Science Centric But the team is the first to apply it to breast cancer. Trials are also underway with PDT for prostate and bile duct and pancreatic cancer. ... and more » |
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Google - Bile Duct Cancer
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Light therapy offers new hope for breast cancer patients - Science Centric
Posted: July 1st, 2009, 12:03pm EDT
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Gastrointestinal Health Specialists - Geneva Sun
Posted: July 1st, 2009, 3:01am EDT
Gastrointestinal Health Specialists
Geneva Sun
Mullick is among the 5 percent of doctors in Illinois who have received 7th-year training in ERCP and EUS (procedures on bile ducts for removal of stones ...
and more » -
This wonderful doc... - HardNews Magazine
Posted: July 1st, 2009, 1:33am EDT
This wonderful doc...
HardNews Magazine
Emerging from anaesthesia after getting a blocked bile duct cleared this April, one of his first questions was about the Indian elections. ...
and more » -
Gastrointestinal Endoscopy June Issue Study Highlights - Medical News Today (press release)
Posted: July 1st, 2009, 1:04am EDT
Gastrointestinal Endoscopy June Issue Study Highlights
Medical News Today (press release)
EUS can also be used to diagnose diseases of the pancreas, bile duct, and gallbladder when other tests are inconclusive, and can be used to determine the ...
and more » -
Did Steve Jobs Liver Transplant show the power of the rich? - MINA
Posted: June 30th, 2009, 3:22pm EDT
MINADid Steve Jobs Liver Transplant show the power of the rich?
MINA
... said a less common scenario would be that Jobs' earlier surgery resulted in scarring or blockage of bile ducts, causing liver damage. ...
and more » -
Former refugee center head Sessler dies - Utica Observer Dispatch
Posted: June 30th, 2009, 3:15pm EDT
Former refugee center head Sessler dies
Utica Observer Dispatch
Harriet Sessler said her husband was diagnosed with bile duct cancer in February. The rare disease affects only 3000 to 4000 people annually in the United ...
and more » -
Allen County official backed new civic center - Toledo Blade
Posted: June 30th, 2009, 12:31pm EDT
Allen County official backed new civic center
Toledo Blade
LIMA, Ohio - Crit Akers, 73, the Allen County administrator for a decade who championed construction of a civic-convention center, died of bile duct cancer ...
and more » -
Light therapy offers 'non-invasive' treatment for breast cancer - Telegraph.co.uk
Posted: June 30th, 2009, 12:05am EDT
Telegraph.co.ukLight therapy offers 'non-invasive' treatment for breast cancer
Telegraph.co.uk
But the team is the first to apply it to breast cancer. Trials are also under way with PDT for prostate and bile duct and pancreatic cancer. ...
and more » -
Last updated at 1:46 AM on 30th June 2009 - Daily Mail
Posted: June 29th, 2009, 8:13pm EDT
Daily MailLast updated at 1:46 AM on 30th June 2009
Daily Mail
PDT trials are already underway for cancers of the prostate, bile duct and pancreas. Around 46000 women are diagnosed with breast cancer each year in the UK ...
and more » -
Can a blast of light really kill breast cancer? - Mail on Sunday
Posted: June 29th, 2009, 5:10pm EDT
Can a blast of light really kill breast cancer?
Mail on Sunday
PDT trials are already underway for cancers of the prostate, bile duct and pancreas. Around 46000 women are diagnosed with breast cancer each year in the UK ...
and more » -
Tech That Could Save Your Life - MSN Indonesia
Posted: June 29th, 2009, 1:34pm EDT
MSN IndonesiaTech That Could Save Your Life
MSN Indonesia
It's especially useful in getting into tiny bile ducts, he adds. The only catch: The procedure is approved for use in the US but isn't yet covered by US ...
and more » -
UNC student climbs mountains for the cure - The Herald-Sun
Posted: June 29th, 2009, 10:51pm EDT
UNC student climbs mountains for the cure
The Herald-Sun
It's an issue that hits close to home for Newsome: his grandmother, Sherry Townsend, was diagnosed with bile duct cancer in 2000 and was given a 2 percent ...
and more » -
Canfield Cancer Benefit - WYTV
Posted: June 28th, 2009, 4:26pm EDT
Canfield Cancer Benefit
WYTV
He has been unable to work the past few months after being diagnosed with bile-duct cancer. Sunday afternoon, people packed into Canfield High School for a ...
and more » -
A public tarring in Saudi Canada - Toronto Star
Posted: June 28th, 2009, 2:31am EDT
A public tarring in Saudi Canada
Toronto Star
In 2006, he raised some questions about the increasing number of rare blood, lymphoma and bile-duct cancers appearing in his patients. ...
and more » -
Jorgenson keeps up the good fight - Williston Daily Herald
Posted: June 27th, 2009, 9:23pm EDT
Jorgenson keeps up the good fight
Williston Daily Herald
On March 15, 2006, doctors there diagnosed her with bile-duct cancer, meaning there was a tumor on the duct to her liver. Jorgenson's life was topsy-turvy ...
and more » -
Spaghetti dinner to benefit family - Youngstown Vindicator
Posted: June 27th, 2009, 10:45pm EDT
Spaghetti dinner to benefit family
Youngstown Vindicator
The Schrums sought a second opinion in Pittsburgh and had a 10-hour surgery to remove the tumor as well as his bile duct, gallbladder and half of his liver. ...
and more » -
Tech That Could Save Your Life - Forbes
Posted: June 26th, 2009, 4:03pm EDT
Tech That Could Save Your Life
Forbes
It's especially useful in getting into tiny bile ducts, he adds. The only catch: The procedure is approved for use in the US but isn't yet covered by US ...
and more » -
Benefit dinner in Canfield will help family with expenses - Youngstown Vindicator
Posted: June 26th, 2009, 10:35am EDT
Benefit dinner in Canfield will help family with expenses
Youngstown Vindicator
... school district bus drivers will have a benefit spaghetti dinner for a driver's husband, Jeff Schrum, diagnosed with a rare form of bile duct cancer. ...
and more » -
Jobs' liver transplant shows money can make a difference - USA Today
Posted: June 25th, 2009, 6:16pm EDT
Jobs' liver transplant shows money can make a difference
USA Today
... said a less common scenario would be that Jobs' earlier surgery resulted in scarring or blockage of bile ducts, causing liver damage. ...
and more » -
Gatemen to host 'Pan-Mass Challenge Night' - Wareham Courier
Posted: June 25th, 2009, 5:59pm EDT
Gatemen to host 'Pan-Mass Challenge Night'
Wareham Courier
... of the famed '50/50' raffle funds to the PMC in honor of longtime GatemenPresident/GM John Wylde, who died from liver bile duct cancer in February. ...
and more » -
Memories of Payton run strong - Fort Wayne Journal Gazette
Posted: June 25th, 2009, 1:40am EDT
Memories of Payton run strong
Fort Wayne Journal Gazette
... feel good a lot of days, as the affliction that killed him – primary schlerosing cholangitis, a disease of the bile ducts – slowly hollowed him out. ...
and more » -
Jobs' liver transplant shows power of the rich - KSL-TV
Posted: June 24th, 2009, 8:04pm EDT
Jobs' liver transplant shows power of the rich
KSL-TV, UT
... that Jobs' earlier surgery resulted in scarring or blockage of bile ducts, causing liver damage. But he said Jobs' doctors would have known to watch for and treat that, and he agreed that it's much more likely Jobs' cancer had spread to the liver. ... -
Jobs' liver transplant shows power of the rich - Mid Columbia Tri City Herald
Posted: June 24th, 2009, 8:02pm EDT
Jobs' liver transplant shows power of the rich
Mid Columbia Tri City Herald, WA
... that Jobs' earlier surgery resulted in scarring or blockage of bile ducts, causing liver damage. But he said Jobs' doctors would have known to watch for and treat that, and he agreed that it's much more likely Jobs' cancer had spread to the liver. ... -
Jobs' liver transplant shows power of the rich - nwitimes.com
Posted: June 24th, 2009, 6:07pm EDT
Jobs' liver transplant shows power of the rich
nwitimes.com, IN
... that Jobs' earlier surgery resulted in scarring or blockage of bile ducts, causing liver damage. But he said Jobs' doctors would have known to watch for and treat that, and he agreed that it's much more likely Jobs' cancer had spread to the liver. ... -
Jobs' liver transplant shows power of the rich - News Channel 8
Posted: June 24th, 2009, 5:44pm EDT
Jobs' liver transplant shows power of the rich
News Channel 8, DC
... that Jobs' earlier surgery resulted in scarring or blockage of bile ducts, causing liver damage. But he said Jobs' doctors would have known to watch for and treat that, and he agreed that it's much more likely Jobs' cancer had spread to the liver. ... -
Jobs' liver transplant shows power of the rich - WJLA
Posted: June 24th, 2009, 5:41pm EDT
Jobs' liver transplant shows power of the rich
WJLA, DC
... that Jobs' earlier surgery resulted in scarring or blockage of bile ducts, causing liver damage. But he said Jobs' doctors would have known to watch for and treat that, and he agreed that it's much more likely Jobs' cancer had spread to the liver. ... -
Jobs' liver transplant shows power of the rich - Maximum Edge
Posted: June 24th, 2009, 5:33pm EDT
Jobs' liver transplant shows power of the rich
Maximum Edge, Canada
... that Jobs' earlier surgery resulted in scarring or blockage of bile ducts, causing liver damage. But he said Jobs' doctors would have known to watch for and treat that, and he agreed that it's much more likely Jobs' cancer had spread to the liver. ... -
Jobs' liver transplant shows power of the rich - Longview Daily News
Posted: June 24th, 2009, 5:01pm EDT
Jobs' liver transplant shows power of the rich
Longview Daily News, WA
... that Jobs' earlier surgery resulted in scarring or blockage of bile ducts, causing liver damage. But he said Jobs' doctors would have known to watch for and treat that, and he agreed that it's much more likely Jobs' cancer had spread to the liver. ... -
Jobs' liver transplant shows power of the rich - Waterloo Cedar Falls Courier
Posted: June 24th, 2009, 4:43pm EDT
Jobs' liver transplant shows power of the rich
Waterloo Cedar Falls Courier, IA
... that Jobs' earlier surgery resulted in scarring or blockage of bile ducts, causing liver damage. But he said Jobs' doctors would have known to watch for and treat that, and he agreed that it's much more likely Jobs' cancer had spread to the liver. ... -
Jobs' liver transplant shows power of the rich - Jefferson City News Tribune
Posted: June 24th, 2009, 4:12pm EDT
Jobs' liver transplant shows power of the rich
Jefferson City News Tribune, MO
... that Jobs' earlier surgery resulted in scarring or blockage of bile ducts, causing liver damage. But he said Jobs' doctors would have known to watch for and treat that, and he agreed that it's much more likely Jobs' cancer had spread to the liver. ... -
Jobs' liver transplant shows power of the rich - Lincoln Journal Star
Posted: June 24th, 2009, 3:38pm EDT
Jobs' liver transplant shows power of the rich
Lincoln Journal Star, Nebraska
... that Jobs' earlier surgery resulted in scarring or blockage of bile ducts, causing liver damage. But he said Jobs' doctors would have known to watch for and treat that, and he agreed that it's much more likely Jobs' cancer had spread to the liver. ... -
Jobs' liver transplant shows power of the rich - The Associated Press
Posted: June 24th, 2009, 2:12pm EDT
ABC NewsJobs' liver transplant shows power of the rich
The Associated Press
... said a less common scenario would be that Jobs' earlier surgery resulted in scarring or blockage of bile ducts, causing liver damage. ...
Jobs's Tumor Is Rare Reason for Liver Transplant, Doctors SayBloomberg
What I need to know about Liver TransplantationFood Consumer
Inside Steve Jobs' liver transplantCNNMoney.com
all 3,333 news articles » -
Baby Cruse on road to recovery - Reporter-Times
Posted: June 23rd, 2009, 8:54am EDT
Baby Cruse on road to recovery
Reporter-Times, IN
It's a disease which affects the ducts between the liver and the intestine. Those ducts are either not there, or not thick enough. Carah and her husband Josh started doing research, gathering as much information as they could about their baby's ... -
Jobs's Tumor Is Rare Reason for Liver Transplant, Doctors Say - Bloomberg
Posted: June 22nd, 2009, 11:23pm EDT
ABC NewsJobs's Tumor Is Rare Reason for Liver Transplant, Doctors Say
Bloomberg
Klug had needed a new liver because of a rare degenerative condition of the bile duct. “It's a pretty standard procedure now,” Lo said June 20 in a ...
What I need to know about Liver TransplantationFood Consumer
Inside Steve Jobs' liver transplantCNNMoney.com
all 3,333 news articles » -
A gentle death - Columbia Daily Tribune
Posted: June 21st, 2009, 6:57am EDT
A gentle death
Columbia Daily Tribune, MO
She rejected a permanent metal stent doctors wanted to implant in her liver to relieve a blocked bile duct and chose to continue on with a plastic stent that will only last three months. “I better not last longer than three months,” she quipped. ... -
'We can face death well if we live life well' - Barre Montpelier Times Argus
Posted: June 21st, 2009, 1:50am EDT
'We can face death well if we live life well'
Barre Montpelier Times Argus, VT
In April, after learning his treatments for stage-4 bile duct cancer were not working, Metcalf took a trip to Washington, DC, with his two sons and visited Welch. "I knew what Steve's future was, he knew what his future was, he was very sick," said ... -
Signs of cancer - AsiaOne
Posted: June 20th, 2009, 2:18pm EDT
AsiaOneSigns of cancer
AsiaOne
It was eventually confirmed to be a cancer cell thatoriginated from the bile ducts within the liver. In other words, this was a form of primary liver cancer ...
and more » -
'Hazey's Heroes' cover 130 miles in fund-raising bike challenge - Sunderland Echo
Posted: June 20th, 2009, 1:42am EDT
'Hazey's Heroes' cover 130 miles in fund-raising bike challenge
Sunderland Echo, UK
Dozens of red-and-white shirted cyclists made the journey from Whitehaven to Wearside in honour of Graeme "Hazey" Kerton, a fanatical Sunderland supporter who fell victim to cancer of the bile duct. A total of 42 cyclists made the 130-mile journey ... -
Cheap oil, but at what cost? - Baltimore Sun
Posted: June 20th, 2009, 11:34pm EDT
Cheap oil, but at what cost?
Baltimore Sun
... noticed an alarming cluster of a rare form of bile duct cancer that's occurring at more than 400 times its usual frequency in the general population. ...
and more » -
Former Aces lineman continues fight for life | Randy Beard column - Evansville Courier & Press
Posted: June 20th, 2009, 11:02pm EDT
Former Aces lineman continues fight for life | Randy Beard column
Evansville Courier & Press, IN
They took out his spleen, liver, pancreas, small intestines, stomach and bile duct. They replaced everything but the spleen." Wildeman said that her brother, who is still in intensive care, is now in the critical phase of recovery in terms of any ... -
Survivor celebrates five years without cancer - Park Rapids Enterprise
Posted: June 17th, 2009, 12:49pm EDT
Survivor celebrates five years without cancer
Park Rapids Enterprise, MN
“To me, cancer was very humbling,” she said. “It's difficult to ask people for help.” She doesn't have family around and her husband, Jim, died from bile duct cancer in 1995. Friends were her support system. The stem cell transplant was done at Mayo ... -
Friends, teachers reflect on Steve Metcalf's life - Rutland Herald
Posted: June 13th, 2009, 12:26pm EDT
Friends, teachers reflect on Steve Metcalf's life
Rutland Herald, VT
"He continued to be engaged, literally until the bitter end," said Hollar on Friday, reflecting on the death of Metcalf, who passed away Thursday evening following a short battle with stage-4 bile duct cancer. "We're in the process of making some ... -
Friends, teachers reflect on Steve Metcalf's life - Barre Montpelier Times Argus
Posted: June 13th, 2009, 5:41am EDT
Friends, teachers reflect on Steve Metcalf's life
Barre Montpelier Times Argus, VT
"He continued to be engaged, literally until the bitter end," said Hollar on Friday, reflecting on the death of Metcalf, who passed away Thursday evening following a short battle with stage-4 bile duct cancer. "We're in the process of making some ... -
A mentor and colleague mourned: Friends, teachers reflect on Steve ... - Barre Montpelier Times Argus
Posted: June 13th, 2009, 1:20am EDT
A mentor and colleague mourned: Friends, teachers reflect on Steve ...
Barre Montpelier Times Argus, VT
"He continued to be engaged, literally until the bitter end," said Hollar on Friday, reflecting on the death of Metcalf, who passed away Thursday evening following a short battle with stage-4 bile duct cancer. "We're in the process of making some ... -
Steve Metcalf, former capital city school superintendent, dies - Barre Montpelier Times Argus
Posted: June 12th, 2009, 6:45am EDT
Steve Metcalf, former capital city school superintendent, dies
Barre Montpelier Times Argus
Metcalf, who was diagnosed with stage-4 bile duct cancer, a rare, incurable and inoperable form of the disease, went on medical leave from his post in ...
Friends, teachers reflect on Steve Metcalf's lifeBarre Montpelier Times Argus
all 3 news articles » -
What Is Endoscopy? What Is An Endoscope? - Medical News Today
Posted: June 12th, 2009, 3:00am EDT
What Is Endoscopy? What Is An Endoscope?
Medical News Today, UK
ERCP (endoscopic retrograde cholangio-pancreatography) - examination of the liver, gallbladder, bile ducts, and pancreas. Laparoscopy - a small incision to examine the abdominal cavity. Laryngoscopy - examination of the back of the throat, ... -
Steve Metcalf, former capital city school superintendent, dies - Barre Montpelier Times Argus
Posted: June 12th, 2009, 1:07am EDT
Steve Metcalf, former capital city school superintendent, dies
Barre Montpelier Times Argus, VT
Former Montpelier School Superintendent Steve Metcalf died Thursday at Gifford Medical Center in Randolph of cancer. Metcalf, who was diagnosed with stage-4 bile duct cancer, a rare, incurable and inoperable form of the disease, went on medical leave ... -
DNA Stool Sample Makes For Less Invasive Colon Cancer Test - WDEF News 12
Posted: June 8th, 2009, 10:50am EDT
DNA Stool Sample Makes For Less Invasive Colon Cancer Test
WDEF News 12, TN
So Dr. Ahlquist says this technology may also be an effective screening tool for cancer in other areas of the digestive tract such as the mouth, esophagus, pancreas and bile duct. Dr. Ahlquist's research team is actively exploring these expanded ... -
Youngest to get liver transplant passes away - Pune Newsline
Posted: June 7th, 2009, 5:17pm EDT
Youngest to get liver transplant passes away
Pune Newsline, India
... with the liver but no bile duct. They sold the family's gold and received around Rs 2 lakh in donations that came after Newsline highlighted the family's plight. A month-and-a-half back, Rohit was detected with Burkitts Lymphoma (a type of cancer). ... -
Youngest to get liver transplant passes away - Indian Express
Posted: June 7th, 2009, 2:48pm EDT
Youngest to get liver transplant passes away
Indian Express, India
... with the liver but no bile duct. They sold the family's gold and received around Rs 2 lakh in donations that came after Newsline highlighted the family's plight. A month-and-a-half back, Rohit was detected with Burkitts Lymphoma (a type of cancer). ... -
Steve Jobs Reportedly Returning to Apple This Month - ChattahBox
Posted: June 5th, 2009, 8:16am EDT
Steve Jobs Reportedly Returning to Apple This Month
ChattahBox, MA
... he had been diagnosed with a hormone imbalance which caused him to lose weight. Jobs had a procedure, which involves removing parts of the pancreas, bile duct and small intestine, after he was diagnosed with a rare type of pancreatic cancer in 2004. -
Christie's cancer drug breakthrough - Manchester Evening News
Posted: June 4th, 2009, 10:58pm EDT
Christie's cancer drug breakthrough
Manchester Evening News, UK
"This establishes the combination treatment cisplatin and gemcitabine as an international standard of care for patients with advanced gallbladder and bile duct cancers. "If gallbladder cancer is picked up early, the best treatment is an operation to ... -
Showing lots of love for Locks of Love - Howell Tri Town News
Posted: June 3rd, 2009, 6:52pm EDT
Showing lots of love for Locks of Love
Howell Tri Town News, NJ
Tumors were found in the bile duct of the child's liver and later in her pancreatic duct. Surgery to remove the tumors was required, in addition to the chemotherapy. "We were told the first tumor [in the bile duct] was inoperable," Koehler said. ... -
DOCTOR IS IN: Patrick Swayze has it, but do you understand ... - Atlanta Journal Constitution
Posted: June 3rd, 2009, 3:16pm EDT
Atlanta Journal ConstitutionDOCTOR IS IN: Patrick Swayze has it, but do you understand ...
Atlanta Journal Constitution
Some patients will develop jaundice (yellowing of the skin) as a result of the tumor blocking the duct draining bile from the liver. ...
and more » -
New Tests Spot Tough-to-Detect Cancers Sooner - EmpowHer
Posted: June 3rd, 2009, 1:54pm EDT
New Tests Spot Tough-to-Detect Cancers Sooner
EmpowHer, AZ
The combination of cytology and FISH increased the bile duct and pancreatic cancer detection rate from 20 percent to 43 percent. About 5000 cases of bile duct cancer are diagnosed every year, mostly in people between ages 50 and 70, making it rare, ... -
GI cancers, precancers detectable by tumor-derived DNA mutations ... - HemOncToday
Posted: June 3rd, 2009, 11:48am EDT
GI cancers, precancers detectable by tumor-derived DNA mutations ...
HemOncToday, NJ
Target mutations were detected in stools from 71% of patients with cancer. Cancers detected included oropharyngeal, esophageal, gastric, pancreatic, biliary or gallbladder, and colorectal. Researchers also discovered target mutations in 61% of patients ... -
New Tests Spot Tough-to-Detect Cancers Sooner - Austin American-Statesman
Posted: June 3rd, 2009, 11:15am EDT
New Tests Spot Tough-to-Detect Cancers Sooner
Austin American-Statesman, TX
The combination of cytology and FISH increased the bile duct and pancreatic cancer detection rate from 20 percent to 43 percent. About 5000 cases of bile duct cancer are diagnosed every year, mostly in people between ages 50 and 70, making it rare, ... -
New Tests Spot Tough-to-Detect Cancers Sooner - Atlanta Journal Constitution
Posted: June 3rd, 2009, 11:01am EDT
New Tests Spot Tough-to-Detect Cancers Sooner
Atlanta Journal Constitution, USA
The combination of cytology and FISH increased the bile duct and pancreatic cancer detection rate from 20 percent to 43 percent. About 5000 cases of bile duct cancer are diagnosed every year, mostly in people between ages 50 and 70, making it rare, ... -
New Tests Spot Tough-to-Detect Cancers Sooner - Forbes
Posted: June 3rd, 2009, 10:46am EDT
New Tests Spot Tough-to-Detect Cancers Sooner
Forbes, NY
The combination of cytology and FISH increased the bile duct and pancreatic cancer detection rate from 20 percent to 43 percent. About 5000 cases of bile duct cancer are diagnosed every year, mostly in people between ages 50 and 70, making it rare, ... -
New Tests Spot Tough-to-Detect Cancers Sooner - MSN Health & Fitness
Posted: June 3rd, 2009, 10:33am EDT
New Tests Spot Tough-to-Detect Cancers Sooner
MSN Health & Fitness, WA
The combination of cytology and FISH increased the bile duct and pancreatic cancer detection rate from 20 percent to 43 percent. About 5000 cases of bile duct cancer are diagnosed every year, mostly in people between ages 50 and 70, making it rare, ... -
Combined anti-cancer drugs may benefit patients with certain types ... - HealthJockey.com
Posted: June 3rd, 2009, 7:20am EDT
HealthJockey.comCombined anti-cancer drugs may benefit patients with certain types ...
