Jin-Xing Zhang, Ye Ding, Hai-Tao Yan, Chun-Gao Zhou, Jin Liu, Sheng Liu, Qing-Quan Zu, Hai-Bin Shi
BACKGROUND: Sarcopenia is emerging as a prognostic factor in patients with malignant diseases. The prognostication of perihilar cholangiocarcinoma (PHC) with obstructive jaundice was complex, because these patients suffered compete mortality events beyond cancer itself. Our study was to investigate the association between low skeletal-muscle index and overall survival (OS) after percutaneous transhepatic biliary drainage (PTBD) for obstructive jaundice due to PHC. METHODS: We performed a retrospective survival analysis of patients undergoing PTBD for PHC-related obstructive jaundice between January 2016 and March 2019...
October 22, 2020: Surgical Endoscopy
Junichi Yoshikawa, Yutaro Kato, Atsushi Sugioka, Ichiro Uyama
BACKGROUND: In an increasing number of patients undergoing radical surgery for perihilar cholangiocarcinoma [1-3], the intrahepatic bile duct is conventionally transected after the vessels to be preserved or reconstructed are confirmed [3,4]. In patients with extremely advanced perihilar cholangiocarcinoma having massive vascular involvement, it is sometimes difficult to confirm the vessels for reconstruction because of restricted working space and/or anatomical variants, even after liver parenchymal dissection [4]...
October 13, 2020: Surgical Oncology
Nobuhito Nitta, Katsuhisa Ohgi, Teiichi Sugiura, Yukiyasu Okamura, Takaaki Ito, Yusuke Yamamoto, Ryo Ashida, Shimpei Otsuka, Keiko Sasaki, Katsuhiko Uesaka
BACKGROUND: Surgical resection in patients with extrahepatic cholangiocarcinoma (EHCC) with paraaortic lymph node metastasis (PALNM) remains controversial. The objective of this study was to investigate the prognostic impact of PALNM in resected EHCC. METHODS: The present retrospective study included 410 patients, including 16 patients with PALNM, who underwent surgical resection of EHCC between September 2002 and December 2018. These were compared to 9 patients in whom EHCC was not resected due to PALNM...
October 20, 2020: World Journal of Surgery
Ali Belkouz, Lynn E Nooijen, Hanae Riady, Lotte C Franken, Martijn G H van Oijen, Cornelis J A Punt, Joris I Erdmann, Heinz-Josef Klümpen
BACKGROUND: According to international guidelines, induction therapy may be considered in selected patients with initially unresectable locally advanced cholangiocarcinoma. The criteria for (un)resectability in cholangiocarcinoma varies between studies and no consensus-based agreement is available about these criteria. By performing a systematic literature review, we aimed to investigate the efficacy and safety of systemic induction therapy in initially unresectable locally advanced perihilar (pCCA) and intrahepatic cholangiocarcinoma (iCCA) and summarize resectability criteria used across studies...
October 6, 2020: Cancer Treatment Reviews
L C Franken, F A Vuijk, E C Soer, E Roos, J I Erdmann, G K J Hooijer, A L Vahrmeijer, S S Gambhir, T M van Gulik, A Farina Sarasqueta, J Verheij, R J Swijnenburg
BACKGROUND: Approximately 15% of patients undergoing resection for presumed perihilar cholangiocarcinoma (PHC) have benign disease at final pathological assessment. Molecular imaging targeting tumor-specific biomarkers could serve as a novel diagnostic tool to reduce these futile surgeries. Imaging agents have been developed, selectively binding integrin αν β6, a cell receptor upregulated in pancreatobiliary malignancies, for both (preoperative) PET and (intraoperative) fluorescent imaging...
