Two hundred and fifty-eight patients with R0 resection of hilar cholangiocarcinoma between 2000 and 2015 were included...
March 13, 2019: Cancer Medicine
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
Umberto Cillo, Constantino Fondevila, Matteo Donadon, Enrico Gringeri, Federico Mocchegiani, Hans J Schlitt, Jan N M Ijzermans, Marco Vivarelli, Krzysztof Zieniewicz, Steven W M Olde Damink, Bas Groot Koerkamp
Surgical resection is the only potentially curative treatment for patients with cholangiocarcinoma. For both perihilar cholangiocarcinoma (pCCA) and intrahepatic cholangiocarcinoma (iCCA), 5-year overall survival of about 30% has been reported in large series. This review addresses several challenges in surgical management of cholangiocarcinoma. The first challenge is diagnosis: a biopsy is typically avoided because of the risk of seeding metastases and the low yield of a brush of the bile duct. However, about 15% of patients with suspected pCCA are found to have a benign diagnosis after resection...
March 6, 2019: Liver International: Official Journal of the International Association for the Study of the Liver
Yutaro Kikuchi, Ryusei Matuyama, Yukihiko Hiroshima, Takashi Murakami, Michael Bouvet, Daisuke Morioka, Robert M Hoffman, Itaru Endo
BACKGROUND: We sought to expand the clinico-anatomical limit of the proximal ductal margin (Limit-PDM) for resectability of hilar cholangiocarcinoma (HCCA). METHODS: The practical boundary of the hilar plate (PBHP) was defined as the location where the bile duct (BD) could not be isolated by dissection. The distance between PBHP and 2 well-known clinical landmarks of Limit-PDM, the right edge of the bifurcation of the anterior and posterior branch of the right portal vein (Posterior-Landmark) and the left edge of the umbilical portion of the portal vein (Left-Landmark), and histological features around the PBHP were assessed using 55 adult cadaver livers...
March 2, 2019: Journal of Hepato-biliary-pancreatic Sciences
Lorenz Biggemann, Johannes Uhlig, Ulrike Streit, Henrik Sack, Xiao Chao Guo, Carlo Jung, Saheeb Ahmed, Joachim Lotz, Rene Müller-Wille, Ali Seif Amir Hosseini
PURPOSE: To compare the efficacy of right portal vein embolization using ethylene vinyl alcohol (EVOH-PVE) compared to other embolic agents and surgical right portal vein ligation (PVL). MATERIAL AND METHODS: Patients with right sided liver malignancies scheduled for extensive surgery and receiving induction of liver hypertrophy via right portal vein embolization/ligature between 2010-2016 were retrospectively evaluated. Treatments included were ethylene vinyl alcohol copolymer (Onyx®, EVOH-PVE), ethiodized oil (Lipiodol® , Lipiodol/PVA-PVE), polyvinyl alcohol (PVA-PVE) or surgical ligature (PVL)...
March 1, 2019: Minimally Invasive Therapy & Allied Technologies: MITAT
Andrea Ruzzenente, Simone Conci, Luca Viganò, Giorgio Ercolani, Serena Manfreda, Fabio Bagante, Andrea Ciangherotti, Corrado Pedrazzani, Antonio D Pinna, Calogero Iacono, Guido Torzilli, Alfredo Guglielmi
BACKGROUND AND AIMS: The role of lymph node dissection (LND) in patients with small intrahepatic cholangiocarcinoma (ICC) is still under debate. The aims of this study were to compare the lymph node (LN) status and its correlation with survival among patients with ICC stratified by tumor size. METHODS: A retrospective analysis of a multi-institutional series of 259 patients undergoing curative-intent surgery was carried out. Patients were stratified into Small-ICC (≤ 3 cm) and Large-ICC (> 3 cm) based on tumor size...