HealthJockey.com
Director of clinical trials at the Cancer Research UK, Kate Law says that, “Treating advanced gallbladder and bile duct cancer is very difficult and these ...
Prevent Cancer By Changing Your DietNatural News.com
all 2 news articles » -
Study: Cancer detection in stool sample - Philadelphia Metro
Posted: June 2nd, 2009, 8:01pm EDT
Study: Cancer detection in stool sample
Philadelphia Metro, PA
Using just a stool sample, doctors may now be able to detect colon and many other cancers of the digestive tract including stomach, pancreatic, bile duct and esophageal cancers, US researchers said yesterday. They said a new test, which detects genetic ... -
Lung Cancer Screening Leads to High Rates of False Positives - National Cancer Institute - NCI Cancer Bulletin
Posted: June 2nd, 2009, 3:17pm EDT
Lung Cancer Screening Leads to High Rates of False Positives
National Cancer Institute - NCI Cancer Bulletin, MD
The combination of cisplatin (Platinol) and gemcitabine (Gemzar) helped patients with advanced, inoperable cancers of the biliary tract (gallbladder and bile duct) live several months longer than patients who received gemcitabine alone (11.7 versus 8.2 ... -
Stool test shows promise in detecting many cancers - U.S. Daily
Posted: June 2nd, 2009, 12:54pm EDT
Stool test shows promise in detecting many cancers
U.S. Daily, ca
REUTERS/Newscom/Handout CHICAGO (Reuters) - Using just a stool sample, doctors may now be able to detect colon and many other cancers of the digestive tract including stomach, pancreatic, bile duct and esophageal cancer, US researchers said on Tuesday. ... -
Stool test shows promise in detecting many cancers - Forbes
Posted: June 2nd, 2009, 12:25pm EDT
Stool test shows promise in detecting many cancers
Forbes, NY
By Julie Steenhuysen CHICAGO, June 2 (Reuters) - Using just a stool sample, doctors may now be able to detect colon and many other cancers of the digestive tract including stomach, pancreatic, bile duct and esophageal cancer, US researchers said on ... -
New Pathology Tests Double Sensitivity To Detect Bile Duct And ... - Science Daily (press release)
Posted: June 2nd, 2009, 12:17pm EDT
New Pathology Tests Double Sensitivity To Detect Bile Duct And ...
Science Daily (press release)
ScienceDaily (June 2, 2009) — Pancreatic cancer and bile duct cancer are difficult to diagnose and often fatal because they are discovered in the advanced ...
DDW: Stool Test Detects Gastrointestinal Cancers DNA analysis may ...Modern Medicine
New Tests Spot Tough-to-Detect Cancers SoonerU.S. News & World Report
Stool test detects digestive tract cancersPRESS TV
Reuters -msnbc.com -Science Daily (press release)
all 93 news articles » -
Simple Test Could Detect More Gastrointestinal Cancers - U.S. News & World Report
Posted: June 2nd, 2009, 8:10am EDT
National PostSimple Test Could Detect More Gastrointestinal Cancers
U.S. News & World Report
... bile ducts and esophagus. "Historically, we've approached cancer screening one organ at a time," the study's lead researcher, Dr. David Ahlquist, ...
Stool test detects digestive tract cancersPRESS TV
DDW: Stool Test Detects Gastrointestinal Cancers DNA analysis may ...Modern Medicine
Stool test shows promise in detecting many cancersReuters
msnbc.com -Science Daily (press release) -U.S. News & World Report
all 81 news articles » -
Trial results show better survival for gallbladder and bile duct ... - News-Medical.net
Posted: June 2nd, 2009, 4:05am EDT
Trial results show better survival for gallbladder and bile duct ...
News-Medical.net
Combining two chemotherapy drugs for advanced gallbladder and bile duct cancer improves survival by a third, according to results from a Cancer Research UK ...
Drug combination boosts cancer survivalHospital Healthcare Europe
all 74 news articles » -
FDA OKs SpyScope® Access and Delivery Catheter - EndoNurse
Posted: June 1st, 2009, 3:28pm EDT
FDA OKs SpyScope® Access and Delivery Catheter
EndoNurse, AZ
... in the bile and hepatic ducts, the SpyGlass System now can be used to guide visualization and accessory devices throughout the entire pancreatico-biliary system, enabling physicians to diagnose and treat pancreatic cancer or pre-cancerous tissues. ... -
Olympus Reveals Biliary Metallic Stents - EndoNurse
Posted: June 1st, 2009, 3:08pm EDT
Olympus Reveals Biliary Metallic Stents
EndoNurse, AZ
The X-Suit NIR's proprietary NIRflex™ cell design provides a physician support and flexibility; both critical to help relieve the symptoms associated with pancreatic, liver and bile duct cancers. The NIRflex™ advanced cell design biliary metallic stent ... -
Visualization System Featured at Digestive Disease Week - EndoNurse
Posted: June 1st, 2009, 12:31pm EDT
Visualization System Featured at Digestive Disease Week
EndoNurse, AZ
Previously available for use only in the bile and hepatic ducts, Boston Scientific recently received clearance from the Food and Drug Administration to market its spyscope® Access and Delivery Catheter for diagnostic and therapeutic applications during ... -
New Pathology Tests Double Sensitivity to Detect Bile Duct ... - DG News
Posted: June 1st, 2009, 9:37am EDT
New Pathology Tests Double Sensitivity to Detect Bile Duct ...
DG News
Pancreatic cancer and bile duct cancer are difficult to diagnose and often fatal because they are discovered in the advanced stages of the disease. In the study, 498 patients with pancreatobiliary duct narrowing underwent an endoscopic procedure, ... -
New pathology tests double sensitivity to detect bile duct and ... - PhysOrg.com
Posted: June 1st, 2009, 5:52am EDT
New pathology tests double sensitivity to detect bile duct and ...
PhysOrg.com, VA
Pancreatic cancer and bile duct cancer are difficult to diagnose and often fatal because they are discovered in the advanced stages of the disease. Researchers have developed new tests that double the ability to detect bile duct and pancreatic cancers, ... -
Mayo Clinic finds new pathology tests double sensitivity to detect ... - Genetic Engineering News (press release)
Posted: June 1st, 2009, 10:42pm EDT
Mayo Clinic finds new pathology tests double sensitivity to detect ...
Genetic Engineering News (press release), NY
Pancreatic cancer and bile duct cancer are difficult to diagnose and often fatal because they are discovered in the advanced stages of the disease. Researchers have developed new tests that double the ability to detect bile duct and pancreatic cancers, ... -
PesticidesPancreatic Cancer Caused By Pesticides - what to do and ... - InjuryBoard.com
Posted: May 31st, 2009, 9:12am EDT
PesticidesPancreatic Cancer Caused By Pesticides - what to do and ...
InjuryBoard.com
Pancreatic cancer, gallbladder cancer and bile duct cancer (cholangiocarcinoma) are among the most devastating cancers. Pancreatic cancer is diagnosed in ...
and more » -
DOCTORS WARN: AVOID GENETICALLY MODIFIED FOODS - NewsWithViews.com
Posted: May 30th, 2009, 11:26pm EDT
DOCTORS WARN: AVOID GENETICALLY MODIFIED FOODS
NewsWithViews.com, OR
Post mortems showed severe irritation and black patches in both intestines and liver (as well as enlarged bile ducts). Investigators said preliminary evidence “strongly suggests that the sheep mortality was due to a toxin. . . . most probably Bt-toxin. ... -
Existing drugs to watch at ASCO - FiercePharma
Posted: May 29th, 2009, 9:04am EDT
Existing drugs to watch at ASCO
FiercePharma, DC
Then there are a host of studies pitting current cancer meds against different types of cancer. Eli Lilly's Gemzar, for instance, will get new studies in cervical cancer and bile-duct cancer. And we'll see a host of data on the Bayer/Onyx ... -
Sweet blues diva Candye Kane to stop in Ann Arbor - Toledo Free Press
Posted: May 29th, 2009, 10:10pm EDT
Sweet blues diva Candye Kane to stop in Ann Arbor
Toledo Free Press, USA
And last year she had surgery for pancreatic cancer; the Whipple procedure removed part of her stomach and bile duct, gall bladder and a segment of the small intestine. “I had 150 stitches and I was very weak and I could hardly talk, much less sing,” ... -
Boston Scientific's SpyGlass(R) Direct Visualization System ... - HotStocked
Posted: May 28th, 2009, 4:55pm EDT
Boston Scientific's SpyGlass(R) Direct Visualization System ...
HotStocked, Bulgaria
Using SpyGlass for Diagnosis of Cholangiocarcinoma in Patients with Primary Sclerosing Cholangitis (Podium Presentation) This study is designed to evaluate the characteristics of bile duct lesions in patients with primary sclerosing cholangitis (PSC) ... -
Make Money, Fight Disease: The ASCO Preview - Motley Fool
Posted: May 28th, 2009, 2:10pm EDT
Make Money, Fight Disease: The ASCO Preview
Motley Fool
Eli Lilly (NYSE: LLY) is trying to expand Gemzar, which is already approved for four different cancers, into cervical and advanced cancer of the bile duct. The company will report the results of two different phase 3 trials at ASCO. ... -
xtremepicks.com: Boston Scientific Corporation (NYSE: BSX) Xtreme ... - Trading Markets (press release)
Posted: May 28th, 2009, 11:41am EDT
xtremepicks.com: Boston Scientific Corporation (NYSE: BSX) Xtreme ...
Trading Markets (press release), CA
... in the bile and hepatic ducts, the SpyGlass System can now be used to guide visualization and accessory devices throughout the entire pancreatico-biliary system, enabling physicians to diagnose and treat pancreatic cancer or pre-cancerous tissues. ... -
FDA Clears Boston Scientific's spyscope(R) Access and Delivery ... - PR Newswire (press release)
Posted: May 28th, 2009, 8:06am EDT
FDA Clears Boston Scientific's SpyScope(R) Access and Delivery ...
PR Newswire (press release), NY
... in the bile and hepatic ducts, the SpyGlass System can now be used to guide visualization and accessory devices throughout the entire pancreatico-biliary system, enabling physicians to diagnose and treat pancreatic cancer or pre-cancerous tissues. ... -
Boston Scientific's SpyGlass(R) Direct Visualization System ... - PR Newswire (press release)
Posted: May 28th, 2009, 8:05am EDT
Boston Scientific's SpyGlass(R) Direct Visualization System ...
PR Newswire (press release), NY
Using SpyGlass for Diagnosis of Cholangiocarcinoma in Patients with Primary Sclerosing Cholangitis (Podium Presentation) This study is designed to evaluate the characteristics of bile duct lesions in patients with primary sclerosing cholangitis (PSC) ... -
Boston Scientific's SpyGlass(R) Direct Visualization System ... - Genetic Engineering News (press release)
Posted: May 28th, 2009, 7:15am EDT
Boston Scientific's SpyGlass(R) Direct Visualization System ...
Genetic Engineering News (press release), NY
Using SpyGlass for Diagnosis of Cholangiocarcinoma in Patients with Primary Sclerosing Cholangitis (Podium Presentation) This study is designed to evaluate the characteristics of bile duct lesions in patients with primary sclerosing cholangitis (PSC) ... -
Showing lots of love for Locks of Love - Colts Neck News Transcript
Posted: May 26th, 2009, 6:22pm EDT
Showing lots of love for Locks of Love
Colts Neck News Transcript, NJ
Tumorswere found in the bile duct of the child's liver and later in her pancreatic duct. Surgery to remove the tumors was required, in addition to the chemotherapy. "We were told the first tumor (in the bile duct) was inoperable," Koehler said. ... -
Combination of Chemotherapy Drugs Improves Survival with Biliary ... - Cancer Consultants
Posted: May 26th, 2009, 10:34am EDT
Combination of Chemotherapy Drugs Improves Survival with Biliary ...
Cancer Consultants, ID
Researchers from the United Kingdom have reported that treatment of gallbladder or bile duct cancer with a combination of Gemzar® (gemcitabine) and cisplatin results in better survival and a lower risk of cancer progression than treatment with Gemzar ... -
Ask the doctor: How can I ease my agonising foot pain? - Daily Mail
Posted: May 25th, 2009, 12:08pm EDT
Ask the doctor: How can I ease my agonising foot pain?
Daily Mail, UK
The body still processes fats as it did before: the only change is that instead of bile going through the gallbladder to the intestine, it goes straight to the intestine via a tube called the common bile duct. Now the flow will be continuous, ... -
A miracle made possible by you - New Straits Times
Posted: May 24th, 2009, 6:01pm EDT
A miracle made possible by you
New Straits Times, Malaysia
Diagnosed at birth with extra-hepatic biliary atresia, where the bile duct is missing, he underwent surgery which proved unsuccessful. Amier was progressively sinking into liver failure with doctors and family members at odds over the next course of ... -
Sunday's Alternative Medicines Researches - Curcumin - Daily Kos
Posted: May 24th, 2009, 6:10am EDT
Sunday's Alternative Medicines Researches - Curcumin
Daily Kos, CA
The volatile oil of turmeric is thought to be responsible for the bile-stimulating activity of turmeric, but this has not been conclusively established. Therefore, curcuminoids are contraindicated in those with bile duct obstructions and those with ... -
Candye Kane & Her Blues Orchestra - Houston Press
Posted: May 24th, 2009, 11:08pm EDT
Candye Kane & Her Blues Orchestra
Houston Press, TX
The once-zaftig Kane has slimmed down considerably – 75 pounds, she says on her Web site – after a bout with pancreatic cancer forced her to have the Whipple procedure, removing part of her stomach, small intestine, bile duct, pancreas and gall bladder ...
Trial - Bile Duct Cancer
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Intra-Ductal Confocal Endomicroscopy for Characterization of Pancreas and Bile Duct Tumor
Posted: June 27th, 2009, 10:00am EDT
Conditions: Pancreas Neoplasms; Bile Duct Diseases
Intervention: Procedure: Endoscopic Retrograde Cholangio-Pancreatography (ERCP)
Sponsor: Institut Paoli-Calmettes
Recruiting - verified June 2009 -
Gemcitabine and Cisplatin Plus Sorafenib in Patients With Advanced Biliary Tract Carcinomas Naive to Systemic Therapy
Posted: June 11th, 2009, 10:00am EDT
Conditions: Extrahepatic Bile Duct Cancer; Gallbladder Cancer
Intervention: Drug: Gemcitabine and Cisplatin plus Sorafenib
Sponsors: Memorial Sloan-Kettering Cancer Center; Bayer
Not yet recruiting - verified June 2009
Google - Cholangiocarcinoma
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Kevin F. Stumm - Seacoastonline.com
Posted: June 9th, 2009, 4:02am EDT
Kevin F. Stumm
Seacoastonline.com
In lieu of flowers, memorial donations may be made to the Cholangiocarcinoma Foundation. For more information, please visit www.cholangiocarcinoma.org. ...
and more » -
Utah Jazz: Jazz center Kosta Koufos honors dad - Salt Lake Tribune
Posted: June 7th, 2009, 9:20am EDT
Utah Jazz: Jazz center Kosta Koufos honors dad
Salt Lake Tribune
He worked for eight years in Akron, treating children with leukemia and other cancers, before he was stricken with cholangiocarcinoma in November 1996. ...
and more » -
Utah Jazz: Jazz center Kosta Koufos honors dad - Salt Lake Tribune
Posted: June 6th, 2009, 9:16pm EDT
Utah Jazz: Jazz center Kosta Koufos honors dad
Salt Lake Tribune, United States
He worked for eight years in Akron, treating children with leukemia and other cancers, before he was stricken with cholangiocarcinoma in November 1996. "It was very heart-rending," Krill said, "because coming from oncologists and physicians, ... -
New Pathology Tests Double Sensitivity To Detect Bile Duct And ... - Science Daily (press release)
Posted: June 2nd, 2009, 12:17pm EDT
New Pathology Tests Double Sensitivity To Detect Bile Duct And ...
Science Daily (press release)
Pancreatobiliary tumors such as bile duct cancer (cholangiocarcinoma) and pancreatic cancer often present as strictures, or a narrowing of the duct that can ...
and more » -
New Pathology Tests Double Sensitivity To Detect Bile Duct And ... - Medical News Today (press release)
Posted: June 2nd, 2009, 4:06am EDT
New Pathology Tests Double Sensitivity To Detect Bile Duct And ...
Medical News Today (press release), UK
Pancreatobiliary tumors such as bile duct cancer (cholangiocarcinoma) and pancreatic cancer often present as strictures, or a narrowing of the duct that can either be caused by benign inflammation or cancer. Physicians insert an endoscope down the ... -
New pathology tests double sensitivity to detect bile duct and ... - PhysOrg.com
Posted: June 1st, 2009, 5:52am EDT
New pathology tests double sensitivity to detect bile duct and ...
PhysOrg.com, VA
Pancreatobiliary tumors such as bile duct cancer (cholangiocarcinoma) and pancreatic cancer often present as strictures, or a narrowing of the duct that can either be caused by benign inflammation or cancer. Physicians insert an endoscope down the ... -
Mayo Clinic finds new pathology tests double sensitivity to detect ... - Genetic Engineering News (press release)
Posted: June 1st, 2009, 10:42pm EDT
Mayo Clinic finds new pathology tests double sensitivity to detect ...
Genetic Engineering News (press release), NY
Pancreatobiliary tumors such as bile duct cancer (cholangiocarcinoma) and pancreatic cancer often present as strictures, or a narrowing of the duct that can either be caused by benign inflammation or cancer. Physicians insert an endoscope down the ... -
New Pathology Tests Double Sensitivity to Detect Bile Duct and ... - Newswise (press release)
Posted: June 1st, 2009, 10:21pm EDT
New Pathology Tests Double Sensitivity to Detect Bile Duct and ...
Newswise (press release)
Pancreatobiliary tumors such as bile duct cancer (cholangiocarcinoma) and pancreatic cancer often present as strictures, or a narrowing of the duct that can either be caused by benign inflammation or cancer. Physicians insert an endoscope down the ... -
Mayo Clinic finds new pathology tests double sensitivity to detect ... - EurekAlert (press release)
Posted: June 1st, 2009, 10:14pm EDT
Mayo Clinic finds new pathology tests double sensitivity to detect ...
EurekAlert (press release), DC
Pancreatobiliary tumors such as bile duct cancer (cholangiocarcinoma) and pancreatic cancer often present as strictures, or a narrowing of the duct that can either be caused by benign inflammation or cancer. Physicians insert an endoscope down the ... -
PesticidesPancreatic Cancer Caused By Pesticides - what to do and ... - InjuryBoard.com
Posted: May 31st, 2009, 9:12am EDT
PesticidesPancreatic Cancer Caused By Pesticides - what to do and ...
InjuryBoard.com
Pancreatic cancer, gallbladder cancer and bile duct cancer (cholangiocarcinoma) are among the most devastating cancers. Pancreatic cancer is diagnosed in ...
and more » -
Boston Scientific's SpyGlass(R) Direct Visualization System ... - HotStocked
Posted: May 28th, 2009, 4:55pm EDT
Boston Scientific's SpyGlass(R) Direct Visualization System ...
HotStocked, Bulgaria
Lead author of the study is Sandeep Patel, MD It Looks Like Cholangiocarcinoma -- But is it? Using SpyGlass for Diagnosis of Cholangiocarcinoma in Patients with Primary Sclerosing Cholangitis (Podium Presentation) This study is designed to evaluate the ... -
Boston Scientific's SpyGlass(R) Direct Visualization System ... - PR Newswire (press release)
Posted: May 28th, 2009, 8:05am EDT
Boston Scientific's SpyGlass(R) Direct Visualization System ...
PR Newswire (press release), NY
Lead author of the study is Sandeep Patel, MD It Looks Like Cholangiocarcinoma -- But is it? Using SpyGlass for Diagnosis of Cholangiocarcinoma in Patients with Primary Sclerosing Cholangitis (Podium Presentation) This study is designed to evaluate the ... -
Boston Scientific's SpyGlass(R) Direct Visualization System ... - Genetic Engineering News (press release)
Posted: May 28th, 2009, 7:15am EDT
Boston Scientific's SpyGlass(R) Direct Visualization System ...
Genetic Engineering News (press release), NY
Lead author of the study is Sandeep Patel, MD -- It Looks Like Cholangiocarcinoma -- But is it? Using SpyGlass for Diagnosis of Cholangiocarcinoma in Patients with Primary Sclerosing Cholangitis (Podium Presentation) This study is designed to evaluate ... -
Boston Scientific's SpyGlass(R) Direct Visualization System ... - CNNMoney.com (press release)
Posted: May 28th, 2009, 6:43am EDT
Boston Scientific's SpyGlass(R) Direct Visualization System ...
CNNMoney.com (press release)
Lead author of the study is Sandeep Patel, MD It Looks Like Cholangiocarcinoma -- But is it? Using SpyGlass for Diagnosis of Cholangiocarcinoma in Patients with Primary Sclerosing Cholangitis (Podium Presentation) This study is designed to evaluate the ... -
Boston Scientific's spyglass(R) Direct Visualization System ... - SYS-CON Media (press release)
Posted: May 28th, 2009, 6:32am EDT
Boston Scientific's SpyGlass(R) Direct Visualization System ...
SYS-CON Media (press release), NJ
Lead author of the study is Sandeep Patel, MD It Looks Like Cholangiocarcinoma -- But is it? Using SpyGlass for Diagnosis of Cholangiocarcinoma in Patients with Primary Sclerosing Cholangitis (Podium Presentation) This study is designed to evaluate the ...
PubMed - Bile Duct Cancer
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Neuroendocrine tumors of the ampulla of Vater: biological behavior and surgical management.
Fetched: July 1st, 2009, 9:00pm EDT
Related Articles Neuroendocrine tumors of the ampulla of Vater: biological behavior and surgical management.
Arch Surg. 2009 Jun;144(6):527-31
Authors: Carter JT, Grenert JP, Rubenstein L, Stewart L, Way LW
OBJECTIVES: To describe the biological behavior and surgical management of ampullary neuroendocrine tumors in 7 patients. DESIGN: Case series and literature review. SETTING: University hospital. PATIENTS: Seven patients with ampullary neuroendocrine tumors. MAIN OUTCOME MEASURES: Clinical presentation, pathologic findings, and survival. RESULTS: The patients presented with jaundice (3 patients), anemia (1 patient), gastric outlet obstruction (1 patient), or incidental discovery (2 patients). No patients had neurofibromatosis. Preoperative biopsy was diagnostic in 5 of 6 patients. All of the tumors expressed chromogranin and synaptophysin. Even when the tumor expressed gastrin, vasoactive intestinal peptide, or somatostatin, no patient had a hypersecretion syndrome. Five patients were treated by pancreaticoduodenectomy, 4 for low-grade neuroendocrine tumors and 1 for high-grade neuroendocrine carcinoma. The lesions measured 1.0 to 3.5 cm in diameter. Computed tomographic scans failed to detect nodal metastases that were present in 4 patients. One patient with a high-grade malignant neoplasm died after 15 months. The rest were disease-free after 19 to 48 months. Two patients had transduodenal local resections, one for a 1.1-cm paraganglioma (disease-free, 11 years) and the other for a 0.6-cm carcinoid tumor (disease-free, 7 months). CONCLUSIONS: This is one of the largest series of neuroendocrine tumors of the ampulla. Preoperative biopsy was accurate, but computed tomographic scans were insensitive in detecting nodal metastases. Unlike duodenal carcinoid tumors, hypersecretion syndromes were absent and small tumor size did not preclude locoregional metastases. Tumor grade predicted survival. We recommend pancreaticoduodenectomy for this disease, with local resection reserved for mobile, superficial lesions.