September 30, 2020: European Journal of Surgical Oncology
Satoshi Nara, Minoru Esaki, Daisuke Ban, Takeshi Takamoto, Kazuaki Shimada, Tatsuya Ioka, Takuji Okusaka, Hiroshi Ishii, Junji Furuse
Cancer originating in the biliary tract can be classified as bile duct cancer (cholangiocarcinoma), gallbladder cancer, or ampullary cancer. Bile duct cancer is further divided to intrahepatic, perihilar and distal bile duct subtypes according to the anatomical location of the tumor. The biological characteristics of each tumor are heterogeneous. However, because of the rarity of each disease, the efficacy of new drugs has been tested in groups of patients with different biliary tract cancers. In patients with metastatic or recurrent biliary tract cancer, recent randomized clinical trials revealed the non-inferiority of gemcitabine + S-1 and the superiority of gemcitabine + cisplatin + S-1 compared with gemcitabine + cisplatin in terms of overall survival, thereby establishing a new standard treatment...
October 10, 2020: Japanese Journal of Clinical Oncology
Shaun Selvadurai, Kulbir Mann, Sanjena Mithra, John Bridgewater, Hassan Malik, Shahid A Khan
INTRODUCTION: Cholangiocarcinoma (CCA) are sub-divided into intrahepatic (iCCA) or extrahepatic (eCCA). eCCA are further subdivided into perihilar (pCCA) and distal (dCCA). Current and previous versions of the WHO International Coding of Disease and Oncology classifications (ICD) have separate topography codes for iCCA and eCCA, but none for pCCA. Over recent decades, multiple studies report rising incidence rates of iCCA with declining rates of eCCA, without reference to pCCA. We hypothesised the lack of a specific code for pCCA has led to errors CCA coding, specifically with miscoding of pCCA as iCCA...
October 1, 2020: European Journal of Surgical Oncology
V Schembri, L Piron, J Le Roy, M Hermida, J Lonjon, L Escal, M-A Pierredon, A Belgour, C Cassinotto, B Guiu
PURPOSE: The purpose of this study was to evaluate the feasibility, safety and efficacy of percutaneous ablation (PA) of obscure hypovascular liver tumors in challenging locations using arterial CT-portography (ACP) guidance. MATERIALS AND METHODS: A total of 26 patients with a total of 28 obscure, hypovascular malignant liver tumors were included. There were 18 men and 6 women with a mean age of 58±14 (SD) years (range: 37-75 years). The tumors had a mean diameter of 14±10 (SD) mm (range: 7-24mm) and were intrahepatic cholangiocarcinoma (4/28; 14%), liver metastases from colon cancer (18/28; 64%), corticosurrenaloma (3/28; 11%) or liver metastases from breast cancer (3/28; 11%)...
October 1, 2020: Diagnostic and Interventional Imaging
Hans-Michael Hau, Felix Meyer, Nora Jahn, Sebastian Rademacher, Robert Sucher, Daniel Seehofer
OBJECTIVES: In our study, we evaluated and compared the prognostic value and performance of the 6th, 7th, and 8th editions of the American Joint Committee on Cancer (AJCC) staging system in patients undergoing surgery for perihilar cholangiocarcinoma (PHC). METHODS: Patients undergoing liver surgery with curative intention for PHC between 2002 and 2019 were identified from a prospective database. Histopathological parameters and stage of the PHC were assessed according to the 6th, 7th, and 8th editions of the tumor node metastasis (TNM) classification...
September 29, 2020: Journal of Clinical Medicine
Robert Sucher, Daniel Seehofer
No abstract text is available yet for this article.
October 1, 2020: Annals of Surgical Oncology
Robert Sucher, Uwe Scheuermann, Daniel Seehofer
BACKGROUND: Laparoscopic liver resection for perihilar cholangiocarcinoma (pCCA) is still in its infancy. The biliary-enteric reconstruction represents one of the most delicate parts of this minimally invasive procedure. METHODS: In this study, a 78-year old woman with perihilar cholangiocarcinoma (pCCA) type 3b underwent a hepaticojejunostomy performed by a parachute technique. RESULTS: The operation, performed totally by minimally invasive resections, was completed in 386 min, with a blood loss of less than 400 ml and no transfusion requirements...