February 28, 2019: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
Jiakun Wang, Enliang Li, Hao Yang, Junjun Wu, Hong Cheng Lu, Chenhao Yi, Jun Lei, Wenjun Liao, Linquan Wu
BACKGROUND: The purpose of this study was to explore trends in incidence, incidence-based (IB) mortality, and survival for combined hepatocellular-cholangiocarcinoma (cHCC-CC) utilizing a population-based database to attract people's attention to this disease. METHODS: The Surveillance, Epidemiology, and End Results (SEER) database was utilized to investigate the incidence and IB mortality for cHCC-CC from 2000 to 2014. Trends in age-adjusted incidence and IB mortality were characterized by the Joinpoint Regression program...
February 27, 2019: World Journal of Surgical Oncology
Chaobin He, Yu Zhang, Zhiyuan Cai, Xiaojun Lin
BACKGROUND: Our objective was to identify risk factors affecting overall survival (OS) and cancer-specific survival (CSS) and build nomograms to predict survival based on a large population-based cohort. METHODS: Two hundred and thirty patients diagnosed with CHCC between 2004 and 2015 were retrospectively extracted from the Surveillance, Epidemiology, and End Results (SEER) database as a training cohort. In addition, Ninety-nine patients diagnosed with CHCC between 2000 and 2017 were retrospectively extracted from Sun Yat-Sen University Cancer Center (SYSUCC) as an external validation...
February 27, 2019: BMC Cancer
Ying Wu, Danyang Zhou, Guoping Zhang, Fengming Yi, Long Feng
Aims: Although prognostic markers are important to establish therapeutic strategies in patients for conducting radical resection of cholangiocarcinoma (CCA), there is still a lack of simple, valid, and repeatable markers in clinical settings. We aim to evaluate the prognostic value of the preoperative serum platelet-lymphocyte ratio (PLR) in CCA patients who underwent radical resection. Methods: We retrospectively analyzed CCA patients who underwent radical resection surgery in our institution from January 2011 to June 2016...
2019: Gastroenterology Research and Practice
Iswanto Sucandy, Sydni Schlosser, Timothy Bourdeau, Janelle Spence, Abdelrahman Attili, Sharona Ross, Alexander Rosemurgy
Minimally invasive hepatectomy for benign and malignant liver lesions has gained popularity in the past decade due to improved perioperative outcomes when compared to conventional 'open' technique. We aim to investigate our initial experience of robotic hepatectomy undertaken in our hepatobiliary program. All patients undergoing robotic hepatectomy between 2013 and 2018 were prospectively followed. Data are presented as median (mean ± SD). A total of 80 patients underwent robotic hepatectomy within the study period...
February 23, 2019: Journal of Robotic Surgery
Yuki Kitano, Yo-Ichi Yamashita, Shigeki Nakagawa, Hirohisa Okabe, Katsunori Imai, Akira Chikamoto, Hideo Baba
BACKGROUND: In this study, we reviewed our experiences and previous studies on surgery for recurrent cholangiocarcinoma (CCA). METHODS: We analyzed outcomes of 117 patients with recurrent CCA between 2000 and 2015. Twenty-one patients (17.9%) underwent surgical resection for recurrence, and the remaining 96 patients (82.1%) did not undergo resection. We evaluated patients' clinicopathological features and prognoses between the two groups. RESULTS: Patients who underwent surgery were significantly associated with better overall survival after recurrence (HR = 0...
February 12, 2019: American Journal of Surgery
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
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
Mohammed Alnaggar, Yan Xu, Jingxia Li, Junyi He, Jibing Chen, Man Li, Qingling Wu, Li Lin, Yingqing Liang, Xiaohua Wang, Jiawei Li, Yi Hu, Yan Chen, Kecheng Xu, Yangzhe Wu, Zhinan Yin
BACKGROUND: Cholangiocarcinoma (CCA) is a highly aggressive and fatal tumor. CCA occurs in the epithelial cells of bile ducts. Due to increasing incidences, CCA accounts for 3% of all gastrointestinal malignancies. In addition to comprehensive treatments for cancer, such as surgery, chemotherapy, and radiotherapy, during the past few years, cellular immunotherapy has played an increasingly important role. As a result of our research, we have discovered the γδ T cell-based immunotherapy for CCA...