PMID: 19528385 [PubMed - indexed for MEDLINE]
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Lymph node involvement in ampullary cancer: the importance of the number, ratio, and location of metastatic nodes.
Fetched: July 1st, 2009, 9:00pm EDT
Related Articles Lymph node involvement in ampullary cancer: the importance of the number, ratio, and location of metastatic nodes.
J Surg Oncol. 2009 Jul 1;100(1):19-24
Authors: Sierzega M, Nowak K, Kulig J, Matyja A, Nowak W, Popiela T
BACKGROUND AND OBJECTIVES: Lymph node involvement significantly affects survival of cancer patients. The aim of this study was to evaluate the importance of the number, ratio, and location of metastatic lymph nodes in ampullary cancers. METHODS: Medical records of 111 patients who underwent curative pancreaticoduodenectomy for ampullary carcinomas were reviewed. RESULTS: Metastatic lymph nodes were found in 52 (47%) patients and the median number of involved nodes was 3 (95% confidence interval (CI) 3-4; range 1-17). In the univariate analysis, gender, type of pancreaticoduodenectomy, depth of tumor invasion, perineural invasion, presence of metastatic nodes, their number, and ratio of metastatic nodes significantly correlated with patient survival. However, the location of metastatic nodes did not influence survival among patients with nodal involvement. Only four or more metastatic nodes (relative risk 7.35, 95% CI 3.34-16.17) and tumor invasion of peripancreatic soft tissues (relative risk 5.00, 95% CI 1.20-20.92) were the independent prognostic factors in the multivariate analysis. CONCLUSIONS: The number of metastatic nodes significantly affected patient survival. Although the location and ratio of metastatic nodes were not independent prognostic factors, these variables should be further evaluated with large-scale population data sets.
PMID: 19384907 [PubMed - indexed for MEDLINE]
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Limited resection procedures for carcinoid of ampulla of Vater.
Fetched: July 1st, 2009, 9:00pm EDT
Related Articles Limited resection procedures for carcinoid of ampulla of Vater.
Indian J Cancer. 2008 Jan-Mar;45(1):37
Authors: Sharma R
PMID: 18453741 [PubMed - indexed for MEDLINE]
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Intraductal papillary neoplasm of bile duct detected on FDG-PET performed for cancer scanning.
Fetched: June 30th, 2009, 9:00pm EDT
Related Articles Intraductal papillary neoplasm of bile duct detected on FDG-PET performed for cancer scanning.
Clin Gastroenterol Hepatol. 2009 Jun 24;
Authors: Inoue H, Isaji S, Takei Y
PMID: 19559815 [PubMed - as supplied by publisher]
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Prognostic significance of fascin expression in extrahepatic bile duct carcinomas.
Fetched: June 27th, 2009, 9:00pm EDT
Related Articles Prognostic significance of fascin expression in extrahepatic bile duct carcinomas.
Pathol Res Pract. 2009 Jun 23;
Authors: Won KY, Kim GY, Lim SJ, Park YK, Kim YW
Extrahepatic bile duct (EBD) carcinoma is an aggressive cancer with a poor prognosis. Fascin is an actin-bundling protein with roles in forming cell protrusions and mesenchymal and neuronal cell motility. Many human neoplasms up-regulate fascin. High fascin expression is thought to be a poor prognostic factor in some cancers; however, few data are available for the role of fascin in EBD carcinoma. We investigated fascin immunoreactivity in EBD carcinoma and tested it for correlations between fascin expression and clinicopathological parameters. Conventional tissue sections of 114 cases of EBD carcinomas were immunohistochemically analyzed for fascin expression. Fascin expression was tested by cytoplasmic staining. Negative, weak positive, and strong positive fascin staining was observed in 49 (43.0%), 32 (28.1%), and 33 cases (28.9%), respectively. Fascin expression in EBD carcinomas was significantly correlated with histological grade (P<0.0001), primary tumor (T) (P=0.002), TNM stage (P=0.036), lymphatic invasion (P=0.048), venous invasion (P=0.024), and adjacent organ invasion (P<0.0001). High fascin expression was a significant poor prognostic factor (P=0.0001) in EBD carcinoma. High fascin expression (P=0.004) and TNM stage (P=0.001) in EBD carcinoma were independent adverse prognostic factors. High fascin expression is significantly correlated with aggressive tumor phenotype in EBD carcinoma and is an independent poor prognostic factor in EBD carcinoma.
PMID: 19556073 [PubMed - as supplied by publisher]
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Malignant liver tumors: treatment with percutaneous microwave ablation--complications among cohort of 1136 patients.
Fetched: June 27th, 2009, 9:00pm EDT
Related Articles Malignant liver tumors: treatment with percutaneous microwave ablation--complications among cohort of 1136 patients.
Radiology. 2009 Jun;251(3):933-40
Authors: Liang P, Wang Y, Yu X, Dong B
PURPOSE: To report the complications for percutaneous microwave (MW) ablation for the treatment of malignant liver tumors and the possible risk factors for complications in a large series of patients. MATERIALS AND METHODS: The study was approved by the institutional review board; informed consent was waived because of the retrospective design. Over a 13-year period, 1136 patients with 1928 malignant liver tumors underwent ultrasonographically guided percutaneous MW ablation (583 with a noncooled-shaft antenna and 553 with a cooled-shaft antenna). A total of 3697 MW ablation sessions (average, 1.8 sessions per patient) were performed. Mortality and treatment-related major and minor complications were documented. Data were subsequently analyzed to determine whether the major complication rate was related to antenna type, tumor size, tumor location, or number of MW sessions. RESULTS: Two deaths not directly attributable to MW ablation were encountered. Major complications occurred in 30 (2.6%) patients and included liver abscess and empyema (n = 5), bile duct injury (n = 2), perforation of the colon (n = 2), tumor seeding (n = 5), pleural effusion requiring thoracentesis (n = 12), hemorrhage requiring arterial embolization (n = 1), and skin burn requiring resection (n = 3). Minor complications included fever; pain; asymptomatic pleural effusion, gallbladder wall thickening, and arterioportal shunt; small stricture of the bile duct; and skin burn requiring no treatment. Use of noncooled-shaft antenna and an increased number of MW ablation sessions were associated with a higher rate of major complications (P < .05). CONCLUSION: MW ablation is a well-tolerated technique with an acceptably low rate of major complications for treatment of malignant liver tumors. Use of a cooled-shaft antenna, as well as fewer MW sessions, may help minimize major complications.
PMID: 19304921 [PubMed - indexed for MEDLINE]
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Lessons from the toxic bile concept for the pathogenesis and treatment of cholestatic liver diseases.
Fetched: June 27th, 2009, 9:00pm EDT
Related Articles Lessons from the toxic bile concept for the pathogenesis and treatment of cholestatic liver diseases.
Wien Med Wochenschr. 2008;158(19-20):542-8
Authors: Trauner M, Fickert P, Halilbasic E, Moustafa T
Alterations in bile secretion at the hepatocellular and cholangiocellular levels may cause cholestasis. Formation of 'toxic bile' may be the consequence of abnormal bile composition and can result in hepatocellular and/or bile duct injury. The canalicular phospholipid flippase (Mdr2/MDR3) normally mediates biliary excretion of phospholipids, which normally form mixed micelles with bile acids and cholesterol to protect the bile duct epithelium from the detergent properties of bile acids. Mdr2 knockout mice are not capable of excreting phospholipids into bile and spontaneously develop bile duct injury with macroscopic and microscopic features closely resembling human sclerosing cholangitis. MDR3 mutations have been linked to a broad spectrum of hepatobiliary disorders in humans ranging from progressive familial intrahepatic cholestasis in neonates to intrahepatic cholestasis of pregnancy, drug-induced cholestasis, intrahepatic cholelithiasis, sclerosing cholangitis and biliary cirrhosis in adults. Other examples for bile injury due to the formation of toxic bile include the cholangiopathy seen in cystic fibrosis, after lithocholate feeding (in mice) and vanishing bile duct syndromes induced by drugs and xenobiotics. Therapeutic strategies for cholangiopathies may target bile composition/toxicity and the affected bile duct epithelium itself, and ideally should also have anti-cholestatic, anti-fibrotic and anti-neoplastic properties. Ursodeoxycholic acid (UDCA) shows some of these properties, but is of limited efficacy in the treatment of human cholangiopathies. By contrast to UDCA, its side chain-shortened homologue norUDCA undergoes cholehepatic shunting leading to a bicarbonate-rich hypercholeresis. Moreover, norUDCA has anti-inflammatory, anti-fibrotic and anti-proliferative effects, and stimulates bile acid detoxification. Upcoming clinical trials will have to demonstrate whether norUDCA or other side chain-modified bile acids are also clinically effective in humans. Finally, drugs for the treatment of cholangiopathies may target bile toxicity via nuclear receptors (FXR, PPARalpha) regulating biliary phospholipid and bile acid excretion.
PMID: 18998069 [PubMed - indexed for MEDLINE]
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Assessment of a biliary hamartoma with contrast-enhanced sonography using two different contrast agents.
Fetched: June 27th, 2009, 9:00pm EDT
Related Articles Assessment of a biliary hamartoma with contrast-enhanced sonography using two different contrast agents.
Ultraschall Med. 2009 Apr;30(2):185-8
Authors: Hohmann J, Loddenkemper C, Albrecht T
A 49 year old male with carcinoma of the esophagus was staged using conventional US of the abdomen. US revealed signs of cirrhosis and a hyporeflexive focal liver lesion of about 5 mm in diameter was found. Low-MI contrast-enhanced ultrasound (CEUS) with SonoVue (Bracco, Milano, Italy) showed an enhancement pattern which was typical for benign liver lesions while high-MI CEUS with Levovist (Schering, Berlin, Germany) revealed a contrast defect in the liver late phase (4:30 min p. i.) which is typical for a malignant lesion. Due to these findings the lesion was evaluated as a potentially malignant lesion and a biopsy was performed. Histology showed a benign biliary hamartoma and incomplete cirrhosis. The findings confirmed that liver-specific contrast agents have the ability to detect very small focal liver lesions not derived from hepatic tissue but may lead to a misinterpretation as a malignant lesion. Nevertheless biliary duct adenomas are benign lesions with almost the same perfusion properties as normal liver parenchyma. Therefore, while using SonoVue, such a misinterpretation of these very common but in most cases very small and not detectable lesions seems unlikely.
PMID: 18726842 [PubMed - indexed for MEDLINE]
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An experience of treatment of postoperative biliary stricture at a single Japanese institute.
Fetched: June 26th, 2009, 9:00pm EDT
Related Articles An experience of treatment of postoperative biliary stricture at a single Japanese institute.
Hepatogastroenterology. 2009 Jan-Feb;56(89):43-6
Authors: Nanashima A, Abo T, Sumida Y, Nonaka T, Tanaka K, Hidaka S, Sawai T, Yasutake T, Nagayasu T
Many causes of biliary stricture are iatrogenic including postoperative complication such as a cholecystectomy. We examined the clinical demographics, surgical records and outcome in 7 patients undergoing biliary surgery between 1994 and 2006. Diseases included gall stone in 6 patients and neuroendocrine tumor of the pancreas head in one. Causes of biliary stricture included bile duct injury during cholecystectomy in 4 patients, and stenosis of hepaticojejunostomy in 3 (Repair of biliary injury in two and reconstruction after pancreaticoduodenectomy (PD) in one). Treatment modalities included surgical resection of stricture and reconstruction in 4 patients, extension by balloon catheter in one, and conservative treatment in two. Six patients have been cured and, however, one patient died of biliary cirrhosis and progressive hepatic failure at 4 years after PD. When improvement by the extension of stricture was not observed, surgical approach should be necessary. Complete resection of stricture and anastomosis between normal bile duct and intestine might be necessary. Indication of placement of metallic stent in stricture was thought to be carefully considered.
PMID: 19455756 [PubMed - indexed for MEDLINE]
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Controversies in periampullary tumors.
Fetched: June 26th, 2009, 9:00pm EDT
Related Articles Controversies in periampullary tumors.
Hepatogastroenterology. 2009 Jan-Feb;56(89):54-8
Authors: Hamaloglu E, Yildiz BD, Karakoc D
Periampullary tumors are one of the most common tumors of the gastrointestinal tract. Despite the increase of 1-5% in five year life expectancy in periampullary tumors prognosis is still poor. The controversies in diagnosis, surgical and adjuvant treatment will be discussed in this article.
PMID: 19453028 [PubMed - indexed for MEDLINE]
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Significance of repeated resection for recurrent intrahepatic cholangiocarcinoma.
Fetched: June 26th, 2009, 9:00pm EDT
Related Articles Significance of repeated resection for recurrent intrahepatic cholangiocarcinoma.
Hepatogastroenterology. 2009 Jan-Feb;56(89):1-5
Authors: Ohtsuka M, Kimura F, Shimizu H, Yoshidome H, Kato A, Yoshitomi H, Furukawa K, Mitsuhashi N, Takeuchi D, Takayashiki T, Suda K, Miyazaki M
BACKGROUND/AIMS: Management of patients with recurrent intrahepatic cholangiocarcinoma (ICC) following surgical resection is difficult, and surgical resection is rarely indicated. We retrospectively reviewed patients with recurrent intrahepatic cholangiocarcinoma. METHODOLOGY: Between April 1998 and March 2007, 57 consecutive patients with ICC underwent surgical resection. Mode of recurrence and treatment of recurrent tumors, especially surgical resection for these tumors, in patients with cancer recurrence were evaluated. RESULTS: 37 (65%) patients experienced tumor recurrence. Out of these patients, 24 underwent some type of cancer-directed therapy, including 9 patients (24%) for whom surgical resection was attempted: the latter included 4 hepatic resections, 2 pulmonary resections, 2 tumor resections, and 1 gastric resection. For 6 patients with recurrent tumor in the liver or the lung, microscopic complete resection was achieved, while incomplete resection was resulted in the remaining 3 patients. No postoperative mortality was encountered. Among patients with complete resection, 3 are alive without disease 32, 39 and 77 months after the second operation, one has lived with disease for 13 months, and 2 died of disease after 22 and 26 months. No significant difference in overall survival was observed between patients undergoing primary and second surgical resections, calculated from the primary and the second operations, respectively. CONCLUSIONS: Repeated surgical resection for recurrent ICC can be performed with acceptable morbidity, and affords selected patients a chance for long-term survival.
PMID: 19453018 [PubMed - indexed for MEDLINE]
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Klatskin tumor with spermatic cord metastasis: a case report.
Fetched: June 26th, 2009, 9:00pm EDT
Related Articles Klatskin tumor with spermatic cord metastasis: a case report.
Chang Gung Med J. 2009 Jan-Feb;32(1):104-7
Authors: Chang YH, Chuang CK, Ng KF, Liao SK
Malignant spermatic cord tumor is quite uncommon. Metastatic spermatic cord tumor is even rarer. Here we report a case of metastatic spermatic cord tumor from a common hepatic duct tumor (Klatskin tumor). A 38-year-old man presented with right scrotal enlargement and chronic testicular pain. He had a Klatskin tumor (cholangiocarcinoma) stage IIIa, and underwent an extended right hepatectomy with resection of the extrahepatic bile duct, and portal vein and reconstruction by Roux-en-y hepatico-jejunostomy one year before this presentation. Scrotal ultrasound revealed a moderate hydrocele with clean content. Scrotal exploration showed turbid fluid and a fibrotic hyperemic spermatic cord. Excision biopsy of the spermatic cord was done, and the pathology revealed adenocarcinoma. The primary cholangiocarcinoma tumor and the spermatic cord tumor showed identical histologic patterns. Klatskin tumor with spermatic cord metastasis was diagnosed. To our knowledge, this case represents the first such report in the literature.
PMID: 19292946 [PubMed - indexed for MEDLINE]
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Clinicopathologic characteristics of hepatocellular carcinoma with bile duct invasion.
Fetched: June 26th, 2009, 9:00pm EDT
Related Articles Clinicopathologic characteristics of hepatocellular carcinoma with bile duct invasion.
J Gastrointest Surg. 2009 Mar;13(3):492-7
Authors: Ikenaga N, Chijiiwa K, Otani K, Ohuchida J, Uchiyama S, Kondo K
To clarify the characteristics of hepatocellular carcinoma (HCC) with bile duct invasion, we retrospectively analyzed clinical features and surgical outcome of HCC with bile duct invasion (b(+) group, n = 15) compared to those without bile duct invasion (b(-) group, n = 256). In the b(+) group, four patients (27%) showed obstructive jaundice, and a diagnosis of bile duct invasion was obtained preoperatively in seven patients (47%). The levels of serum bilirubin and carbohydrate antigen 19-9 were significantly higher in the b(+) group. Macroscopically, confluent multinodular type and infiltrative type were predominant in the b(+) group (P = 0.002). Microscopically, capsule infiltration (P = 0.040) and intrahepatic metastasis (P = 0.013) were predominant in the b(+) group. Portal vein invasion was associated significantly with the b(+) group (P = 0.004); however, the frequency of hepatic vein invasion was similar (P = 0.096). The median survival after resection was significantly shorter in the b(+) group than in the b(-) group (11.4 vs. 56.1 months, P = 0.002), and eight of 11 intrahepatic recurrences in the b(+) group occurred within 3 months after surgery. HCC with bile duct invasion has an infiltrative nature and a high risk of intrahepatic recurrence, resulting in poor prognosis.
PMID: 19011945 [PubMed - indexed for MEDLINE]
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Evaluation of the gross type and longitudinal extent of extrahepatic cholangiocarcinomas on contrast-enhanced multidetector row computed tomography.
Fetched: June 25th, 2009, 9:00pm EDT
Related Articles Evaluation of the gross type and longitudinal extent of extrahepatic cholangiocarcinomas on contrast-enhanced multidetector row computed tomography.
J Comput Assist Tomogr. 2009 May-Jun;33(3):376-82
Authors: Seo H, Lee JM, Kim IH, Han JK, Kim SH, Jang JY, Kim SW, Choi BI
OBJECTIVE: The objective of this study was to determine the accuracy of contrast-enhanced multidetector row computed tomography (MDCT) in classifying the morphological subtype and revealing the longitudinal extent of extrahepatic cholangiocarcinomas (EHCs). METHODS: Our institutional review board approved this retrospective study, and informed consent was waived. Two radiologists reviewed the preoperative MDCT images of 56 patients who had undergone surgical treatment of EHCs from 2000 to 2006. The reviewers classified the morphological subtypes and measured the enhancing segment of the bile duct with wall thickening on axial images; they then reviewed the axial and multiplanar reconstruction images of 39 patients. The image analysis results were compared with the pathological findings. RESULTS: The accuracy of MDCT for morphological classification was 78.6% (44/56). The differences between the radiological and pathological measurements of the longitudinal extent of the tumors ranged from 0 to 53.5 mm, with a mean (SD) of 5.89 mm (11.42 mm). There was moderate correlation between the 2 measurements of the longitudinal extent of the tumors (P < 0.05, gamma = 0.4455). In 35 patients, MDCT measurements did not differ significantly from the pathological measurements (62.5%). In 18 patients, computed tomography (CT) underestimated the longitudinal extent of the tumor by more than 6 mm (32.1%). In the 39 patients with multiplanar reconstruction images, the correlation between the CT and the pathological measurements of the longitudinal extent was better in the combined interpretation of the axial and coronal images (P < 0.05, gamma = 0.4153) than that in the interpretation of only the axial images (P > 0.05, gamma = 0.2652). CONCLUSIONS: Our results demonstrate that MDCT can correctly classify the morphological subtype of EHC. Nevertheless, CT has a strong tendency to underestimate the longitudinal tumor extent compared with the pathological results.
PMID: 19478630 [PubMed - indexed for MEDLINE]
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Detection of serum MMP-7 and MMP-9 in cholangiocarcinoma patients: evaluation of diagnostic accuracy.
Fetched: June 24th, 2009, 9:00pm EDT
Related Articles Detection of serum MMP-7 and MMP-9 in cholangiocarcinoma patients: evaluation of diagnostic accuracy.
BMC Gastroenterol. 2009;9:30
Authors: Leelawat K, Sakchinabut S, Narong S, Wannaprasert J
BACKGROUND: Cholangiocarcinoma is an aggressive tumor with a tendency for local invasion and distant metastases. Timely diagnosis is very important because surgical resection (R0) remains the only hope for a cure. However, at present, there is no available tumor marker that can differentiate cholangiocarcinoma from benign bile duct disease. Previous studies have demonstrated that matrix metalloproteinase (MMP)-7 and MMP-9 are frequently expressed in cholangiocarcinoma specimens. METHODS: This study was designed to determine whether the serum levels of MMP-7 and MMP-9 can discriminate cholangiocarcinoma patients from benign biliary tract disease patients in comparison to carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9). We measured the level of CEA, CA19-9, MMP-7 and MMP-9 in the serum of 44 cholangiocarcinoma and 36 benign biliary tract diseases patients. RESULTS: Among the serum levels of CEA, CA19-9, MMP-7 and MMP-9, only the serum MMP-7 level was significantly higher in the patients with cholangiocarcinoma (8.9 +/- 3.43 ng/ml) compared to benign biliary tract disease patients (5.9 +/- 3.03 ng/ml) (p < 0.001). An receiver operating characteristic (ROC) curve analysis revealed that the detection of the serum MMP-7 level is reasonably accurate in differentiating cholangiocarcinoma from benign biliary tract disease patients (area under curve = 0.73; 95% CI = 0.614-0.848). While the areas under the curve of the ROC curves for CEA, CA19-9 and MMP-9 were 0.63 (95% CI = 0.501-0.760), 0.63 (95% CI = 0.491-0.761) and 0.59 (95% CI = 0.455-0.722), respectively. CONCLUSION: Serum MMP-7 appears to be a valuable diagnostic marker in the discrimination of cholangiocarcinoma from benign biliary tract disease. Further prospective studies for serum MMP-7 measurement should be carried out to further investigate the potential of this molecule as a biomarker of cholangiocarcinoma.
PMID: 19405942 [PubMed - indexed for MEDLINE]
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Agrin and CD34 immunohistochemistry for the discrimination of benign versus malignant hepatocellular lesions.
Fetched: June 24th, 2009, 9:00pm EDT
Related Articles Agrin and CD34 immunohistochemistry for the discrimination of benign versus malignant hepatocellular lesions.