September 30, 2020: Annals of Surgical Oncology
Yu-Chan Chang, Ming-Huang Chen, Chun-Nan Yeh, Michael Hsiao
Cholangiocarcinoma (CCA) has been identified as a highly malignant cancer that can be transformed from epithelial cells of the bile duct, including intrahepatic, perihilar and extrahepatic. High-resolution imaging tools (abdominal ultrasound, computed tomography and percutaneous transhepatic cholangial drainage) are recruited for diagnosis. However, the lack of early diagnostic biomarkers and treatment evaluation can lead to serious outcomes and poor prognosis (i.e., CA19-9, MUC5AC). In recent years, scientists have established a large number of omics profiles to reveal underlying mechanisms and networks (i...
September 28, 2020: Biomolecules
Lorenzo Nevi, Sabina Di Matteo, Guido Carpino, Ilaria Zizzari, Samira Safarikia, Valeria Ambrosino, Daniele Costantini, Diletta Overi, Antonella Giancotti, Marco Monti, Daniela Bosco, Valerio De Peppo, Andrea Oddi, Agostino Maria De Rose, Fabio Melandro, Maria Consiglia Bragazzi, Jessica Faccioli, Sara Massironi, Gian Luca Grazi, Pierluigi Benedetti Panici, Paquale Bartomeo Berloco, Felice Giuliante, Vincenzo Cardinale, Pietro Invernizzi, Giuseppina Caretti, Eugenio Gaudio, Domenico Alvaro
BACKGROUND & AIMS: Cholangiocarcinoma (CCA) is a very aggressive cancer showing high cancer stem cells (CSCs) presence. Doublecortin-like kinase1 (DCLK1) has been demonstrated as a CSC marker in different gastroenterological solid tumours. Our aim was to evaluate in vitro the expression and the biological function of DCLK1 in intrahepatic CCA (iCCA) and perihilar CCA (pCCA). APPROACH & RESULTS: Specimens surgically resected of human CCA were enzymatically digested, submitted to immunosorting for specific CSC markers (LGR5, CD90, EpCAM, CD133, CD13) and primary cell cultures were prepared...
September 25, 2020: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
Takashi Mizuno, Tomoki Ebata, Yukihiro Yokoyama, Tsuyoshi Igami, Junpei Yamaguchi, Shunsuke Onoe, Nobuyuki Watanabe, Yuzuru Kamei, Masato Nagino
OBJECTIVE: To evaluate the efficacy and safety of combined vascular resection (VR) in advanced perihilar cholangiocarcinoma (PHC). SUMMARY OF BACKGROUND DATA: Hepatectomy combined with portal vein resection (PVR) and/or hepatic artery resection (HAR) is technically demanding but an option only for tumor eradication against PHC involving the hilar hepatic inflow vessels; however, its efficacy and safety have not been well evaluated. METHODS: Patients diagnosed with PHC during 2001-2018 were included...
September 24, 2020: Annals of Surgery
John E Eaton, Christopher L Welle, Zeinab Bakhshi, Shannon P Sheedy, Ilkay S Idilman, Gregory J Gores, Charles B Rosen, Julie K Heimbach, Timucin Taner, Denise M Harnois, Keith D Lindor, Nicholas F LaRusso, Andrea A Gossard, Konstantinos N Lazaridis, Sudhakar K Venkatesh
BACKGROUND & AIMS: Early detection of perihilar cholangiocarcinoma (CCA) among patients with primary sclerosing cholangitis (PSC) is important to identify more people eligible for curative therapy. While many recommend CCA screening, there are divergent opinions and limited data regarding the use of ultrasound or magnetic resonance imaging (MRI) for early CCA detection and it is unknown if there is benefit in testing asymptomatic individuals. Our aims were to assess the diagnostic performances and prognostic implications of ultrasound and MRI based CCA detection...