February 8, 2019: Journal for Immunotherapy of Cancer
Bing-Jie Lu, Xue-Dong Cao, Nong Yuan, Ning-Ning Liu, Nisma L Azami, Ming-Yu Sun
BACKGROUND: Infiltrative adenosquamous carcinoma (ASC) of the extrahepatic bile duct is reported infrequently, which is an unusual variant of the ordinary adenocarcinoma. The simultaneous development of ASC and cystadenocarcinoma in the extrahepatic biliary tree is rare. In addition, the accurate preoperative diagnosis of concomitant carcinoma in the multiple biliary trees at an early stage is often difficult. Thus, awareness of the risk of the multiplicity of biliary tumors is perhaps the most important factor in identifying these cases...
January 26, 2019: World Journal of Clinical Cases
Petko Karagyozov, Irina Boeva, Ivan Tishkov
Due to the need for improvement in the diagnosis and minimally invasive therapy of the bile duct disorders new technologies for cholangioscopy have been recently developed. Per-oral cholangioscopy has become an important diagnostic and therapeutic tool leading to avoidance of aggressive and unnecessary surgery in many clinical scenarios. This paper focuses on the newly developed SpyGlass DS technology, its advantages, and the technique of single-operator cholangioscopy (SOC), biliary indications and possible adverse events...
January 16, 2019: World Journal of Gastrointestinal Endoscopy
Charlotte Maulat, Léopoldine Lapierre, Isabelle Migueres, Xavier Chaufour, Guillaume Martin-Blondel, Fabrice Muscari
BACKGROUND: Caval vein thrombosis after hepatectomy is rare, although it increases mortality and morbidity. The evolution of this thrombosis into a septic thrombophlebitis responsible for persistent septicaemia after a hepatectomy has not been reported to date in the literature. We here report the management of a 54-year-old woman operated for a peripheral cholangiocarcinoma who developed a suppurated thrombophlebitis of the vena cava following a hepatectomy. CASE SUMMARY: This patient was operated by left lobectomy extended to segment V with bile duct resection and Roux-en-Y hepaticojejunostomy...
January 27, 2019: World Journal of Hepatology
Ka Wing Ma, Tan To Cheung, Brian Leung, Brian Wong Hoi She, Kenneth Siu Ho Chok, Albert Chi Yan Chan, Wing Chiu Dai, Chung Mau Lo
OBJECTIVE: To define the role of adjuvant chemotherapy in the management of resectable intrahepatic cholangiocarcinoma (ICC) by performing a meta-analysis. SUMMARY BACKGROUND DATA: Oncological benefit of adjuvant chemotherapy in resectable ICC remains controversial, high-level evidence in such context is lacking. METHOD: A comprehensive search using Pubmed, EMbase, and Web of Science was performed from inception to October 2018. Studies compared the survival of patients receiving adjuvant chemotherapy versus surgery alone were included...
February 2019: Medicine (Baltimore)
Johannes Uhlig, Cortlandt M Sellers, Charles Cha, Sajid A Khan, Jill Lacy, Stacey M Stein, Hyun S Kim
OBJECTIVE: The aim of this study was to evaluate socioeconomic discrepancies in current treatment approaches and survival trends among patients with intrahepatic cholangiocarcinoma (ICC). METHODS: The 2004-2015 National Cancer Database was retrospectively analyzed for histopathologically proven ICC. Treatment predictors were evaluated using multinomial logistic regression and overall survival via multivariable Cox models. RESULTS: Overall, 12,837 ICC patients were included...
January 28, 2019: Annals of Surgical Oncology
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