Am J Surg Pathol. 2009 Jun;33(6):874-85
Authors: Tátrai P, Somorácz A, Batmunkh E, Schirmacher P, Kiss A, Schaff Z, Nagy P, Kovalszky I
Agrin is a recently identified proteoglycan component of vascular and bile duct basement membranes in the liver. The selective deposition of agrin in hepatocellular carcinoma (HCC) microvessels versus sinusoidal walls prompted us to investigate the utility of agrin immunohistochemistry (IHC) in detecting malignant hepatocellular lesions. We focused on the differential diagnostic problems often presented by hepatocellular adenomas (HCAs) and dysplastic nodules. IHC for agrin was performed on 138 formalin-fixed, paraffin-embedded surgical specimens from 93 patients, including cirrhotic liver tissues (25), focal nodular hyperplasia (10), large regenerative nodules (8), low-grade (23) and high-grade (7) dysplastic nodules, small HCC (8), HCC (27), and HCA (30). Agrin immunostaining was compared with that of CD34 and, in selected cases, to glypican-3. The combination of agrin and CD34 sensitively (0.94) and specifically (0.93) identified lesions judged previously as malignant by histology. The majority of benign lesions were clearly agrin-negative, whereas the strength and extent of agrin IHC faithfully reflected dysplasia in "atypical" HCAs and in high-grade dysplastic nodules. Malignant lesions were uniformly positive. In conclusion, as agrin is highly selective for tumor blood vessels, IHC for agrin facilitates the discrimination of benign and malignant hepatocellular lesions. Moreover, whereas glypican-3 in some HCCs may appear in few scattered cells only, agrin is diffusely deposited in virtually all malignant lesions, which may prove advantageous in the evaluation of small specimens such as core biopsies.
PMID: 19194276 [PubMed - indexed for MEDLINE]
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Liver transplantation as a primary indication for intrahepatic cholangiocarcinoma: a single-center experience.
Fetched: June 24th, 2009, 9:00pm EDT
Related Articles Liver transplantation as a primary indication for intrahepatic cholangiocarcinoma: a single-center experience.
Transplant Proc. 2008 Nov;40(9):3194-5
Authors: Sotiropoulos GC, Kaiser GM, Lang H, Molmenti EP, Beckebaum S, Fouzas I, Sgourakis G, Radtke A, Bockhorn M, Nadalin S, Treckmann J, Niebel W, Baba HA, Broelsch CE, Paul A
BACKGROUND: Intrahepatic cholangiocarcinoma (ICC) is not a widely accepted indication for orthotopic liver transplantation (OLT). The present study describes our institutional experience with patients who underwent transplantation for ICC as well as those with ICC who underwent transplantation with the incorrect diagnosis of hepatocellular carcinoma (HCC). PATIENTS AND METHODS: Data corresponding to ICC patients were reviewed for the purposes of this study. Patients with hilar cholangiocarcinoma and incidentally found ICC after OLT for benign diseases were excluded from further consideration. RESULTS: Among the 10 patients, 6 underwent transplantation before 1996 and 4 after 2001. Those who underwent transplantation in the early period had a preoperative diagnosis of inoperable ICC (n = 4) and ICC in the setting of primary sclerosing cholangitis (n = 2). In the latter period the subjects had a diagnosis of HCC in cirrhosis (n = 3) or recurrent ICC after an extended right hepatectomy (n = 1). Median survival was 25.3 months for the whole series and 32.2 months (range, 18-130 months) when hospital mortality was excluded (n = 3). Four patients are currently alive after 30, 35, 42, and 130 months post-OLT, respectively. Two patients died of tumor recurrence at 18 and 21 months post-OLT, respectively. One-, 3-, and 5-year survival rates were 70%, 50%, and 33%, respectively. CONCLUSIONS: The role of OLT in the setting of ICC may be re-evaluated in the future under strict selection criteria and with prospective multicenter randomized studies. Potential candidates to be included are those with liver cirrhosis and no hilar involvement who meet the Milan criteria for HCC.
PMID: 19010231 [PubMed - indexed for MEDLINE]
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Liver transplantation for hilar cholangiocarcinoma: a German survey.
Fetched: June 24th, 2009, 9:00pm EDT
Related Articles Liver transplantation for hilar cholangiocarcinoma: a German survey.
Transplant Proc. 2008 Nov;40(9):3191-3
Authors: Kaiser GM, Sotiropoulos GC, Jauch KW, Löhe F, Hirner A, Kalff JC, Königsrainer A, Steurer W, Senninger N, Brockmann JG, Schlitt HJ, Zülke C, Büchler MW, Schemmer P, Settmacher U, Hauss J, Lippert H, Hopt UT, Otto G, Heiss MM, Bechstein WO, Timm S, Klar E, Hölscher AH, Rogiers X, Stangl M, Hohenberger W, Müller V, Molmenti EP, Fouzas I, Erhard J, Malagó M, Paul A, Broelsch CE, Lang H
BACKGROUND: The present study reports a German survey addressing outcomes in nonselected historical series of liver transplantation (OLT) for hilar cholangiocarcinoma (HL). PATIENTS AND METHODS: We sent to all 25 German transplant centers performing OLT a survey that addressed (1) the number of OLTs for HL and the period during which they were performed; (2) the incidence of HL diagnosed prior to OLT/rate of incidental HL (for example, in primary sclerosing cholangitis); (3) tumor stages according to Union Internationale Centre le Cancer; (4) patient survival; and (5) tumor recurrence rate. RESULTS: Eighty percent of centers responded, reporting 47 patients who were transplanted for HL. Tumors were classified as pT2 (25%), pT3 (73%), or pT4 (2%). HL was diagnosed incidentally in 10% of cases. A primary diagnosis of PSC was observed in 16% of patients. Overall median survival was 35.5 months. When in-hospital mortality (n = 12) was excluded, the median survival was 45.4 months, corresponding to 3- and 5-year survival rates of 42% and 31%, versus 31% and 22% when in-hospital mortality was included. HL recurred in 34% of cases. Three- and 5-year survivals for the 15 patients transplanted since 1998 was 57% and 48%, respectively. Median survival ranged from 20 to 42 months based on the time period (P = .014). CONCLUSIONS: The acceptable overall survival, the improved results after careful patient selection since 1998, and the encouraging outcomes from recent studies all suggest that OLT may be a potential treatment for selected cases of HL. Prospective multicenter randomized studies with strict selection criteria and multimodal treatments seem necessary.
PMID: 19010230 [PubMed - indexed for MEDLINE]
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Current topics in pancreato-biliary endotherapy: what can we do?
Fetched: June 23rd, 2009, 9:00pm EDT
Related Articles Current topics in pancreato-biliary endotherapy: what can we do?
J Hepatobiliary Pancreat Surg. 2009 Jun 19;
Authors: Isayama H
INTRODUCTION: Endotherapy is progressing steadily, especially for various pancreato-biliary diseases. This article introduced new procedures and devices, and revealed improvement of treatment outcomes. MATERIALS AND METHODS: Biliary covered metallic stent (CMS) has developed, and the indication of CMS placement is changing because of its removability. CMS is effective not only for unresectable biliary malignancies but also for resectable tumors, benign biliary strictures, and benign pancreatic strictures. Drug-eluting CMS can be used as anti-tumor agents. Interventional endoscopic ultrasonography (EUS) has shifted the treatment paradigm because it is possible to approach lesions through the digestive tract wall. The diagnosis and treatment of pancreatic cancer using interventional EUS technique are effective, feasible, and promising. Recently, trans-gastric necrosectomy for an infected pseudocyst was reported as an alternative treatment to surgery. Double- and single-balloon enteroscopy will be performed more frequently to treat the pancreato-biliary disorders in the patients with altered anatomy. Endoscopic papillary large balloon dilation (EPLBD), new procedure to the papilla, can treat large bile duct stones effectively without lithotripsy. CONCLUSION: This paper introduces current developments in endotherapy to surgeons. These procedures are of very great interest because they alter the treatment algorithms for many pancreato-biliary diseases.
PMID: 19543686 [PubMed - as supplied by publisher]
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Migration of plastic biliary stents and endoscopic retrieval: an experience of three referral centers.
Fetched: June 23rd, 2009, 9:00pm EDT
Related Articles Migration of plastic biliary stents and endoscopic retrieval: an experience of three referral centers.
Surg Laparosc Endosc Percutan Tech. 2009 Jun;19(3):217-21
Authors: Katsinelos P, Kountouras J, Paroutoglou G, Chatzimavroudis G, Paikos D, Zavos C, Karakousis K, Gelas G, Tzilves D
BACKGROUND: Proximal or distal migration of a plastic biliary stent is uncommon, but its management can be a technical challenge to the pancreatobiliary endoscopist. PATIENTS AND METHODS: All cases (n=51) of proximally and distally migrated plastic biliary stents over an 8-year period at 3 referral pancreaticobiliary centers were included in this retrospective study. Indications for stenting, risk factors for migration, presentation of migration, and various techniques used for stent's retrieval are herein analyzed. RESULTS: Twenty-one proximal and 30 distal bile duct-migrated stents were identified. All patients with proximally and 17 (56.7%) with distally migrated stents were symptomatic. Choledocholithiasis, dilated common bile duct, short and large size stent were the main risk factors. The retrieval of proximally migrated stents was successful in 15 patients (71.4%) and in all symptomatic patients with distal migration. The retrieval techniques included forceps, Dormia basket, snare, Soehendra stent retriever, and balloon. One patient died of sepsis due to peritonitis from duodenal perforation from a distally migrated stent. CONCLUSIONS: Retrieval of a proximally migrated stent requires experience with different endoscopic devices. Moreover, distal migration needs attention because it can cause severe complications.
PMID: 19542849 [PubMed - in process]
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Intraductal oncocytic papillary neoplasm of the bile duct: clinicopathologic and immunohistochemical characteristics of 6 cases.
Fetched: June 23rd, 2009, 9:00pm EDT
Related Articles Intraductal oncocytic papillary neoplasm of the bile duct: clinicopathologic and immunohistochemical characteristics of 6 cases.
Hum Pathol. 2009 Jun 18;
Authors: Tanaka M, Fukushima N, Noda N, Shibahara J, Kokudo N, Fukayama M
Intraductal oncocytic papillary neoplasm is known as a distinct subtype of intraductal papillary mucinous neoplasm of the pancreas. Similar neoplasms of the bile duct are rarely reported, and their disease characteristics are not well established. In this study, we examined 6 cases of biliary neoplasms consisting of oncocytic cells with almost exclusively intraductal growth. The patients were 5 women and 1 man of 51 to 68 years. Grossly, 4 appeared to be cystic neoplasms with papillary projections located in the liver and the other two were papillary neoplasms of the dilated hilar bile duct that ranged from 1.5 to 16 cm in size. The most prominent neoplastic cells were cuboidal epithelial cells that showed abundant eosinophilic granular cytoplasm with strongly positive staining for antimitochondrial antibody. Four neoplasms were mixed with minor components of nononcocytic cells. All neoplasms showed arborized papillary and/or cribriform formations except one, which showed a villous architecture. All neoplasms were adenocarcinomas accompanied by a microscopic minimally invasive carcinoma. The oncocytic neoplastic cells, as well as the nononcocytic cells, produced gastric-type mucin (MUC5AC and MUC6) and showed claudin18 and HepPar-1 positivity. Five patients lived disease-free for 10 to 112 months after resection, and 1 died of tumor recurrence at 26 months postoperatively. The present series of biliary tumors are intraductal papillary neoplasms with oncocytic features and can be clinicopathologically regarded as counterparts of pancreatic intraductal oncocytic papillary neoplasm. Our results also suggest that oncocytic changes occur in epithelial cells of biliary tracts that show a predominant gastric phenotype.
PMID: 19540556 [PubMed - as supplied by publisher]
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EUS: state of the art in the USA.
Fetched: June 23rd, 2009, 9:00pm EDT
Related Articles EUS: state of the art in the USA.
Gastrointest Endosc. 2009 Feb;69(2 Suppl):S217-9
Authors: Van Dam J
PMID: 19179161 [PubMed - indexed for MEDLINE]
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Diagnosis of cholangiocarcinoma: a case series and literature review.
Fetched: June 20th, 2009, 9:00pm EDT
Related Articles Diagnosis of cholangiocarcinoma: a case series and literature review.
J La State Med Soc. 2009 Mar-Apr;161(2):89-94
Authors: Jabara B, Fargen KM, Beech S, Slakey DR
INTRODUCTION: Cholangiocarcinoma is a rare neoplasm of the bile ducts. Risk factors include primary sclerosing cholangitis, Caroli's disease, infection, liver flukes, and chronic typhoid. Improvements in imaging and surgical techniques may allow for earlier diagnosis and improvements in patient survival. METHODS: A retrospective review of patients referred to a single center, and a literature review. RESULTS: Of 23 patients 14 were male, 9 female; mean age 64 years. Mean survival time was 621 days. Stage I, II, III and IV patients had mean survival times of 1120.5, 117.5, 479.5, and 448.9 days, respectively. Patients with resectable disease had improved survival (964.5 days) compared to non-surgically treated (174.4 days) and unresectable patients (558.1 days). CONCLUSIONS: Despite advances in imaging techniques and surgical care, overall survival of cholangiocarcinoma remains poor. Early recognition and minimization of delay may allow for definitive surgical therapy (complete resection) and improved survival.
PMID: 19489389 [PubMed - indexed for MEDLINE]
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[An unusual complication of hepatocellular carcinoma: the pleuro-biliary fistula]
Fetched: June 20th, 2009, 9:00pm EDT
Related Articles [An unusual complication of hepatocellular carcinoma: the pleuro-biliary fistula]
Recenti Prog Med. 2009 Feb;100(2):84-6
Authors: Tirotta D, Durante V
A patient with hepatocellular carcinoma had fever, cough, dyspnea. The analysis and the transcatheter arterial chemoembolization (TACE) showed leucocytosis, cholestasis and pleural viscous fluid with bilirubin. The patient was stabilized and two chest tube were placed. Abdomen CT demonstrated dilated bile duct and pleuro-biliary fistula: dilated bile duct, necrosis and portal thrombus were predictive for TACE-induced pleuro-biliary fistula.
PMID: 19350800 [PubMed - indexed for MEDLINE]
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Effect of histone deacetylase inhibitor on proliferation of biliary tract cancer cell lines.
Fetched: June 20th, 2009, 9:00pm EDT
Related Articles Effect of histone deacetylase inhibitor on proliferation of biliary tract cancer cell lines.
World J Gastroenterol. 2008 Apr 28;14(16):2578-81
Authors: Xu LN, Wang X, Zou SQ
AIM: To explore the effect of histone deacetylase inhibitor, trichostatin A (TSA) on the growth of biliary tract cancer cell lines (gallbladder carcinoma cell line and cholangiocarcinoma cell line) in vivo and in vitro, and to investigate the perspective of histone deacetylase inhibitor in its clinical application. METHODS: The survival rates of gallbladder carcinoma cell line (Mz-ChA-l cell line) and cholangiocarcinoma cell lines (QBC939, KMBC and OZ cell lines) treated with various doses of TSA were detected by methylthiazoy tetrazolium (MTT) assay. A nude mouse model of transplanted gallbladder carcinoma (Mz-ChA-l cell line) was successfully established, and changes in the growth of transplanted tumor after treated with TSA were measured. RESULTS: TSA could inhibit the proliferation of gallbladder carcinoma cell line (Mz-ChA-l cell line) and cholangiocarcinoma cell lines (QBC939, KMBC and OZ cell lines) in a dose-dependent manner. After the nude mouse model of transplanted gallbladder carcinoma (Mz-ChA-l cell line) was successfully established, the growth of cancer was inhibited in the model after treated with TSA. CONCLUSION: TSA can inhibit the growth of cholangiocarcinoma and gallbladder carcinoma cell lines in vitro and in vivo.
PMID: 18442209 [PubMed - indexed for MEDLINE]
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Identification of osteopontin as the most consistently over-expressed gene in intrahepatic cholangiocarcinoma: detection by oligonucleotide microarray and real-time PCR analysis.
Fetched: June 20th, 2009, 9:00pm EDT
Related Articles Identification of osteopontin as the most consistently over-expressed gene in intrahepatic cholangiocarcinoma: detection by oligonucleotide microarray and real-time PCR analysis.
World J Gastroenterol. 2008 Apr 28;14(16):2501-10
Authors: Hass HG, Nehls O, Jobst J, Frilling A, Vogel U, Kaiser S
AIM: To investigate the molecular pathways involved in human cholangiocarcinogenesis by gene expression profiling. METHODS: Oligonucleotide arrays (Affymetrix U133A) were used to establish a specific gene expression profile of intrahepatic CCC in comparison to corresponding non-malignant liver tissue. To validate the expression values of the most overexpressed genes, RT-PCR experiments were performed. RESULTS: Five hundred and fifty-two statistically differentially expressed genes/ESTs (221 probes significantly up-regulated, 331 probes down-regulated; P < 0.05; fold change > 2; > or = 70%) were identified. Using these data and two-dimensional cluster analysis, a specific gene expression profile was obtained allowing fast and reproducible differentiation of CCC, which was confirmed by supervised neuronal network modelling. The most consistently overexpressed gene (median fold change 33.5, significantly overexpressed in 100%) encoded osteopontin. Furthermore, an association of various genes with the histopathological grading could be demonstrated. CONCLUSION: A highly specific gene expression profile for intrahepatic CCC was identified, allowing for its fast and reproducible discrimination against non-malignant liver tissue and other liver masses. The most overexpressed gene in intrahepatic CCC was the gene encoding osteopontin. These data may lead to a better understanding of human cholangiocarcinogenesis.
PMID: 18442196 [PubMed - indexed for MEDLINE]
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Radiation lobectomy: preliminary findings of hepatic volumetric response to lobar yttrium-90 radioembolization.
Fetched: June 19th, 2009, 9:00pm EDT
Related Articles Radiation lobectomy: preliminary findings of hepatic volumetric response to lobar yttrium-90 radioembolization.
Ann Surg Oncol. 2009 Jun;16(6):1587-96
Authors: Gaba RC, Lewandowski RJ, Kulik LM, Riaz A, Ibrahim SM, Mulcahy MF, Ryu RK, Sato KT, Gates V, Abecassis MM, Omary RA, Baker TB, Salem R
PURPOSE: To describe volumetric changes of "radiation lobectomy," a manifestation of hepatic parenchymal response to lobar (90)Y microsphere radioembolization. METHODS: Twenty patients exhibiting this phenomenon were identified. Pre- and posttreatment absolute right and left hepatic lobar volume (HLV), relative HLV (rHLV = HLV/total liver volume), and degree of lobar atrophy (DA) or hypertrophy (DH) (DA or DH = |posttreatment rHLV - pretreatment rHLV|) were determined. Laboratory toxicities, tumor response, and patient survival were also assessed. RESULTS: Twenty patients with primary (HCC, n = 17; peripheral cholangiocarcinoma, n = 3) liver malignancies demonstrated findings of radiation lobectomy. Initial absolute right and left HLV was 955 cm(3) (range 644-1,842 cm(3), rHLV = 57%) and 719 cm(3) (range 328-1,387 cm(3), rHLV = 43%), respectively. Following (90)Y, absolute right HLV decreased to 460 cm(3) (range 185-948 cm(3), 52% reduction, rHLV = 31%, DA = 26%, P < 0.0001), while absolute left HLV increased to 1,004 cm(3) (range 560-1,558 cm(3), 40% increase, rHLV = 69%, DH = 26%, P < 0.0001). No grade 3 or 4 bilirubin toxicities were encountered. Tumor response ranged from 55% to 70% by size criteria. Forty-six percent 5-year survival was achieved in HCC patients. CONCLUSIONS: Radiation lobectomy following (90)Y radioembolization of right lobe tumors manifests extensive contralateral lobar hypertrophy, high response rates, and prolonged survival. This phenomenon was noted in 6.4% (20/315) of the entire cohort and 19.8% (20/101) of patients with unilobar right lobe tumors. Further investigation is necessary to determine contributing factors that may predict this effect.
PMID: 19357924 [PubMed - indexed for MEDLINE]
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Alpha-smooth muscle actin-positive fibroblasts promote biliary cell proliferation and correlate with poor survival in cholangiocarcinoma.
Fetched: June 19th, 2009, 9:00pm EDT
Related Articles Alpha-smooth muscle actin-positive fibroblasts promote biliary cell proliferation and correlate with poor survival in cholangiocarcinoma.
Oncol Rep. 2009 Apr;21(4):957-69
Authors: Chuaysri C, Thuwajit P, Paupairoj A, Chau-In S, Suthiphongchai T, Thuwajit C
Cancer-associated fibroblasts have been proposed to play a role in promoting carcinogenesis and tumor progression. To our knowledge, no direct evidence concerning fibroblasts in the genesis of cholangiocarcinoma (CCA) has previously been presented. This study aims to assess the value of activated fibroblasts with high alpha-smooth muscle actin (alpha-SMA) expression as an indicator for survival in CCA patients. The immunohistochemistry results indicated a high expression of alpha-SMA in CCA fibroblasts which had a statistically significant correlation with larger tumor size (P=0.009) and shorter survival time (P=0.013). The effect of CCA-associated fibroblasts (Cfs) on non-tumorigenic biliary epithelial cells (H-69) and CCA cell lines was investigated in vitro and compared to the effect of non-tumorigenic liver fibroblasts (Lfs). The increased proliferation effect of Cfs having high alpha-SMA on H-69 and 4 CCA cell lines compared to Lfs that expressed low alpha-SMA was observed. Cell cycle analysis indicated that Cf-derived conditioned-medium and direct Cf-epithelial cell contaction could drive epithelial cells into S+G2/M phases. These results indicate that fibroblasts in CCA stroma express high alpha-SMA and can be a prognostic indicator for poor patient survival. CCA fibroblasts have proliferative effects which may directly effect tumor promotion and progression of biliary epithelial cells. This warrants further investigation of fibroblasts as alternative therapeutic targets in CCA patients.
PMID: 19287994 [PubMed - indexed for MEDLINE]
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[Assessment of the value of PEF (cisplatin, epirubicin, 5 fluorouracil) in advanced extrahepatic biliary tract and pancreatic cancer]
Fetched: June 19th, 2009, 9:00pm EDT
Related Articles [Assessment of the value of PEF (cisplatin, epirubicin, 5 fluorouracil) in advanced extrahepatic biliary tract and pancreatic cancer]
Przegl Lek. 2008;65(12):825-8
Authors: Zygulska AL, Pawlega J
INTRODUCTION: Extrahepatic biliary tract and pancreatic cancer are relatively rare malignant tumors. Prognosis is usually poor and surgical treatment gives a chance of cure in nonadvanced cases only. THE AIM OF THIS STUDY: Evaluation of efficacy and toxicity of PEF regimen (cisplatin + epirubicin + 5 fluorouracil) in advanced extrahepatic biliary tract and pancreatic cancer. MATERIAL AND METHODS: Chemotherapy regimen: cisplatin 20 mg/m2 i.v, epirubicin 25 mg/m2 i.v., 5 fluorouracil was given in 28 patients with advanced extrahepatic biliary tract and pancreatic cancer at the Clinic of Oncology of the Collegium Medicum of the Jagiellonian University in Krakow in years 1997 to 2004. The treatment was repeated every 4 weeks up to 6 cycles. 12 patients with extrahepatic biliary tract cancer and 16 patients with pancreatic cancer were treated. RESULTS: Median time from the diagnosis to death was 8.8 months in patients with extrahepatic biliary tract and 8.7 months in patients with pancreatic cancer. 1-year survival was 25% and 16.7%, respectively. Hematological toxicity G 3 and G 4 occured in 5 patients (17.9% treated). CONCLUSIONS: Chemotherapy PEF seems to be an active and well tolerated regimen of palliative chemotherapy for advanced extrahepatic biliary tract carcinomas and pancreas carcinomas. Overall survival in the pancreatic cancer group is comparable to results obtained with gemcitabine monotherapy.