September 25, 2020: Hepatology: Official Journal of the American Association for the Study of Liver Diseases
Hirokazu Okada, Norimitsu Uza, Tomoaki Matsumori, Shimpei Matsumoto, Yuya Muramoto, Sakiko Ota, Takeharu Nakamura, Hiroyuki Yoshida, Tomonori Hirano, Takeshi Kuwada, Saiko Marui, Yuko Sogabe, Toshihiro Morita, Nobuyuki Kakiuchi, Atsushi Mima, Tatsuki Ueda, Yoshihiro Nishikawa, Motoyuki Tsuda, Takahisa Maruno, Masahiro Shiokawa, Ken Takahashi, Kojiro Taura, Sachiko Minamiguchi, Yuzo Kodama, Hiroshi Seno
BACKGROUND : Accurate preoperative assessment of the longitudinal extension of perihilar cholangiocarcinoma (PHCC) is essential for treatment planning. Mapping biopsies for PHCC remain challenging owing to technical difficulties and insufficient sample amounts. The aim of this study was to investigate the usefulness of a novel technique for mapping biopsies of PHCC. METHODS : Our novel method focused on a biliary stent delivery system for mapping biopsies. Fifty patients with PHCC undergoing endoscopic transpapillary mapping biopsy using the novel method were reviewed from August 2015 to June 2019...
September 22, 2020: Endoscopy
Shunsuke Uno, Tatsuki R Kataoka, Hideaki Okajima, Kojiro Taura, Takaki Sakurai, Hironori Haga
Kasai operation is widely performed for biliary atresia (BA), as it improves the prognosis. Biliary tract cancer has rarely been reported as a complication after Kasai operation. A 17-year-old man underwent liver transplantation for progressive jaundice and liver dysfunction after Kasai operation for BA. A macroscopic examination of the explanted liver revealed a 3.6-cm-diameter mass in the hilus of the explanted liver. The tumor consisted of an atypical proliferation of glandular cells in the collagenous stroma...
September 16, 2020: Pathology International
Yoshitsugu Nakanishi, Mitsunobu Oba, Satoshi Hirano
No abstract text is available yet for this article.
September 15, 2020: Annals of Surgical Oncology
Raluca Maria Fostea, Elisa Fontana, Gonzalo Torga, Hendrik-Tobias Arkenau
Cholangiocarcinomas (CCAs) comprise of a heterogeneous group of cancers arising in the biliary tract (intrahepatic or iCCA, perihilar or pCCA and distal or dCCA; the latter are known under the collective term of eCCA), each subtype having its own particularities in carcinogenesis, management and prognosis. The increasing incidence in recent decades, limited treatment options and high mortality rates, even in the early stages, have led to an imperious need for more in-depth understanding and development of tailored treatments for this type of aggressive tumour...
September 11, 2020: Cancers
Jaynee J A Vugts, Marcia P Gaspersz, Eva Roos, Lotte F Franken, Pim B Olthof, Robert J S Coelen, Jeroen L A van Vugt, Tim A Labeur, Lieke Brouwer, Marc G H Besselink, Jan N M IJzermans, Sarwa Darwish Murad, Thomas M van Gulik, Jeroen de Jonge, Wojciech G Polak, Olivier R C Busch, Joris L Erdmann, Bas Groot Koerkamp, Stefan Buettner
BACKGROUND: Liver transplantation (LT) has been performed in a select group of patients presenting with unresectable or primary sclerosing cholangitis (PSC)-associated perihilar cholangiocarcinoma (pCCA) in the Mayo Clinic with a reported 5-year overall survival (OS) of 53% on intention-to-treat analysis. The objective of this study was to estimate eligibility for LT in a cohort of pCCA patients in two tertiary referral centers. METHODS: Patients diagnosed with pCCA between 2002 and 2014 were included from two tertiary referral centers in the Netherlands...
September 8, 2020: Annals of Surgical Oncology
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