PMID: 19441672 [PubMed - indexed for MEDLINE]
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Transplantation for cholangiocarcinoma: when and for whom?
Fetched: June 18th, 2009, 9:00pm EDT
Related Articles Transplantation for cholangiocarcinoma: when and for whom?
Surg Oncol Clin N Am. 2009 Apr;18(2):325-37, ix
Authors: Rea DJ, Rosen CB, Nagorney DM, Heimbach JK, Gores GJ
Liver transplantation for cholangiocarcinoma has historically been maligned. Because of a high recurrence rate and poor patient survival, the disease has been viewed as an absolute contraindication to transplantation. Based on good results using neoadjuvant and palliative radiation, a protocol for liver transplantation in selected patients with unresectable hilar cholangiocarcinoma was developed in 1993. Neoadjuvant radiation is followed by operative staging to rule out patients with lymph node metastases before liver transplantation. This approach has achieved results superior to standard surgical therapy, with 72% 5-year survival for patients with unresectable disease.
PMID: 19306815 [PubMed - indexed for MEDLINE]
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Management and extent of resection for intrahepatic cholangiocarcinoma.
Fetched: June 18th, 2009, 9:00pm EDT
Related Articles Management and extent of resection for intrahepatic cholangiocarcinoma.
Surg Oncol Clin N Am. 2009 Apr;18(2):289-305, viii-ix
Authors: Carpizo DR, D'Angelica M
Intrahepatic cholangiocarcinoma is the second most common primary liver cancer behind hepatocellular cancer. Although it is an uncommon malignancy, several reports have documented a significant rise in incidence, not only in the United States, but worldwide over the last several decades. As a result, interest in understanding the presentation, diagnosis, natural history, and efficacy of various treatment modalities has increased. This article reviews the clinical presentation, preoperative work-up, surgical management, and outcomes of patients undergoing resection for intrahepatic cholangiocarcinoma. Treatment options in unresectable patients are also reviewed.
PMID: 19306813 [PubMed - indexed for MEDLINE]
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Extrahepatic cholangiocarcinoma: current surgical strategy.
Fetched: June 18th, 2009, 9:00pm EDT
Related Articles Extrahepatic cholangiocarcinoma: current surgical strategy.
Surg Oncol Clin N Am. 2009 Apr;18(2):269-88, viii
Authors: Boutros C, Somasundar P, Espat NJ
Cholangiocarcinoma is a rare cancer. Although rare, it remains the second most common hepatobiliary cancer and its incidence is increasing worldwide. Extrahepatic cholangiocarcinoma can occur anywhere along the biliary tree and prognosis varies according to the location of disease.
PMID: 19306812 [PubMed - indexed for MEDLINE]
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Portal vein embolization in hilar cholangiocarcinoma.
Fetched: June 18th, 2009, 9:00pm EDT
Related Articles Portal vein embolization in hilar cholangiocarcinoma.
Surg Oncol Clin N Am. 2009 Apr;18(2):257-67, viii
Authors: Palavecino M, Abdalla EK, Madoff DC, Vauthey JN
In patients with hilar cholangiocarcinoma, extended hepatectomy and caudate lobe resection are often performed to achieve an R0 resection. In patients whose standardized future liver remnant is less than or equal to 20% of total liver volume, portal vein embolization (PVE) should be performed. In patients with biliary dilatation of the future liver remnant, a biliary drainage catheter should be placed before PVE. If the planned surgery is an extended right hepatectomy, segment 4 branch embolization improves the hypertrophy of segments 2 and 3. In high-volume centers, PVE can be safely performed; it increases the resectability rate and results in the same survival rates as those in patients who undergo resection without PVE.
PMID: 19306811 [PubMed - indexed for MEDLINE]
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Multimodality imaging of biliary malignancies.
Fetched: June 18th, 2009, 9:00pm EDT
Related Articles Multimodality imaging of biliary malignancies.
Surg Oncol Clin N Am. 2009 Apr;18(2):225-39, vii-viii
Authors: Gakhal MS, Gheyi VK, Brock RE, Andrews GS
Detection, accurate staging, and optimal management of biliary malignancies continue to present a significant challenge. This article reviews the current capabilities and roles of the various imaging modalities available in clinical practice, followed by a discussion of their integrated use at initial presentation, particularly with respect to potential surgical management of central hilar and intrahepatic cholangiocarcinoma. The main imaging modalities include MRI, CT, ultrasound, positron emission tomography, and conventional cholangiography. Alternative and emerging imaging methods, problematic diagnostic imaging issues, and other rarer bile duct malignancies are also briefly discussed.
PMID: 19306809 [PubMed - indexed for MEDLINE]
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[Multidetector computed tomography of the liver]
Fetched: June 18th, 2009, 9:00pm EDT
Related Articles [Multidetector computed tomography of the liver]
Radiologe. 2005 Jan;45(1):15-23
Authors: Schima W, Kulinna C, Ba-Ssalamah A, Grünberger T
Multidetector-row CT (MDCT) scanners have dramatically improved liver imaging. With the newest generation of 40-64 row scanners, true isotropic imaging with a z-axis resolution of 0.3-0.6 mm has become possible. Acquisition time for the scan has been shortened to a few seconds. To fully exploit the advantages of MDCT scanners in liver imaging, the examination protocols have to be optimized with regard to contrast material flow rate, scan delay, and the number of scans performed. The possible advantages of double arterial phase scans in the detection of HCC are discussed. The clinical value of 3D reconstructions, such as multiplanar reconstructions and curved planar reconstructions, for assessment of the vascular and biliary duct infiltration is demonstrated. Optimized MDCT imaging improves detection and characterization of focal liver lesions.
PMID: 15609013 [PubMed - indexed for MEDLINE]
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Decreased intratumoral arteries reflect portal tract destruction and aggressive characteristics in intrahepatic cholangiocarcinoma.
Fetched: June 16th, 2009, 9:00pm EDT
Related Articles Decreased intratumoral arteries reflect portal tract destruction and aggressive characteristics in intrahepatic cholangiocarcinoma.
Histopathology. 2009 Mar;54(4):452-61
Authors: Aishima S, Iguchi T, Nishihara Y, Fujita N, Taguchi K, Taketomi A, Maehara Y, Tsuneyoshi M
AIMS: To assess the relationship between arterial blood supply and the progression of intrahepatic cholangiocarcinoma (ICC). METHODS AND RESULTS: The intratumoral arterial vessel density (AVD) was assessed in 76 cases of mass-forming type of ICC using anti-h-caldesmon antibody, a marker of smooth muscle cells, and AVD compared with pathological findings. AVD was directly correlated with the presence of intratumoral portal tracts (P < 0.0001) and inversely correlated with the grade of tumour necrosis (P = 0.0013). AVD was inversely correlated with vascular invasion and lymph node metastasis (P = 0.0159 and P = 0.0023, respectively). The hilar type of ICC had lower AVD regardless of tumour size, whereas the peripheral type with high AVD showed branching ductular formation composed of cuboidal cells with mild nuclear atypia. AVD was found to be an independent prognostic factor on multivariate survival analysis (P = 0.0013). CONCLUSIONS: This study demonstrates that intratumoral arterial vessels reflect engulfed portal tracts in ICC and decreased arterial vessels indicate aggressive tumour behaviour. Our results could contribute to clinical tumour staging and more effective therapy.
PMID: 19309397 [PubMed - indexed for MEDLINE]
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Adjuvant therapy for resected extrahepatic cholangiocarcinoma: a review of the literature and future directions.
Fetched: June 16th, 2009, 9:00pm EDT
Related Articles Adjuvant therapy for resected extrahepatic cholangiocarcinoma: a review of the literature and future directions.
Cancer Treat Rev. 2009 Jun;35(4):322-7
Authors: Anderson C, Kim R
Cholangiocarcinoma is a rare neoplasm originating from the intra- or extrahepatic bile duct epithelium. Incidence has been increasing worldwide in the last three decades. Complete surgical resection provides the only possibility of cure, but even with resection 5-yr survival can be as low as 11%. Adjuvant therapy has the potential to play a crucial role in prolonging survival and local control. Retrospective series have suggested benefit to adjuvant radiation, chemotherapy or concurrent chemo-radiation. The scarce prospective data has not shown a survival benefit to adjuvant therapy. In this article we review and summarize the published data regarding adjuvant therapy for resected extrahepatic cholangiocarcinoma. Prospective, multi-institutional randomized trials are needed to clarify the role of adjuvant therapy in this disease.
PMID: 19147294 [PubMed - indexed for MEDLINE]
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Endoscopic snare papillectomy with biliary and pancreatic stent placement for tumors of the major duodenal papilla.
Fetched: June 12th, 2009, 9:00pm EDT
Related Articles Endoscopic snare papillectomy with biliary and pancreatic stent placement for tumors of the major duodenal papilla.
Surg Endosc. 2009 Jun 11;
Authors: Yamao T, Isomoto H, Kohno S, Mizuta Y, Yamakawa M, Nakao K, Irie J
BACKGROUND: This study aimed to evaluate the feasibility, safety, and follow-up results of endoscopic papilletomy (ESP) with pancreatic and biliary duct stent placement for ampullary tumors. The therapeutic approach to benign ampullary tumors remains unsettled. The ESP procedure is a curative treatment option for benign papillary tumors, but ESP raises concerns about a relatively high risk for procedure-related complications such as pancreatitis. A pancreatic stent may protect against complications. METHODS: Between September 2000 and June 2008, 36 patients with ampullary tumors confined to the mucosa and no intraductal tumor growth underwent ESP. The preprocedural diagnostic tools included endoscopic ultrasound, transpapillary intraductal ultrasound, and endoscopic retrograde cholangiopancreatography. Pancreatic and biliary stent placement was attempted if feasible. Endoscopic follow-up evaluation was conducted periodically as surveillance for recurrence. RESULTS: En bloc ESP was achieved for 94% of lesions with a median size of 14 mm. There were 26 adenomas including 4 high-grade intraepithelial neoplasias (HGINs), 5 carcinomas in adenoma, and 3 intramucosal cancers. Complete resections with tumor-free lateral and basal margins was achieved for 81% of the cases. During the median follow-up period of 14 months, there was one recurrent adenoma, which was successfully eradicated by a repeat ESP. A pancreatic stent was placed in 35 cases and a biliary stent in 29 cases. Mild acute pancreatitis and bleeding, managed endoscopically, occurred in 3 cases each (8%). CONCLUSION: The ESP procedure can be feasible for benign ampullary adenoma, HGIN, and noninvasive cancer without intraductal tumor growth. Prophylactic stent placement in the pancreatic and bile ducts may reduce procedure-related complications.
PMID: 19517183 [PubMed - as supplied by publisher]
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Endoscopic ultrasound in the evaluation of radiologic abnormalities of the liver and biliary tree.
Fetched: June 12th, 2009, 9:00pm EDT
Related Articles Endoscopic ultrasound in the evaluation of radiologic abnormalities of the liver and biliary tree.
Curr Gastroenterol Rep. 2009 Apr;11(2):150-4
Authors: Mishra G, Conway JD
Gastroenterologists increasingly find themselves in the un-enviable position of having to choose the optimal radiographic test to visualize the biliary tree and the liver. This dilemma is compounded by the rapid evolution of the available technologies and their ever-increasing resolution capabilities. Endoscopic ultrasound (EUS) has shown itself to be equally capable of providing detailed imaging of the biliary tree and of surrounding structures; its potential for evaluating liver lesions is just now being realized. EUS-fine needle aspiration (FNA) may supplant some of the existing technologies as it offers a way to sample masses, strictures, lymph nodes, and now certain segments of the liver and periportal regions. This review takes an in-depth look at the role of EUS in evaluating bile duct dilatation, suspected choledocholithiasis, biliary strictures, and polyps and masses of the gallbladder. It also reviews the literature on the exciting and rapidly evolving role of EUS-FNA evaluation of occult, metastatic, and primary hepato-cellular malignancies, as well as periportal lesions. Technologies such as EUS elastography may completely obviate FNA of liver lesions.
PMID: 19281703 [PubMed - indexed for MEDLINE]
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Phase II study of capecitabine and oxaliplatin for advanced adenocarcinoma of the small bowel and ampulla of Vater.
Fetched: June 12th, 2009, 9:00pm EDT
Related Articles Phase II study of capecitabine and oxaliplatin for advanced adenocarcinoma of the small bowel and ampulla of Vater.
J Clin Oncol. 2009 Jun 1;27(16):2598-603
Authors: Overman MJ, Varadhachary GR, Kopetz S, Adinin R, Lin E, Morris JS, Eng C, Abbruzzese JL, Wolff RA
PURPOSE: Adenocarcinomas of the small bowel and ampulla of Vater represent rare cancers that have limited data regarding first-line therapy. We conducted a phase II trial to evaluate the benefit of capecitabine in combination with oxaliplatin (CAPOX) in patients with advanced adenocarcinoma of small bowel or ampullary origin. PATIENTS AND METHODS: Eligible patients with metastatic or unresectable tumors and no prior systemic chemotherapy for advanced disease participated in this phase II trial. CAPOX was administered as a 21-day cycle with oxaliplatin 130 mg/m(2) on day 1 and capecitabine 750 mg/m(2) twice a day on days 1 through 14. The primary end point was overall response rate as assessed by Response Evaluation Criteria in Solid Tumors. RESULTS: Thirty-one patients were enrolled onto the study, and 30 patients received study treatment. The confirmed overall response rate was 50%; three patients with metastatic disease achieved complete responses. The median time to progression (TTP) was 11.3 months, and the median overall survival (OS) was 20.4 months. Subset analysis of patients with metastatic disease only (n = 25) revealed a median TTP of 9.4 months and median OS of 15.5 months. The most common grades 3 or 4 toxicities included fatigue (30%), peripheral neuropathy (10%), vomiting (10%), diarrhea (10%), and neutropenia (10%). CONCLUSION: When administered to patients with good performance status, CAPOX is well tolerated and produces a superior response rate and longer OS compared with other regimens in the literature. CAPOX should be considered a new standard regimen for advanced small bowel and ampullary adenocarcinomas.
PMID: 19164203 [PubMed - indexed for MEDLINE]
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Adenosquamous carcinoma of the extrahepatic bile duct: clinicopathologic and radiologic features.
Fetched: June 12th, 2009, 9:00pm EDT
Related Articles Adenosquamous carcinoma of the extrahepatic bile duct: clinicopathologic and radiologic features.
Abdom Imaging. 2009 Mar-Apr;34(2):217-24
Authors: Kim KW, Kim SH, Kim MA, Lee JM, Park HS, Kim JY, Lee JY, Han JK, Choi BI
BACKGROUND: To retrospectively analyze computed tomography (CT) features of adenosquamous carcinoma (ASC) of the extrahepatic bile duct and to correlate them with pathologic findings. METHODS: Six patients who underwent radical surgical resection for ASC of extrahepatic bile duct were included. CT and pathologic findings were analyzed and correlated with each other. RESULTS: Five ASCs were periductal infiltrative type and the remaining one was intraductal polypoid type. Histologically, ASC was composed of squamous and glandular components which mixed in an intermingled pattern and was characterized by a high local aggressiveness mainly due to the squamous component. The most common CT findings were a segmental wall thickening with delayed enhancement. Overall, CT features were well correlated with pathologic findings. However, CT tended to underestimate radial extent of the tumor compared with histologic findings. CONCLUSIONS: Histopathologically, ASC of the extrahepatic bile duct is characterized by greater local aggressiveness. However, their CT findings are not quite different from those of usual adenocarcinoma due to the unique geographic characteristic of being located at a very limited space.
PMID: 18204917 [PubMed - indexed for MEDLINE]
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Preemptive Surgery for Premalignant Foregut Lesions.
Fetched: June 11th, 2009, 9:00pm EDT
Related Articles Preemptive Surgery for Premalignant Foregut Lesions.
J Gastrointest Surg. 2009 Jun 10;
Authors: Sharma RR, London MJ, Magenta LL, Posner MC, Roggin KK
INTRODUCTION: Preemptive surgery is the prophylactic removal of an organ at high risk for malignant transformation or the resection of a precancerous or "early" malignant neoplasm in an individual with a hereditary predisposition to cancer. Recent advances in molecular diagnostic techniques have improved our understanding of the biologic behavior of these conditions. Predictive testing is an emerging field that attempts to assess the potential risk of cancer development in predisposed individuals. Despite substantial improvement in these forms of testing, all results are imperfect. This information often becomes an important tool that is used by healthcare providers to evaluate the risk-benefit ratio of various risk modifying strategies (i.e., intensive surveillance or preemptive surgery). METHODS: A systematic literature review was performed using Medline and the bibliographies of all referenced publications to identify articles relating to preemptive surgery for premalignant foregut lesions. RESULTS AND DISCUSSION: In this review, we outline the controversies surrounding predictive risk assessment, surveillance strategies, and preemptive surgery in the management of high-grade dysplasia (HGD) in Barrett's esophagus (BE), hereditary diffuse gastric cancer (HDGC), bile duct cysts, primary sclerosing cholangitis (PSC), and pancreatic cystic neoplasms. Resection of BE is supported by the progressive nature of the disease, the risk of occult carcinoma, and the lethality of esophageal cancer. Prophylactic total gastrectomy for HDGC appears reasonable in the absence of accurate screening tests but must be balanced by the impact of surgical complications and altered quality of life. Surgical resection of biliary cysts theoretically eliminates the exposed epithelium to decrease the lifetime risk of cholangiocarcinoma. Liver transplantation for PSC remains controversial given the scarcity of donor organs and inability to accurately identify high-risk individuals. Given the uncertain natural history of pancreatic cystic neoplasms, the merits of selective versus obligatory resection will continue to be debated. CONCLUSIONS: Preemptive operations require optimal judgment and surgical precision to maximize function and enhance survival. Ultimately, balancing the risk of surgical intervention with less invasive interventions or observation must be individualized on a case-by-case basis.
PMID: 19513795 [PubMed - as supplied by publisher]
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Embryonal rhabdomyosarcoma of the ampulla of Vater in early childhood: report of a case and review of literature.
Fetched: June 10th, 2009, 9:00pm EDT
Related Articles Embryonal rhabdomyosarcoma of the ampulla of Vater in early childhood: report of a case and review of literature.
J Pediatr Surg. 2009 Feb;44(2):e9-e11
Authors: Perera MT, McKiernan PJ, Brundler MA, Hobin DA, Mayer DA, Mirza DF, Sharif K
Embryonal rhabdomyosarcoma of the ampullary region is a very rare childhood tumor (2 reported cases), and herein we describe a child presenting with obstructive jaundice at early age owing to such tumor in the ampullary region. Successful management with multidisciplinary approach is discussed with reference to the literature.
PMID: 19231522 [PubMed - indexed for MEDLINE]
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Hepatocellular carcinoma with bile duct tumor thrombi: Correlation of magnetic resonance imaging features to histopathologic manifestations.
Fetched: June 9th, 2009, 9:00pm EDT
Related Articles Hepatocellular carcinoma with bile duct tumor thrombi: Correlation of magnetic resonance imaging features to histopathologic manifestations.
Eur J Radiol. 2009 Jun 5;
Authors: Liu Q, Chen J, Li H, Liang B, Zhang L, Hu T
PURPOSE: This study was to analyze the magnetic resonance imaging (MRI) features of hepatocellular carcinoma (HCC) with bile duct tumor thrombi, and explore their correlations to histopathology to improve the accuracy of diagnosis. MATERIALS AND METHODS: 21 patients with pathologically confirmed HCC with bile duct tumor thrombi was performed with a superconducting 1.5-T MR imager within two weeks before operation. Magnetic resonance cholangiopancreatography (MRCP) was performed on 18 patients. Images were retrospectively assessed for the size, location and MRI manifestations of HCC lesions and associated bile duct tumor thrombi. The differentiation of HCC lesions and the pathologic changes of bile duct tumor thrombi were retrospectively analyzed under microscope. RESULTS: The average diameter of HCC lesions was 5.8+/-2.8cm, and </=5.0cm in nine cases. Capsule formation was observed on MRI or pathology in 4 cases of HCC (19%). Of the 21 cases with bile duct tumor thrombi, 20 were clearly presented on MRI as cord-like or columnar masses in the bile duct with proximal cholangiectasis. The tumor thrombi showed slightly hypointense on T1WI and slightly hyperintense on T2WI. On enhanced scan, three cases of tumor thrombi, which were mainly consisted of necrotic tissue, did not show enhancement; 17 cases, which were mainly consisted of cancer cells, showed mild or moderate enhancement. On magnetic resonance cholangiopancreatogram (MRCP), 14 cases of tumor thrombi presented as filling defect in the bile duct, abrupt obstruction of the bile duct, and cholangiectasis above the obstruction; four presented as dilated intra-hepatic bile ducts with missing common bile duct. Of the 21 patients, 16 had biliary hemorrhage; three also had tumor thrombi in the portal vein. Seventeen of the 21 HCC with biliary thrombi were poorly differentiated, unencapsulated and with an invasive growth. Nineteen of 21 bile duct tumor thrombi did not invade the bile duct wall and could be easily extracted. CONCLUSION: MRI plays a valuable role in diagnosing HCC with bile duct tumor thrombi and identifying the extent of the thrombi; the MRI features of HCC with bile duct tumor thrombi are associated with its pathologic changes.
PMID: 19501994 [PubMed - as supplied by publisher]
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A novel approach for treatment of unresectable extrahepatic bile duct carcinoma: design of radioactive stents and an experimental trial in healthy pigs.
Fetched: June 6th, 2009, 9:00pm EDT
Related Articles A novel approach for treatment of unresectable extrahepatic bile duct carcinoma: design of radioactive stents and an experimental trial in healthy pigs.
Gastrointest Endosc. 2009 Mar;69(3):517-24
Authors: Liu Y, Liu JL, Cai ZZ, Lu Z, Gong YF, Wu HY, Man XH, Jin ZD, Li ZS
BACKGROUND: Patients diagnosed with extrahepatic bile duct carcinoma (EBDC) have a poor prognosis. OBJECTIVE: The purpose of these studies was to design radioactive stents for EBDC and to evaluate the feasibility and safety of the stents in healthy pigs. DESIGN: Plastic stents with inserted iodine-125 seeds were designed and tested in 11 healthy pigs. The pigs were divided into 4 groups on the basis of radiation doses. INTERVENTIONS: The stents with estimated radiation dose at a 5-mm radial distance from the axis of the seeds of 30 Gy, 60 Gy, and 90 Gy were implanted in the common bile duct (CBD) in groups A, B, and C (n = 3 in each group), with the control group (n = 2) being implanted with the stents containing nonradioactive seeds. MAIN OUTCOME MEASUREMENTS: Histologic evaluation was performed under a light microscope. RESULTS: The procedures were successfully performed on all pigs. Severe hyperplasia of the mucosa was seen in the control group. In the experimental groups, obvious mucosal necrosis near the radioactive seeds was observed but without perforation of the CBD wall. In lower-dose groups (30 Gy), mild hyperplasia of mucosal glands with fibrosis under the necrosis layer was seen. However, after the increase of the dose, mucosal glands were disappearing without a visible mucosal layer. CONCLUSIONS: The radioactive stents are safe at each dose in healthy pigs. Moreover, our observations indicate the feasibility to design specific radioactive stents according to the size, shape, and position of EBDC in future clinical applications.
PMID: 19231492 [PubMed - indexed for MEDLINE]
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Assessment of survival advantage in ampullary carcinoma in relation to tumour biology and morphology.
Fetched: June 6th, 2009, 9:00pm EDT
Related Articles Assessment of survival advantage in ampullary carcinoma in relation to tumour biology and morphology.
Eur J Surg Oncol. 2009 Jul;35(7):746-50
Authors: Morris-Stiff G, Alabraba E, Tan YM, Shapey I, Bhati C, Tanniere P, Mayer D, Buckels J, Bramhall S, Mirza DF
INTRODUCTION: Carcinoma of the ampulla of Vater is said to carry a significantly better prognosis than pancreatic ductal adenocarcinomas arising in the pancreatic head. However, it is uncertain as to whether this is due to the fact that they have differing oncological characteristics or simply an earlier presentation as a result of the exophytic morphology of ampullary lesions causing obstruction of the bile ducts. METHODS: All patients undergoing pancreaticoduodenectomy between January 1998 and December 2004 were identified from a prospectively maintained database. Patients with a pathologically confirmed ampullary (AMP) tumour were compared to those with a carcinoma of the head of the pancreas (HOP). Tumour characteristics including size, stage and degree of differentiation were analysed as were survival data. RESULTS: 71 AMP and 144 HOP tumours were resected during the period studied and had full histology reports available for assessment. The median diameter of the AMP tumours was significantly less than those of the HOP (2 cm vs. 3 cm; p = 0.04). The T stage distribution differed significantly between the AMP and HOP tumours in favour of the former (Stages I--10 vs. 0 (p = 0.03); II--29 vs. 13 (p = 0.04); III--25 vs. 121 (p = 0.01); IV--7 vs. 10). The number of resection specimens with positive lymph nodes was lower in the AMP group (31 vs. 121; p = 0.03) as was the prevalence of vascular invasion (33 vs. 114; p = 0.006) and neural invasion (23 vs. 134; p = 0.009). There was no difference in the degree of differentiation of the AMP and HOP tumours. The 5-year survival rates were significantly better in the AMP group at 60% vs. 20% (p = 0.008). Subdivision of AMP carcinoma into polypoid (60%) and ulcerating (40%) lesions revealed a non-significant survival advantage in favour of polypoid tumours at (64% vs. 60%; p = 0.07) at 5 years. CONCLUSIONS: The outcome of resection for AMP is significantly better than for pancreatic ductal adenocarcinomas arising in the periampullary region. Although the anatomical position of AMP tumours may contribute to this survival advantage, the HOP tumours exhibit more adverse histological features suggesting that they are different diseases and hence the difference in survival.
PMID: 19167859 [PubMed - indexed for MEDLINE]
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Evolving Treatment Strategies for Gallbladder Cancer.
Fetched: June 6th, 2009, 9:00pm EDT
Related Articles Evolving Treatment Strategies for Gallbladder Cancer.
Ann Surg Oncol. 2009 Jun 3;
Authors: Hueman MT, Vollmer CM, Pawlik TM
Gallbladder cancer is an uncommon cancer that has traditionally been associated with a poor prognosis. In the era of laparoscopic cholecystectomy, incidental gallbladder cancer has dramatically increased and now constitutes the major way patients present with gallbladder cancer. While patients with incidental gallbladder cancer have a better survival than patients with nonincidental gallbladder cancer, incidental gallbladder cancer can be associated with a varied prognosis. Imaging with computed tomography (CT), magnetic resonance imaging (MRI), and [18]F-fluorodeoxyglucose (FDG) positron emission tomography (PET), as well as diagnostic laparoscopy, all have varying roles in the workup of patients with incidental gallbladder cancer. For patients with T1b, T2, and T3 incidental gallbladder cancer re-resection is generally recommended. At re-exploration, many patients with incidental gallbladder cancer will have residual disease. Definitive oncologic management requires re-resection of the liver, portal lymphadenectomy, and attention to the common bile duct. The extent of the hepatic resection should be dictated by the ability to achieve a microscopically negative (R0) margin. Routine resection of the common bile duct is unnecessary but should be undertaken in the setting of a positive cystic duct margin. If an incidental gallbladder cancer is discovered at the time of surgery, whether the surgeon should directly proceed with a more definitive oncologic operation should depend on the surgeon's skill-set and experience. Gallbladder cancer has a propensity to recur. Although data for adjuvant therapy following resection are limited, some data do suggest a survival benefit for adjuvant chemoradiation therapy. Management of patients with gallbladder cancer requires a multidisciplinary approach with input from a surgeon skilled in hepatobiliary surgery.
PMID: 19495882 [PubMed - as supplied by publisher]
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Carcinosarcoma of pancreas with liver metastasis combined with gastrointestinal stromal tumour of the stomach: is there a good prognosis with the complete resection?
Fetched: June 3rd, 2009, 9:00pm EDT
Related Articles Carcinosarcoma of pancreas with liver metastasis combined with gastrointestinal stromal tumour of the stomach: is there a good prognosis with the complete resection?
Eur J Cancer Care (Engl). 2009 May 27;
Authors: Shen ZL, Wang S, Ye YJ, Wang YL, Sun KK, Yang XD, Jiang KW
SHEN Z.L., WANG S., YE Y.J., WANG Y.L., SUN K.K., YANG X.D. & JIANG K.W. (2009) European Journal of Cancer Care Carcinosarcoma of pancreas with liver metastasis combined with gastrointestinal stromal tumour of the stomach: is there a good prognosis with the complete resection?We report a carcinosarcoma of the pancreas with liver metastasis combined with gastrointestinal stromal tumour (GIST) of the stomach in a 72-year-old woman who presented with right upper quadrant pain, nausea and vomiting. A radical resection including pancreaticoduodenectomy, left hepatic lobe resection and local resection of the gastric mass was performed. The tumour in the head of pancreas was found to be grossly yellow-white, and it infiltrated the common bile duct and duodenum; the mass of the liver metastasis is solitary. Pathologic examination showed two components separated from each other: one component was a conventional infiltrating pancreatic ductal adenocarcinoma, and the other component showed sarcomatous growth pattern composed of pleomorphic spindle cells. The neoplasm of the stomach was confirmed a low malignant potential GIST by histology and immunohistochemistry. The patient was obliged to be in hospital because of abnormal bowel function; moreover, surveillance CT scans performed at 1.5 months post-operatively showed multiple liver metastasis and recurrence in the tail of pancreas. Unfortunately, the patient died of multiple organ failure at 2 months post-operatively. To our knowledge, this is the first experience report about surgical treatment of carcinosarcoma of pancreas with liver metastasis combined with GIST of the stomach. The patient performed a radical surgery for the metastatic carcinosarcoma even if that could be resected completely did not have a good consequence.
PMID: 19486125 [PubMed - as supplied by publisher]
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Golgi protein 73 as a biomarker of hepatocellular cancer: development of a quantitative serum assay and expression studies in hepatic and extrahepatic malignancies.
Fetched: June 3rd, 2009, 9:00pm EDT
Related Articles Golgi protein 73 as a biomarker of hepatocellular cancer: development of a quantitative serum assay and expression studies in hepatic and extrahepatic malignancies.
Hepatology. 2009 May;49(5):1421-3
Authors: Fimmel CJ, Wright L
PMID: 19402061 [PubMed - indexed for MEDLINE]
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Golgi phosphoprotein 2 (GOLPH2) expression in liver tumors and its value as a serum marker in hepatocellular carcinomas.
Fetched: June 3rd, 2009, 9:00pm EDT
Golgi phosphoprotein 2 (GOLPH2) expression in liver tumors and its value as a serum marker in hepatocellular carcinomas.
Hepatology. 2009 May;49(5):1602-9
Authors: Riener MO, Stenner F, Liewen H, Soll C, Breitenstein S, Pestalozzi BC, Samaras P, Probst-Hensch N, Hellerbrand C, Müllhaupt B, Clavien PA, Bahra M, Neuhaus P, Wild P, Fritzsche F, Moch H, Jochum W, Kristiansen G
Hepatocellular carcinomas (HCCs) and bile duct carcinomas (BDCs) have a poor prognosis. Therefore, surveillance strategies including sensitive and specific serum markers for early detection are needed. Recently, Golgi Phosphoprotein 2 (GOLPH2) has been proposed as a serum marker for HCC, but GOLPH2 expression data in liver tissues was not available. Using tissue microarrays and immunohistochemistry, we semiquantitatively analyzed GOLPH2 protein expression in patients with HCC (n = 170), benign liver tumors (n = 22), BDC (n = 114) and normal liver tissue (n = 105). A newly designed sandwich enzyme-linked immunoassay (ELISA) was used to analyze GOLPH2 levels in the sera of patients with HCC (n = 62), hepatitis C virus (HCV) (n = 29), BDC (n = 10), and healthy control persons (n = 12). By immunohistochemistry 121/170 (71%) of HCC showed strong GOLPH2 expression, which was significantly associated with a higher tumor grade (P = 0.01). A total of 97/114 (85%) BDCs showed a strong GOLPH2 expression which proved to be an independent prognostic factor for overall survival (P < 0.05). Serum levels of GOLPH2 measured by ELISA were significantly elevated in patients with HCC with underlying HCV infection (median 18 mg/L, P < 0.05) and patients with BDC (median = 14.5 mg/L, P < 0.01) in comparison to healthy controls (median 4 mg/L). Conclusion: GOLPH2 protein is highly expressed in tissues of HCC and BDC. GOLPH2 protein levels are detectable and quantifiable in sera by ELISA. In patients with hepatitis C, serial ELISA measurements in the course of the disease appear to be a promising complementary serum marker in the surveillance of HCC. GOLPH2 should be further evaluated as a serum tumor marker in BDC on a larger scale.
PMID: 19291786 [PubMed - indexed for MEDLINE]
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Morbidity and mortality after liver resection for benign and malignant hepatobiliary lesions.
Fetched: June 2nd, 2009, 9:00pm EDT
Related Articles Morbidity and mortality after liver resection for benign and malignant hepatobiliary lesions.
Liver Int. 2009 Feb;29(2):175-80
Authors: Erdogan D, Busch OR, Gouma DJ, van Gulik TM
AIM: Although most partial liver resections are performed for malignant lesions, an increasing contingent of benign lesions is also considered for surgery. The aim was to assess post-operative morbidity and mortality after liver resection for benign hepatobiliary lesions in comparison with outcome after resection of malignant lesions. METHODS: A total of 286 liver resections were undertaken between January 1992 and December 2004. After exclusion of resection for bile duct tumours or hepatocellular carcinoma, 205 partial liver resections were retrospectively analysed. RESULTS: Patients with benign lesions comprised 34% of the group (n=70). Benign lesions mainly consisted of focal nodular hyperplasia (n=12; 17%) and liver haemangiomas (11; 15.7%). The malignant lesions consisted of colorectal tumour metastases (n=121; 89%). Patients with benign lesions predominantly underwent minor liver resections (66 vs. 47%; P=0.013). The overall post-operative morbidity occurred in 31% (64/205). Major morbidity occurred in 16% (22/135) in the malignant group compared with 9% (6/70) in the benign group (P=0.099). No differences were seen in major post-operative morbidity in the earlier period compared with the later period (14 vs. 14.3%, P=0.950). In multivariate analysis, only presence of comorbidity (P=0.017), prolonged surgical procedure (P=0.021) and surgical irradicality (P=0.039) maintained significance as independent risk factors for major morbidity. CONCLUSION: Limited liver resections for the treatment of a wide range of benign hepatobiliary lesions are associated with low morbidity and no mortality. However, the indications must be assessed with care. The presence of comorbidity, prolonged surgical time and incomplete resections were associated with major morbidity.
PMID: 18564213 [PubMed - indexed for MEDLINE]
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[Surgical management of schwannoma of biliary tract]
Fetched: May 31st, 2009, 9:00pm EDT
Related Articles [Surgical management of schwannoma of biliary tract]
Chir Ital. 2009 Jan-Feb;61(1):119-21
Authors: De Sena G, Molino C, De Riitis MR, Candela S, Cifarelli V, Di Maio V, Chianese F, Rossetti DA, Rossi M, Miranda G
A borderline Schwann cell tumour with common bile duct compression and jaundice is extremely rare. This paper presents the first report in the Italian literature of a hepatojejunostomy for a symptomatic lesion midway between benign and malignant.
PMID: 19391350 [PubMed - indexed for MEDLINE]
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Isolated tuberculosis of the ampulla of vater masquerading as periampullary carcinoma: a case report.
Fetched: May 31st, 2009, 9:00pm EDT
Related Articles Isolated tuberculosis of the ampulla of vater masquerading as periampullary carcinoma: a case report.
JOP. 2009;10(2):184-6
Authors: Tewari M, Mishra RR, Kumar V, Kar AG, Shukla HS
CONTEXT: Isolated tuberculosis of the ampulla of Vater has not yet been reported. The clinical features of isolated periampullary tuberculosis are at times similar to those seen in patients with periampullary carcinoma. Diagnosis is difficult, and biopsy and culture of the suspected lesion are often negative for Mycobacterium tuberculosis. CASE REPORT: We herein describe one such case masquerading as periampullary carcinoma in a 70-year-old woman. Due to comorbid conditions only a local excision of the ampulla was carried out. Histopathology revealed giant cells in the absence of caseation necrosis and the presence of Mycobacterium tuberculosis was proven using the polymerase chain reaction. CONCLUSION: Isolated tuberculosis of ampulla of Vater is extremely rare but must be kept in mind when making the differential diagnosis of isolated ampullary lesion.
PMID: 19287114 [PubMed - indexed for MEDLINE]
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Intrahepatic cholestasis without jaundice.
Fetched: May 31st, 2009, 9:00pm EDT
Related Articles Intrahepatic cholestasis without jaundice.
Hepatobiliary Pancreat Dis Int. 2009 Feb;8(1):103-5
Authors: Namdar T, Raffel A, Topp SA, am Esch JS, Fürst G, Knoefel WT, Eisenberger CF
BACKGROUND: Cholangiocarcinoma (CC), the most common biliary tract malignancy, is frequently seen in advanced unresectable stages and is typically localized extrahepatically. Early diagnosis is unusual because of nonspecific symptoms. Painless jaundice is usually the first sign of tumor. METHOD: We present a patient with a CC (Klatskin tumor) with a complete biliary drainage by an aberrant bile duct without jaundice. RESULTS: A 67-year-old woman presented with persisting elevation of liver parameters. Diagnostic tests showed a Klatskin tumor type II. A curative right hepatic trisegmentectomy was performed after liver volume augmentation by preoperative vein embolization. CONCLUSIONS: A direct drainage of the right posterior bile duct into the common bile duct as an aberrant hepatic duct is a rare variation and is present in less than 5% of the population. In case of persistently perturbed liver function tests, an aberrant bile duct can cover up severe intrahepatic cholestasis and even obscure the diagnosis of a Klatskin tumor. Up to now it has not been described in the literature.
PMID: 19208525 [PubMed - indexed for MEDLINE]
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[Long-term outcome of interventional therapy for malignant biliary obstruction: a retrospective analysis of 109 cases]
Fetched: May 29th, 2009, 9:00pm EDT
Related Articles [Long-term outcome of interventional therapy for malignant biliary obstruction: a retrospective analysis of 109 cases]
Zhonghua Yi Xue Za Zhi. 2008 Oct 28;88(39):2743-7
Authors: Li MQ, Zhang JX, Lu CH, Pan H, Ru FM, Cao CW, Xu JC, Xu JH
OBJECTIVE: To evaluate the long-term outcome and its relative influenced factors of interventional therapy in dealing malignant biliary obstruction (MBO). METHOD: 109 MBO patients, 54 males and 55 females, aged (71 +/- 12), underwent interventional therapy: 55 patients received percutaneous transhepatic cholangiography and drainage (PTCD), and 54 underwent bile duct stent implantation. One week later, total bilirubin (TB), direct bilirubin (DB), and alanine transaminase (ALT) were examined, and Child-Pugh scoring was conducted.38 of the patient underwent transcatheter arterial chemo-embolization (TACE). RESULTS: One week after drainage the levels of ALT, TB, and DB of the patients undergoing PTCD and stent implantation all decreased in comparison with those before the treatment, the levels of the stent implantation group being significantly lower than those of the PTCD group (P = 0.019, 0.002, and 0.002 respectively), but there was no significant difference in Child-Pugh scale between these 2 group (P = 0.396). One week after TACE the levels of TB, DB, and Child-Pugh scale of the TACE group were all significantly lower than those of the patients without TACE (P = 0.000, 0.002, and 0.002 respectively), however, there was no significant difference in ALT level between these 2 groups (P = 0.834). The cumulative mean survival time was 26.45 weeks [standard error (SE) 4.07], and the mean survival time of the PTCD group was 28.19 weeks (SE, 6.54), not significantly different from that of the stenting groups were [21.38 weeks (SE, 2.51), P = 0.713]. The mean survival time of the TACE group was 43.71 weeks (SE, 8.32), significantly longer than that of the patients without TACE [14.38 weeks (SE, 2.66), P = 0.000]. CONCLUSION: Stenting is more effective than PTCD on relieving jaundice when the decreasing extent of bilirubin level is concerned. TACE therapy following PTCD and stent implantation will significantly contribute to the survival time of MBO patients.
PMID: 19080446 [PubMed - indexed for MEDLINE]
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Chemical ablation of the gallbladder using alcohol in cholecystitis after palliative biliary stenting.
Fetched: May 27th, 2009, 8:18am EDT
Related Articles Chemical ablation of the gallbladder using alcohol in cholecystitis after palliative biliary stenting.
World J Gastroenterol. 2009 Apr 28;15(16):2041-3
Authors: Lee TH, Park SH, Kim SP, Park JY, Lee CK, Chung IK, Kim HS, Kim SJ
Chemical ablation of the gallbladder is effective in patients at high risk of complications after surgery. Percutaneous gallbladder drainage is an effective treatment for cholecystitis; however, when the drain tube cannot be removed because of recurrent symptoms, retaining it can cause problems. An 82-year-old woman presented with cholecystitis and cholangitis caused by biliary stent occlusion and suspected tumor invasion of the cystic duct. We present successful chemical ablation of the gallbladder using pure alcohol, through a percutaneous gallbladder drainage tube, in a patient who developed intractable cholecystitis with obstruction of the cystic duct after receiving a biliary stent. Our results suggest that chemical ablation therapy is an effective alternative to surgical therapy for intractable cholecystitis.
PMID: 19399941 [PubMed - indexed for MEDLINE]
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Giant hepatobiliary cystadenoma in a male with obvious convex papillate.
Fetched: May 27th, 2009, 8:18am EDT
Related Articles Giant hepatobiliary cystadenoma in a male with obvious convex papillate.
World J Gastroenterol. 2009 Apr 21;15(15):1906-9
Authors: Qu ZW, He Q, Lang R, Pan F, Jin ZK, Sheng QS, Zhang D, Zhang XS, Chen DZ
Hepatobiliary cystadenoma is an uncommon lesion that is most often found in middle-aged women and difficult to diagnose preoperatively. Here, we report a case of giant hepatobiliary cystadenoma in a male patient with obvious convex papillate. On the basis of imaging examinations, the patient was diagnosed as hepatobiliary cystadenoma prior to operation. Left hepatectomy was performed and the patient was symptom-free during a 6-mo follow-up period, suggesting that imaging examination is the major diagnostic method of hepatobiliary cystadenoma, and operation is its best treatment modality.
PMID: 19370793 [PubMed - indexed for MEDLINE]
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Addition of hepatectomy decreases liver recurrence and leads to long survival in hilar cholangiocarcinoma.
Fetched: May 27th, 2009, 8:18am EDT
Related Articles Addition of hepatectomy decreases liver recurrence and leads to long survival in hilar cholangiocarcinoma.
World J Gastroenterol. 2009 Apr 21;15(15):1892-6
Authors: Shi Z, Yang MZ, He QL, Ou RW, Chen YT
AIM: To evaluate hepatic recurrence and prognostic factors for survival in patients with surgically resected hilar cholangiocarcinoma in a single institution over the last 13 years. METHODS: From 1994 to 2007, all patients with hilar cholangiocarcinoma referred to a surgical clinic were evaluated. Demographic data, tumor characteristics, and outcome were analyzed retrospectively. Outcome was compared in patients who underwent additional liver resection with resection of the tumor. RESULTS: Of the 69 patients submitted to laparotomy for tumor resection, curative resection (R(0) resection) was performed in 40 patients, and palliative resection in 29. Thirty-one patients had only duct resection, and 38 patients had combined duct resection with liver resection including 34 total or part caudate lobes. Curative rates with the combined hepatectomy were significantly improved compared with those without additional hepatectomy (27/38 vs 13/31; chi2 = 5.94, P < 0.05). Concomitant liver resection was associated with a decreased incidence of initial recurrence in liver one year after surgery (11/38 vs 23/31; chi2 = 13.98, P < 0.01). The 3-year survival rate after R(0) resection was 30.7% and was 10.5% for palliative resection. R(0) resection improved the 3-year survival rate (30.7% vs 10.5%; chi2 = 12.47, P < 0.01). CONCLUSION: Hepatectomy, especially including the caudate lobe combined with bile duct resection should be considered standard treatment to cure hilar cholangiocarcinoma.
PMID: 19370789 [PubMed - indexed for MEDLINE]
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Larger short-axis length of lymph nodes predicts malignant involvement.
Fetched: May 27th, 2009, 8:18am EDT
Related Articles Larger short-axis length of lymph nodes predicts malignant involvement.
Gastrointest Endosc. 2009 Feb;69(2):387; author reply 387-8
Authors: Matsushita M, Uchida K, Nishio A, Okazaki K
PMID: 19185700 [PubMed - indexed for MEDLINE]
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Evaluation of hilar biliary strictures by using a newly developed forward-viewing therapeutic echoendoscope: preliminary results of an ongoing experience.
Fetched: May 27th, 2009, 8:18am EDT
Related Articles Evaluation of hilar biliary strictures by using a newly developed forward-viewing therapeutic echoendoscope: preliminary results of an ongoing experience.
Gastrointest Endosc. 2009 Feb;69(2):356-60
Authors: Larghi A, Lecca PG, Ardito F, Rossi ED, Fadda G, Nuzzo G, Costamagna G
BACKGROUND: Obtaining a definitive tissue diagnosis in patients with hilar biliary strictures (HBS) is often difficult. OBJECTIVE: To describe our experience using a newly developed forward-viewing linear echoendoscope (FVL-EUS) with FNA as a primary diagnostic tool in patients with HBS. DESIGN: Case series. SETTING: A tertiary care, academic medical center. PATIENTS: Four patients with HBS who underwent the procedure. MAIN OUTCOME MEASUREMENTS: Performance of FNA with the FVL-EUS. RESULTS: Visualization and puncture of the primary lesion with a definitive tissue diagnosis was obtained in all of the 4 cases performed. Metastatic hilar cholangiocarcinoma and recurrent neuroendocrine tumor were diagnosed in 2 patients and followed by placement of a self-expandable metal stent, when possible. In the other 2 patients, a diagnosis of resectable hilar cholangiocarcinoma and poorly differentiated adenocarcinoma of unclear origin without evidence of vascular involvement was made, and plastic stents were placed before surgery; the first patient was found to have peritoneal metastases, and resection was aborted, and in the second patient, a gallbladder tumor was diagnosed in the surgical specimen. LIMITATION: The small number of patients. CONCLUSIONS: These preliminary data suggest that FVL-EUS used as a primary tool for the evaluation of patients with HBS may be of value and should be further explored in properly designed studies with a meaningful number of patients.
PMID: 19185697 [PubMed - indexed for MEDLINE]
PubMed - Cholangiocarcinoma
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Sulindac Prevents Carcinogen-Induced Intrahepatic Cholangiocarcinoma Formation In Vivo.
Fetched: July 1st, 2009, 9:00pm EDT
Related Articles Sulindac Prevents Carcinogen-Induced Intrahepatic Cholangiocarcinoma Formation In Vivo.
J Surg Res. 2008 Nov 7;
Authors: Wentz SC, Yip-Schneider MT, Gage EA, Saxena R, Badve S, Schmidt CM
BACKGROUND: Intrahepatic cholangiocarcinoma (ICC) incidence and mortality are increasing in the United States and worldwide. ICC etiologies involve chronic inflammation. We hypothesize that the nonsteroidal anti-inflammatory agent sulindac may prevent ICC by targeting cyclooxygenase-1 and -2 (COX-1, -2) as well as COX-independent pathways. MATERIALS AND METHODS: ICC was induced with the carcinogen N-nitrosobis(2-oxopropyl)amine (BOP) in Syrian golden hamsters. Cholangiocarcinogenesis was accelerated by a choline-deficient diet and administration of DL-ethionine and L-methionine. Hamsters were gavaged twice daily for 10 wk with vehicle or sulindac 25, 50, or 75 mg/kg/dose. Harvested livers underwent gross and histopathological examinations. Tissues were analyzed by immunostaining, Western blot, and enzyme-linked immunosorbent assay (ELISA). RESULTS: ICC incidence and multiplicity were decreased in sulindac treatment groups versus control (P < 0.05). In addition, ICC and nontumor lesion sizes decreased in treatment versus control animals. Proliferative indices (Ki-67 immunostaining) decreased and apoptosis (ApopTag immunostaining) increased in treatment versus control (P < 0.05). No changes in COX-1 and -2 protein levels were detected by Western blot. Furthermore, prostaglandin E(2) (PGE(2)) levels were unchanged in treatment and control serum and liver tissues (P > 0.05), suggesting that the antitumor effects of sulindac are mediated by COX-independent mechanisms. Nuclear p65 (activated NF-kappaB) immunostaining decreased (P < 0.05), and protein levels of the NF-kB inhibitor IkappaB-alpha increased in treatment versus control groups. p65 ELISA of liver extracts confirmed decreased NF-kappaB binding activity in sulindac-treated versus control animals (P < 0.05). CONCLUSION: Sulindac effectively prevents experimental cholangiocarcinogenesis, in part by inhibiting the NF-kappaB pathway.
PMID: 19564027 [PubMed - as supplied by publisher]
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[Binding pancreaticogastrostomy]
Fetched: July 1st, 2009, 9:00pm EDT
Related Articles [Binding pancreaticogastrostomy]
Zhonghua Wai Ke Za Zhi. 2009 Jan 15;47(2):139-42
Authors: Peng SY, Hong DF, Liu YB, Tan ZJ, Li JT, Tao F
OBJECTIVE: To discuss the value of a new technique of the binding pancreaticogastrostomy (BPG) in pancreaticoduodenectomy. METHODS: From May 2008 to October 2008, 15 patients were performed with BPG, included pancreatic head cancer in 7 cases, duodenal adenocarcinoma in 2 cases,mass-type chronic pancreatitis with pancreatolithiasis in 1 case, ampullary carciloma in 1 case, gallbladder cancer in 1 case, islet cell tumor in 1 case and cholangiocarcinoma in 2 cases. The main procedures of BPG included: isolating remnant pancreas; slitting partial posterior wall of stomach and preplaced with seromuscular purse-string suture; cutting gastric anterior wall; performing pancreaticogastrostomy (binding of outer seromuscular and inner mucous layer of stomach). RESULTS: The procedures were successful in 15 patients. Postoperative complications included small amount of pleural effusion in 2 cases, delayed gastric emptying in 2 cases and bile leakage in 2 cases. All patients were cured in 2 weeks. No mortality and anstomosis leakage occurred. CONCLUSION: The application of BPG technique can prevent the anastomosis leakage and improve the safety for pancreaticoduodenectomy.
PMID: 19563012 [PubMed - in process]
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[Analysis of the surgical outcome and prognostic factors for hilar cholangiocarcinoma]
Fetched: July 1st, 2009, 9:00pm EDT
Related Articles [Analysis of the surgical outcome and prognostic factors for hilar cholangiocarcinoma]
Zhonghua Wai Ke Za Zhi. 2009 Jan 15;47(2):94-7
Authors: Li Q, Li HK, Hao XS
OBJECTIVE: To assess the therapeutic strategies and prognostic factors which influence on clinical outcome of hilar cholangiocarcinoma. METHODS: A total of 144 patients with hilar cholangiocarcinoma underwent operation between January 1990 and December 2005 were analyzed, including 102 males and 42 females with 36- 74-years-old. All patients underwent resection among which 86 cases (59.7%) had an R0 resection (negative histologic margins), 34 cases (23.6%) had an R1 resection (positive histologic margins), 24 cases (16.7%) had an R2 resection. The Bismuth-Corlette classification of group R0 and R1: 28 cases (23.3%) in type I , 49 cases (40.8%) in type II, 10 cases (8.3%) in type III A, 19 cases (15. 8%) in type III B and 14 cases (11.7%) in type IV. The TNM stages of group R0 and R1: 19 cases (15.8%) in stage I, 80 cases in stage II (66.7%), 16 cases in stage III (13.3%), 5 cases in stage IV (4.2%). In group R0 and R1, there were 41 cases with well differentiated and 79 cases with moderately and poorly differentiated, 62 cases (51.7%) with negative lymph nodes and 58 cases (48.3%) with positive lymph nodes, 42 cases in stage T1 and 78 cases in stage T2-3, 86 cases with negative blood vessel metastasis and 34 cases with positive blood vessel metastasis. RESULTS: The median survival time was 46.8 months after R0 resection, 18.3 months after R1 resection, and 11.2 months after R2 resection. The 1-, 3- and 5-year cumulative survival rates of the patients were 60.2%, 36.1% and 29.4%. Survival rates after resection in patients with negative lymph nodes (n = 62) were significantly longer than that in those with positive lymph nodes (n = 58) (P < 0.01). The T stage system predicted respectability and the likelihood of an R0 resection and correlated with survival (P = 0.030). Patients requiring portal vein resection had a worse prognosis than those without vascular resection (P = 0.047) but still survived longer than patients who were unresectable (P < 0.01). CONCLUSIONS: Negative histologic margins, concomitant partial hepatectomy, and well-differentiated tumor histology are associated with improved outcome after all hilar cholangiocarcinoma resections. In patients who underwent an R0 resection, concomitant partial hepatectomy is the only independent predictor of long-term survival.
PMID: 19563000 [PubMed - in process]
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A left hepatectomy and caudate lobectomy combined resection of the ventral segment of the right anterior sector for hilar cholangiocarcinoma--the efficacy of PVE (portal vein embolization) in identifying the hepatic subsegment: report of a case.
Fetched: June 30th, 2009, 9:00pm EDT
Related Articles A left hepatectomy and caudate lobectomy combined resection of the ventral segment of the right anterior sector for hilar cholangiocarcinoma--the efficacy of PVE (portal vein embolization) in identifying the hepatic subsegment: report of a case.
Surg Today. 2009;39(7):628-32
Authors: Igami T, Yokoyama Y, Nishio H, Ebata T, Sugawara G, Senda Y, Oda K, Abe T, Uehara K, Nagino M
This report presents a case of a left hepatectomy and a caudate lobectomy combined resection of the ventral segment of the right anterior sector for hilar cholangiocarcinoma using percutaneous transhepatic portal vein embolization (PVE). The patient was a 44-year-old man admitted to a local hospital with obstructive jaundice. He was diagnosed to have hilar cholangiocarcinoma and was referred to the hospital for further treatment. Cholangiography revealed stenosis of the left hepatic duct and the hilar bile ducts. The dorsal branch of the right anterior sector joined the right posterior branch and the tumor did not invade to the confluence of these branches. Arteriography and portography reconstructed by multidetector-raw computed tomography revealed the ventral branches of the right anterior sector, which separately diverged from the other right anterior branches. It was therefore necessary to perform a left hepatectomy and caudate lobectomy combined resection of the ventral segment of the right anterior sector to completely remove the tumor. Portal vein embolization was thus performed on the left portal vein and the ventral branches of the right anterior sector. Intraoperatively, when the hepatic artery was temporally clamped, the demarcation between the ventral segment and the dorsal segment of the right anterior sector could be clearly visualized. The planned surgery was performed safely. This case demonstrates that the utilization of PVE is useful for a difficult and intricate hepatectomy, which requires an accurate identification of a hepatic subsegment.
PMID: 19562455 [PubMed - in process]
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Laparoscopic Liver Resection-Understanding its Role in Current Practice: The Henri Mondor Hospital Experience.
Fetched: June 30th, 2009, 9:00pm EDT
Related Articles Laparoscopic Liver Resection-Understanding its Role in Current Practice: The Henri Mondor Hospital Experience.
Ann Surg. 2009 Jun 24;
Authors: Bryant R, Laurent A, Tayar C, Cherqui D
OBJECTIVE:: To report our complete experience with laparoscopic liver resection (LLR) to understand what role it may play in the broader context of liver surgery. BACKGROUND:: The goal of LLR is to extend the benefits of the laparoscopic approach without compromising the fundamental principles of open liver surgery. LLR, however, presents unique technical challenges and its evaluation is made difficult by the restricted indications for this approach, the few centers world-wide experienced in the technique, and the heterogeneity of procedures and pathologies involved. METHODS:: Retrospective analysis of a prospectively maintained database of liver resections from a unit with a comprehensive liver program, including resection and transplantation. RESULTS:: There were 166 laparoscopic liver resections between May 23, 1996 and December 31, 2007, including 100 (60%) for malignant pathology (64 HCC, 3 cholangiocarcinoma, 33 hepatic metastases) and 66 for benign pathology (adenoma, 23; FNH, 19; cystic, 17; other, 7). Numbers of resections for benign indications remained stable over time whereas those for malignant indications increased. There were 31 major resections, 56 left lateral sectionectomies, 28 segmentectomies, and 51 tumorectomies. There was 0% mortality and 15.1% morbidity. Median blood loss was 200 mL, 9 patients (5.4%) required transfusion, and median operating time was 180 minutes. Left lateral sectionectomies demonstrated reduced bleeding (median, 175 vs. 300 mL, P = 0.0015) and faster operating time (median, 170 vs. 180 minutes, P = 0.0265). In the second half of the experience, there was reduced bleeding (median, 200 vs. 300 mL, P = 0.0022) and a lower conversion rate (2.4% vs. 16.9%, P = 0.0015). CONCLUSIONS:: Good patient selection and refined surgical technique are the keys to successful LLR. The indications for resection of asymptomatic benign lesions should not be increased because the laparoscopic approach is available. Hepatocellular carcinomas (HCCs) are more likely to be suitable to a laparoscopic approach than colorectal liver metastases. Left lateral sectionectomy and limited resection of solitary peripheral lesions are particularly suitable while hemihepatectomies remain challenging procedures. LLR requires an ongoing robust audit to identify any emerging problems.
PMID: 19561476 [PubMed - as supplied by publisher]
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Autopsy case of Gaucher disease type I in a patient on enzyme replacement therapy. Comments on the dynamics of persistent storage process.
Fetched: June 27th, 2009, 9:00pm EDT
Related Articles Autopsy case of Gaucher disease type I in a patient on enzyme replacement therapy. Comments on the dynamics of persistent storage process.
J Inherit Metab Dis. 2009 Jun 26;
Authors: Hůlková H, Ledvinová J, Poupětová H, Kohout A, Malinová V, Elleder M
We report a female patient with Gaucher disease (GD) type I on ERT (imiglucerase) for 5 years, which led to a significant general improvement. Aged 59 years she underwent an episode of altitude sickness followed by sepsis, disseminated intravascular coagulation, and multiorgan failure. She succumbed to a cerebral haemorrhage. Autopsy revealed liver cholestatic cirrhosis and multifocal liver carcinoma with immunophenotype compatible with cholangiocarcinoma. Analysis of the storage process revealed its absence or very low levels in the majority of liver and spleen macrophages. Gaucher cells (GCs) were seen only as occasional aggregates of various sizes in these organs. GCs were seen also in the leptomeninx of the cerebellum and as infrequent perivascular clusters in both the grey and white cerebral matters. Bone marrow was heavily infiltrated with GCs, especially in the adipocyte-rich part. GCs in this location displayed varied degrees of cytoplasmic vacuolation unrelated to the lysosomal compartment, caused by droplets of triglyceride, and interpreted as due to resorption of fragments of altered white adipocytes. All these observations point to the relative efficacy of ERT in covering the standard substrate load, which should not be exceeded as it would lead to the evolution of mature GCs. The results are discussed in relation to our recently published hypothesis on GD cell pathology.
PMID: 19557545 [PubMed - as supplied by publisher]
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Incidence and prognosis of cholangiocarcinoma in Danish patients with and without inflammatory bowel disease: a national cohort study, 1978-2003.
Fetched: June 27th, 2009, 9:00pm EDT
Related Articles Incidence and prognosis of cholangiocarcinoma in Danish patients with and without inflammatory bowel disease: a national cohort study, 1978-2003.
Eur J Epidemiol. 2009 Jun 26;
Authors: Erichsen R, Jepsen P, Vilstrup H, Ekbom A, Sørensen HT
Patients with inflammatory bowel disease (IBD) are at increased risk of cholangiocarcinoma (CC), but quantitative data are scant. Furthermore, little is known about the impact of IBD on CC occurrence and prognosis. Based on nationwide population-based registries we compared the incidence and survival of CC patients with and without IBD from 1978 to 2003. We used the National Registry of Patients and the Danish Cancer Registry to identify patients with IBD and CC. From the Civil Registration System we identified population controls. We calculated incidence rates, incidence rate ratios (compared with population controls), and absolute cumulative risks. We also computed median survival in CC patients with and without IBD. 2,725 CC patients were identified. The incidence of CC among the 41,280 IBD patients was 7.6 per 100,000 person years compared with 1.9 per 100,000 among the 412,796 population controls (four-fold increased risk). The 10 year cumulative risk of CC in IBD patients was 0.07%. Sub analyses showed that the increased risk of CC was more pronounced in male IBD patients and in patients with ulcerative colitis. We found a decreasing CC incidence in IBD patients over calendar time. CC patients with IBD were, on average, 15 years younger at cancer diagnosis than IBD-free CC patients, and median survival was 1 month in both groups. In conclusion, the absolute risk of CC in IBD patients was low and the CC incidence decreased over calendar time. The prognosis was equally grave, regardless of the presence of IBD.
PMID: 19557525 [PubMed - as supplied by publisher]
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Retrospective Analysis of Histopathologic Prognostic Factors After Hepatectomy for Intrahepatic Cholangiocarcinoma.
Fetched: June 27th, 2009, 9:00pm EDT
Related Articles Retrospective Analysis of Histopathologic Prognostic Factors After Hepatectomy for Intrahepatic Cholangiocarcinoma.
Cancer J. 2009 May/June;15(3):257-261
Authors: Jiang BG, Sun LL, Yu WL, Tang ZH, Zong M, Zhang YJ
BACKGROUND:: The aim of this study was to investigate histopathologic prognostic factors in patients with intrahepatic cholangiocarcinoma (ICC) whose tumors were resected to determine the optimal surgical strategies. METHODS:: One hundred and two ICC patients who underwent laparotomy from July 1998 to December 2000 were followed up successfully. Histopathologic variables were selected for univariate and multivariate analyses to evaluate their influence on the outcome. RESULTS:: The 1-, 3-, and 5-year survival rates after surgery were 56.9%, 25.5%, and 16.9%, respectively. The average survival duration was 21.91 +/- 20.17 months. In univariate analysis, the presence of lymph node (LN) metastasis, number of LNs with metastases, presence of intrahepatic metastasis, curative resection, and TNM stage were significant risk factors for survival. Multivariate analysis revealed that intrahepatic metastasis, noncurative resection, and TNM stage IVa were independent prognostic factors. CONCLUSIONS:: The histopathologic characteristics of intrahepatic metastasis were closely related to poor prognosis in ICC patients. Extensive hepatectomy with LN dissection may offer the only chance for long-term survival in patients with ICC.
PMID: 19556914 [PubMed - as supplied by publisher]
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Intrahepatic Cholangiocarcinoma: A Worthy Challenge.
Fetched: June 27th, 2009, 9:00pm EDT
Related Articles Intrahepatic Cholangiocarcinoma: A Worthy Challenge.
Cancer J. 2009 May/June;15(3):255-256
Authors: Bartlett DL
PMID: 19556913 [PubMed - as supplied by publisher]
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Lessons from the toxic bile concept for the pathogenesis and treatment of cholestatic liver diseases.
Fetched: June 27th, 2009, 9:00pm EDT
Related Articles Lessons from the toxic bile concept for the pathogenesis and treatment of cholestatic liver diseases.
Wien Med Wochenschr. 2008;158(19-20):542-8
Authors: Trauner M, Fickert P, Halilbasic E, Moustafa T
Alterations in bile secretion at the hepatocellular and cholangiocellular levels may cause cholestasis. Formation of 'toxic bile' may be the consequence of abnormal bile composition and can result in hepatocellular and/or bile duct injury. The canalicular phospholipid flippase (Mdr2/MDR3) normally mediates biliary excretion of phospholipids, which normally form mixed micelles with bile acids and cholesterol to protect the bile duct epithelium from the detergent properties of bile acids. Mdr2 knockout mice are not capable of excreting phospholipids into bile and spontaneously develop bile duct injury with macroscopic and microscopic features closely resembling human sclerosing cholangitis. MDR3 mutations have been linked to a broad spectrum of hepatobiliary disorders in humans ranging from progressive familial intrahepatic cholestasis in neonates to intrahepatic cholestasis of pregnancy, drug-induced cholestasis, intrahepatic cholelithiasis, sclerosing cholangitis and biliary cirrhosis in adults. Other examples for bile injury due to the formation of toxic bile include the cholangiopathy seen in cystic fibrosis, after lithocholate feeding (in mice) and vanishing bile duct syndromes induced by drugs and xenobiotics. Therapeutic strategies for cholangiopathies may target bile composition/toxicity and the affected bile duct epithelium itself, and ideally should also have anti-cholestatic, anti-fibrotic and anti-neoplastic properties. Ursodeoxycholic acid (UDCA) shows some of these properties, but is of limited efficacy in the treatment of human cholangiopathies. By contrast to UDCA, its side chain-shortened homologue norUDCA undergoes cholehepatic shunting leading to a bicarbonate-rich hypercholeresis. Moreover, norUDCA has anti-inflammatory, anti-fibrotic and anti-proliferative effects, and stimulates bile acid detoxification. Upcoming clinical trials will have to demonstrate whether norUDCA or other side chain-modified bile acids are also clinically effective in humans. Finally, drugs for the treatment of cholangiopathies may target bile toxicity via nuclear receptors (FXR, PPARalpha) regulating biliary phospholipid and bile acid excretion.
PMID: 18998069 [PubMed - indexed for MEDLINE]
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A case of mucin-producing cholangiocarcinoma.
Fetched: June 26th, 2009, 9:00pm EDT
Related Articles A case of mucin-producing cholangiocarcinoma.
Jpn J Clin Oncol. 2009 Jul;39(7):467
Authors: Matsuba H, Sakamoto Y
PMID: 19553400 [PubMed - in process]
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Case report: appearance of an intestinal metastasis from intrahepatic cholangiocarcinoma occurring 5 years after resection of the primary tumor.
Fetched: June 25th, 2009, 9:00pm EDT
Related Articles Case report: appearance of an intestinal metastasis from intrahepatic cholangiocarcinoma occurring 5 years after resection of the primary tumor.
Eur J Gastroenterol Hepatol. 2009 Jun 22;
Authors: Izzo F, Piccirillo M, Albino V, Botti G, Foggia M, Iodice R, Pagano F, Piccirillo G, Tornillo L, Delrio P
We present the unusual case of a 76-year-old male who developed an intestinal recurrence of the same tumor 5 years after hepatic resection for an intrahepatic cholangiocarcinoma. At the time of the first surgery, the patient had undergone hepatic bisegmentectomy of segments IV and V with an 'en bloc' gallbladder resection and porta hepatis lymphadenectomy for the presence of a focal cholangiocarcinoma measuring about 3.0 x 2.5 cm in diameter. The histological report confirmed intrahepatic cholangiocarcinoma, the resection margins were free from disease, and there were no lymph node metastases. Five years later colonoscopy showed, at the level of the splenic flexure, the presence of a sessile bilobate polypoid neoplasm. The patient underwent left hemicolectomy with a histological diagnosis of an isolated recurrence of cholangiocarcinoma.
PMID: 19550345 [PubMed - as supplied by publisher]
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Photodynamic therapy for cholangiocarcinoma: overview and new developments.
Fetched: June 25th, 2009, 9:00pm EDT
Related Articles Photodynamic therapy for cholangiocarcinoma: overview and new developments.
Curr Opin Gastroenterol. 2009 Jun 22;
Authors: Ortner MA
PURPOSE OF REVIEW: Photodynamic therapy (PDT) with hematoporphyrins has emerged as promising treatment for nonresectable cholangiocarcinoma in several prospective observational studies and two randomized studies. This review describes the mechanism of action of PDT, gives an overview of clinical experience in cholangiocarcinoma and summarizes the results published in 2007 and 2008. RECENT FINDINGS: The mechanism of action of PDT has been further elucidated. PDT induces an apoptotic, antiangiogenic as well as an immunomodulatory response. Interleukin-6, a bile duct epithelium growth factor correlating with tumor burden, decreases after PDT. The efficacy of PDT was confirmed in a comparative study in the United States. Patients with no visible mass on imaging studies, high serum albumin levels and treatment immediately after diagnosis seem to benefit most from PDT. Although it is recommended to perform PDT in bile ducts without stents in place, illumination through metal stents is possible if the light dose is adjusted. Meso-tetrahydroxyphenyl chlorine is a new potent photosensitizer for PDT of cholangiocarcinoma. SUMMARY: In advanced nonresectable cholangiocarcinoma, PDT is the only evidence-based treatment that improves survival when compared with stenting. Therefore, PDT should be offered to those who are unsuitable for surgery.
PMID: 19550314 [PubMed - as supplied by publisher]
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Evaluation of the gross type and longitudinal extent of extrahepatic cholangiocarcinomas on contrast-enhanced multidetector row computed tomography.
Fetched: June 25th, 2009, 9:00pm EDT
Related Articles Evaluation of the gross type and longitudinal extent of extrahepatic cholangiocarcinomas on contrast-enhanced multidetector row computed tomography.
J Comput Assist Tomogr. 2009 May-Jun;33(3):376-82
Authors: Seo H, Lee JM, Kim IH, Han JK, Kim SH, Jang JY, Kim SW, Choi BI
OBJECTIVE: The objective of this study was to determine the accuracy of contrast-enhanced multidetector row computed tomography (MDCT) in classifying the morphological subtype and revealing the longitudinal extent of extrahepatic cholangiocarcinomas (EHCs). METHODS: Our institutional review board approved this retrospective study, and informed consent was waived. Two radiologists reviewed the preoperative MDCT images of 56 patients who had undergone surgical treatment of EHCs from 2000 to 2006. The reviewers classified the morphological subtypes and measured the enhancing segment of the bile duct with wall thickening on axial images; they then reviewed the axial and multiplanar reconstruction images of 39 patients. The image analysis results were compared with the pathological findings. RESULTS: The accuracy of MDCT for morphological classification was 78.6% (44/56). The differences between the radiological and pathological measurements of the longitudinal extent of the tumors ranged from 0 to 53.5 mm, with a mean (SD) of 5.89 mm (11.42 mm). There was moderate correlation between the 2 measurements of the longitudinal extent of the tumors (P < 0.05, gamma = 0.4455). In 35 patients, MDCT measurements did not differ significantly from the pathological measurements (62.5%). In 18 patients, computed tomography (CT) underestimated the longitudinal extent of the tumor by more than 6 mm (32.1%). In the 39 patients with multiplanar reconstruction images, the correlation between the CT and the pathological measurements of the longitudinal extent was better in the combined interpretation of the axial and coronal images (P < 0.05, gamma = 0.4153) than that in the interpretation of only the axial images (P > 0.05, gamma = 0.2652). CONCLUSIONS: Our results demonstrate that MDCT can correctly classify the morphological subtype of EHC. Nevertheless, CT has a strong tendency to underestimate the longitudinal tumor extent compared with the pathological results.
PMID: 19478630 [PubMed - indexed for MEDLINE]
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Hepatic Stellate Cells May Relate to Progression of Intrahepatic Cholangiocarcinoma.
Fetched: June 24th, 2009, 9:00pm EDT
Related Articles Hepatic Stellate Cells May Relate to Progression of Intrahepatic Cholangiocarcinoma.
Ann Surg Oncol. 2009 Jun 23;
Authors: Okabe H, Beppu T, Hayashi H, Horino K, Masuda T, Komori H, Ishikawa S, Watanabe M, Takamori H, Iyama KI, Baba H
BACKGROUND: Although cumulative evidence supports the fact that stromal myofibroblasts promote tumor progression, the influence of myofibroblasts on intrahepatic cholangiocarcinoma (ICC) is unclear. We hypothesized that hepatic stellate (HS) cells can differentiate into myofibroblasts in ICC stroma and that they promote cancer progression. This study aims to: (1) assess the influence of myofibroblasts on the prognosis of ICC, (2) identify HS cells in ICC stroma, and (3) investigate the interaction between HS cells (LI90 and LX-2) and ICC cells (HuCCT-1 and MEC) in vitro. METHODS: The association between alpha-smooth muscle actin (alpha-SMA) expression and the prognoses of 46 ICC patients after hepatic resection was evaluated by immunohistochemical analysis. The HS cells in myofibroblasts of ICC were identified (double immunostaining) using antibodies for alpha-SMA, glial fibrillary acidic protein (GFAP), and desmin. The influence of HS cells on the invasion and growth of ICC cells was examined in vitro using a coculture system. RESULTS: Patients with high alpha-SMA expression exhibited the worse outcomes. Multivariate analyses revealed that high alpha-SMA expression (P = 0.0045) and positivity for lymph-node metastasis were independent prognostic factors. Because desmin- or GFAP-positive cells coexpressing alpha-SMA were observed in the ICC samples, they were considered to be derived from the HS cells. On coculturing with HS cells, a remarkable increase was observed in the invasion and growth of the two ICC cell lines. CONCLUSIONS: Stromal myofibroblasts may relate to the poor prognoses in ICC patients. HS cells appear to be involved in the progression of ICC.
PMID: 19548033 [PubMed - as supplied by publisher]
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An Update on Long-Term Outcome of Curative Hepatic Resection for Hepatocholangiocarcinoma.
Fetched: June 24th, 2009, 9:00pm EDT
Related Articles An Update on Long-Term Outcome of Curative Hepatic Resection for Hepatocholangiocarcinoma.
World J Surg. 2009 Jun 23;
Authors: Chok KS, Ng KK, Cheung TT, Yuen WK, Poon RT, Lo CM, Fan ST
BACKGROUND: Hepatocholangiocarcinoma (HCC-CC) is a rare primary liver cancer. Its long-term prognosis is still not well-defined. Results from the Eastern and Western literature have been conflicting and no conclusions can be drawn. The aim of the present study was to review the long-term outcome of curative hepatectomy for HCC-CC. PATIENTS AND METHODS: Prospectively collected data from December 1991 to 2006 recording patients with primary liver cancer receiving curative hepatectomy were reviewed. Twenty-five patients, 16 men and 9 women with a median age of 48 years, all ethnic Chinese, had HCC-CC. Their long-term outcome of resection was analyzed and compared to that of patients with cholangiocarcinoma (CC) or hepatocellular carcinoma (HCC). RESULTS: The HCC-CC patients had a median tumor size of 7.5 cm. Five of them developed postoperative complications. The median follow-up period was 25 months. All of the patients developed recurrence. The median overall survival was 25.2 months. The HCC-CC and CC groups had significantly worse overall survival than the HCC group (HCC versus HCC-CC, p = 0.012; HCC versus CC, p = 0.001) whereas between them there was no significant difference (p = 0.822). As for disease-free survival, there was no significant difference between the three groups; the median disease-free survival for HCC-CC patients was 13.5 months; that for CC patients, 16.1 months; and that for HCC patients, 19.0 months. All HCC-CC patients died within 120 months of primary surgery. CONCLUSIONS: Hepatocholangiocarcinoma entails poor long-term outcome after potentially curative hepatectomy. Other modalities of treatment should be explored in order to prolong survival of patients with this disease.
PMID: 19548027 [PubMed - as supplied by publisher]
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HCC diagnosis with liver-specific MRI--close to histopathology.
Fetched: June 24th, 2009, 9:00pm EDT
Related Articles HCC diagnosis with liver-specific MRI--close to histopathology.
Dig Dis. 2009;27(2):125-30
Authors: Bartolozzi C, Battaglia V, Bozzi E
Thanks to the sensible and continuous improvements achieved, magnetic resonance imaging (MRI) can nowadays be considered the most accurate modality to image the liver. Moreover, the technique is the only one able to provide at the same time information about intracellular and vascular changes occurring in parenchymas. For these reasons, MRI plays a major role in the surveillance and follow-up of patients with cirrhosis. If a baseline MR study investigates the progressive alteration of lesion architecture, grading, stromal component, as well as intracellular content of fat, glycogen, or metal ions, thus leading to a frequent confident diagnosis of lesion nature, a dynamic study provides additional information about lesion vascular enhancement, which may represent the only clue for the differential diagnosis between premalignant and malignant lesions. In addition, the introduction of hepatobiliary contrast agents has further implemented the diagnostic confidence of the technique, permitting to explore the so-called grey area in which significant histological changes are already present without an evident arterial supply of the nodule. Although in the evaluation of liver pathologies MRI is mainly applied in the study of cirrhosis, the technique also plays a fundamental role in the assessment of other primitive liver malignancies, such as fibrolamellar carcinoma or cholangiocarcinoma. In these cases in particular, MRI is required to pose a differential diagnosis with other liver malignancies (such as metastases), and, once the nature of the neoplasm is assessed, to give an accurate locoregional staging.
PMID: 19546550 [PubMed - in process]
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Cholangiocarcinoma in experimental hamsters with long-standing Opisthorchis viverrini infection.
Fetched: June 23rd, 2009, 9:00pm EDT
Related Articles Cholangiocarcinoma in experimental hamsters with long-standing Opisthorchis viverrini infection.
Asian Pac J Cancer Prev. 2009 Apr-Jun;10(2):299-302
Authors: Songserm N, Prasongwattana J, Sithithaworn P, Sripa B, Pipitkool V
Liver fluke infection of Opisthorchis viverrini (O. viverrini) is closely associated with several hepatobiliary diseases including cholangiocarcinoma (CCA), but no reports have described these diseases in chronic and long-standing experimental opisthorchiasis in hamsters more than 10 months of age. A longer period of infection could induce different pathological lesions. To prove the hypothesis, we therefore sequentially investigated histological changes of the hepatobiliary system in 4 groups of hamsters: O. viverrini infection (OV group) for up to 20 months; O. viverrini infection combined with short-term DMN (OV+DMN group) until 7 months; long-term treatment with DMN (DMN group) to 7 months; and normal controls for up to 20 months. Pathological changes in hamsters of the OV group gradually increased. Induction of CCA in this study was apparent with all three protocols. Importantly, this is the first report of CCA-induction in hamsters solely with long-term opisthorchiasis for up to 20 months. Although the histopathology of CCA in the OV group showed some differences in appearance from the OV+DMN and DMN groups, overall, O. viverrini itself can really induce CCA. In addition, this study confirms the previous studies both in vitro and in vivo on of effects of parasites and their metabolic products inducing cell proliferation, resulting in cholangiocarcinogenesis.
PMID: 19537899 [PubMed - in process]
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Risk factors for cholangiocarcinoma in Khon Kaen, Thailand: a nested case-control study.
Fetched: June 23rd, 2009, 9:00pm EDT
Related Articles Risk factors for cholangiocarcinoma in Khon Kaen, Thailand: a nested case-control study.
Asian Pac J Cancer Prev. 2009 Apr-Jun;10(2):251-8
Authors: Poomphakwaen K, Promthet S, Kamsa-Ard S, Vatanasapt P, Chaveepojnkamjorn W, Klaewkla J, Sujirarat D, Pichainarong N
The present nested case-control study within the Khon Kaen cohort study was conducted to assess risk factors for cholangiocarcinoma (CCA) development. Cases were 108 subjects with proven CCA, by ultrasound at least, and controls also numbered 108, matched by sex, age (not more than 3 years difference) and period of recruitment to the cohort (not more than 3 months difference). A questionnaire was constructed based on that employed for the Khon Kaen cohort study recruitment. McNemar's chi-square test and conditional logistic regression were used for crude analysis and multiple conditional logistic regression for multivariate analysis. Results revealed a sex ratio of 2:1 for males:females. The current study found a statistically significant relationship when adjusted for other potential covariate factors between cholangiocarcinoma and the consumption of total fruits 3-4.6 times per day (OR= 0.32, 95% CI= 0.12-0.88) and history of Opisthorchis viverrini eggs in stools at recruitment plus consumption of meat <0.45 times per day (OR= 2.99, 95% CI= 1.04-8.62). The findings suggest that O. viverrini infestation is the strongest risk factor for development of cholangiocarcinoma and also suggests decrease in risk among individuals who consume more fruit.
PMID: 19537893 [PubMed - in process]
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Comments on "Chemoembolization (TACE) of Unresectable Intrahepatic Cholangiocarcinoma with Slow-Release Doxorubicin-Eluting Beads: Preliminary Results"
Fetched: June 18th, 2009, 9:00pm EDT
Related Articles Comments on "Chemoembolization (TACE) of Unresectable Intrahepatic Cholangiocarcinoma with Slow-Release Doxorubicin-Eluting Beads: Preliminary Results"
Cardiovasc Intervent Radiol. 2009 Jun 16;
Authors: Kim JH
PMID: 19533225 [PubMed - as supplied by publisher]
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Malignant masquerade: dilemmas in diagnosing biliary obstruction.
Fetched: June 18th, 2009, 9:00pm EDT
Related Articles Malignant masquerade: dilemmas in diagnosing biliary obstruction.
Surg Oncol Clin N Am. 2009 Apr;18(2):207-14, vii
Authors: Bennett JJ, Green RH
The hepatobiliary surgeon must be as familiar with the nonmalignant processes that can affect the extrahepatic biliary tree as they are with the malignant causes. Subtleties in the patient's history, presentation, and imaging studies may prevent unnecessary extensive hepatobiliary resection. The focus of this article deals with the etiology of nonmalignant obstruction at the biliary bifurcation and hilum and the mid-bile duct. It does not focus on either choledocholithiasis or pancreatitis, the two most common causes of distal bile duct obstruction. Obstruction from pancreatic cancer is also not the focus of this discussion.
PMID: 19306807 [PubMed - indexed for MEDLINE]
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[Multidetector computed tomography of the liver]
Fetched: June 18th, 2009, 9:00pm EDT
Related Articles [Multidetector computed tomography of the liver]
Radiologe. 2005 Jan;45(1):15-23
Authors: Schima W, Kulinna C, Ba-Ssalamah A, Grünberger T
Multidetector-row CT (MDCT) scanners have dramatically improved liver imaging. With the newest generation of 40-64 row scanners, true isotropic imaging with a z-axis resolution of 0.3-0.6 mm has become possible. Acquisition time for the scan has been shortened to a few seconds. To fully exploit the advantages of MDCT scanners in liver imaging, the examination protocols have to be optimized with regard to contrast material flow rate, scan delay, and the number of scans performed. The possible advantages of double arterial phase scans in the detection of HCC are discussed. The clinical value of 3D reconstructions, such as multiplanar reconstructions and curved planar reconstructions, for assessment of the vascular and biliary duct infiltration is demonstrated. Optimized MDCT imaging improves detection and characterization of focal liver lesions.
PMID: 15609013 [PubMed - indexed for MEDLINE]
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Risk factors for endoscopic retrograde cholangiopancreatography-related cholangitis: a prospective study.
Fetched: June 17th, 2009, 9:00pm EDT
Related Articles Risk factors for endoscopic retrograde cholangiopancreatography-related cholangitis: a prospective study.
Turk J Gastroenterol. 2009 Jun;20(2):116-21
Authors: Ertuğrul I, Yüksel I, Parlak E, Ciçek B, Ataseven H, Başar O, Ibiş M, Saşmaz N, Sahin B
BACKGROUND/AIMS: Cholangitis is one of the most morbid complications of endoscopic biliary drainage and among the commonest causes of endoscopic retrograde cholangiopancreatography-related death. The aim of this prospective study was to investigate the risk factors for the development of cholangitis after endoscopic retrograde cholangiopancreatography in a tertiary referral center. METHODS: The study involved 503 consecutive patients with naive papilla who underwent endoscopic retrograde cholangiopancreatography. We included the cholangitis occurring within 72 hours after endoscopic retrograde cholangiopancreatography for all patients undergoing the procedure. All patients received antibiotic prophylaxis before endoscopic retrograde cholangiopancreatography. Factors including age, gender, presentation, nature of the papilla, therapeutic procedures, and the diagnosis were analyzed to predict post-endoscopic retrograde cholangiopancreatography cholangitis. RESULTS: Median age was 61.2 +/- 14.8 years and there were 274 (54.5%) women and 229 (45.5%) men. Seventeen (3.3%) patients (9 F, 8 M) developed cholangitis after endoscopic retrograde cholangiopancreatography. The risk of post-endoscopic retrograde cholangiopancreatography cholangitis development was most probable in patients with hilar cholangiocarcinoma. Post-endoscopic retrograde cholangiopancreatography cholangitis risk was significantly higher in patients with biliary dilatation and biliary stent insertion, and without periampullary diverticula (odds ratio, OR: 4.8, 4.4, 1.2, respectively). Total procedure duration was significantly prolonged and common bile duct diameter was significantly increased in patients who had cholangitis. Five patients (3 F, 2 M; 0.9%) died because of post-endoscopic retrograde cholangiopancreatography complicated sepsis. CONCLUSIONS: Increased common bile duct diameter, biliary dilatation, biliary stent insertion, prolonged total procedure time, and hilar cholangiocarcinoma have higher post-endoscopic retrograde cholangiopancreatography cholangitis risk. Moreover, the presence of periampullary diverticula was found to decrease cholangitis risk.
PMID: 19530044 [PubMed - in process]
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Overexpression of Adenovirus-mediated p27kip1 Lacking the Jab1-binding Region Enhances Cytotoxicity and Inhibits Xenografted Human Cholangiocarcinoma Growth.
Fetched: June 17th, 2009, 9:00pm EDT
Related Articles Overexpression of Adenovirus-mediated p27kip1 Lacking the Jab1-binding Region Enhances Cytotoxicity and Inhibits Xenografted Human Cholangiocarcinoma Growth.
Anticancer Res. 2009 Jun;29(6):2015-24
Authors: Shiraso S, Katayose Y, Yamamoto K, Mizuma M, Yabuuchi S, Oda A, Rikiyama T, Onogawa T, Yoshida H, Hayashi H, Ohtsuka H, Motoi F, Egawa S, Kato J, Unno M
The cyclin-dependent kinase inhibitor (CDK1) p27(kip1) is a negative regulator of cell cycling and has antitumor effects. In our previous study, the recombinant adenovirus expressing wild-type p27(kip1) (Adp27-wt) induced cell cycle arrest and apoptosis, and proved that p27 is a tumor suppressor gene like p53. Another adenovirus vector expressing mutant p27(kip1) (Adp27-mt), which inhibited degradation by the ubiquitin-proteasome system, showed increased protein stability and caused a stronger induction of apoptosis. Recently, the p27(kip1) protein binding with Jab1 (Jun activating binding protein 1) was found to translocate from the nucleus into the cytosol, and then become degraded by the 26S proteasome system. The inhibition of nuclear-cytoplasmic translocation increases the protein stability of p27(kip1) and p27(kip1) with a deletion of the Jab1-binding region (p27-jab-d) is not translocated and not degraded. Therefore, a new recombinant adenovirus (Adp27-jab-d) expressing p27-jab-d was made which was able to induce greater cytotoxicity. Adp27-jab-d inhibited the growth of human cholangiocarcinoma cell line (TFK-1) cells in vitro at 3.3 times (IC(50)) lower concentration than Adp27-wt. Moreover, in a xenografted severe combined immuno-deficient (SCID) mouse model injected with TFK-1 cells in the subcutaneous tissue, treatment by intratumor injection of Adp27-jab-d once a day for 3 days after the tumor was established, inhibited tumor growth more strongly than Adp27-wt or Adp27-mt and even induced tumor regression. However, the flow cytometric TUNEL assay showed little enhancement of apoptosis. Adp27-jab-d was thought to induce not only apoptosis but also necrosis, which was due to a specific effect of the Adp27-jab-d. Thus, by enhancing the cytotoxicity through inhibiting the translocaton of p27(kip1), p27(kip1) lacking the Jab1-binding region might be useful for cancer therapy. The control protein localization might also be a new target not only for cancer treatment, but also other diseases.
PMID: 19528460 [PubMed - in process]
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Preemptive Surgery for Premalignant Foregut Lesions.
Fetched: June 11th, 2009, 9:00pm EDT
Related Articles Preemptive Surgery for Premalignant Foregut Lesions.
J Gastrointest Surg. 2009 Jun 10;
Authors: Sharma RR, London MJ, Magenta LL, Posner MC, Roggin KK
INTRODUCTION: Preemptive surgery is the prophylactic removal of an organ at high risk for malignant transformation or the resection of a precancerous or "early" malignant neoplasm in an individual with a hereditary predisposition to cancer. Recent advances in molecular diagnostic techniques have improved our understanding of the biologic behavior of these conditions. Predictive testing is an emerging field that attempts to assess the potential risk of cancer development in predisposed individuals. Despite substantial improvement in these forms of testing, all results are imperfect. This information often becomes an important tool that is used by healthcare providers to evaluate the risk-benefit ratio of various risk modifying strategies (i.e., intensive surveillance or preemptive surgery). METHODS: A systematic literature review was performed using Medline and the bibliographies of all referenced publications to identify articles relating to preemptive surgery for premalignant foregut lesions. RESULTS AND DISCUSSION: In this review, we outline the controversies surrounding predictive risk assessment, surveillance strategies, and preemptive surgery in the management of high-grade dysplasia (HGD) in Barrett's esophagus (BE), hereditary diffuse gastric cancer (HDGC), bile duct cysts, primary sclerosing cholangitis (PSC), and pancreatic cystic neoplasms. Resection of BE is supported by the progressive nature of the disease, the risk of occult carcinoma, and the lethality of esophageal cancer. Prophylactic total gastrectomy for HDGC appears reasonable in the absence of accurate screening tests but must be balanced by the impact of surgical complications and altered quality of life. Surgical resection of biliary cysts theoretically eliminates the exposed epithelium to decrease the lifetime risk of cholangiocarcinoma. Liver transplantation for PSC remains controversial given the scarcity of donor organs and inability to accurately identify high-risk individuals. Given the uncertain natural history of pancreatic cystic neoplasms, the merits of selective versus obligatory resection will continue to be debated. CONCLUSIONS: Preemptive operations require optimal judgment and surgical precision to maximize function and enhance survival. Ultimately, balancing the risk of surgical intervention with less invasive interventions or observation must be individualized on a case-by-case basis.
PMID: 19513795 [PubMed - as supplied by publisher]
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[In vivo proton magnetic resonance spectroscopy of hepatocellular carcinoma and cholangiocarcinoma]
Fetched: June 11th, 2009, 9:00pm EDT
Related Articles [In vivo proton magnetic resonance spectroscopy of hepatocellular carcinoma and cholangiocarcinoma]
Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 2009 Apr;31(2):151-4
Authors: Dong AS, Tian JM, Lu JP, Zuo CJ, Wang L, Wang J
OBJECTIVE: To investigate the value of in vivo proton magnetic resonance spectroscopy (1H MRS) in the assessment of hepatocellular carcinoma (HCC) and cholangiocarcinoma. METHODS: 1H MRS was performed in normal volunteers and in patients with pathologically confirmed HCC and cholangiocarcinomas using a whole-body 1.5-T scanner. The choline-to-lipid ratios were measured by dividing the peak area of choline at 3.2 ppm and lipid at 1.3 ppm. RESULTS: The ratio of choline-to-lipid for normal liver, cholangiocarcinomas, and HCC were 0.07 +/- 0.04, 0.11 +/- 0.06, and 0.52 +/- 0.15, respectively. The ratio of choline-to-lipid was significantly higher in HCC compared than those in cholangiocarcinomas or normal livers (P < 0.05). However, it was not significantly different between cholangiocarcinomas and normal livers (P > 0.05). CONCLUSION: In vivo 1H MRS can reflect the pathological changes of HCC and cholangiocarcinomas at metabolic level and thus is useful in the diagnosis of these two cancers.
PMID: 19507591 [PubMed - in process]
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CDX2, cytokeratins 7 and 20 immunoreactivity in rectal adenocarcinoma.
Fetched: June 10th, 2009, 9:00pm EDT
Related Articles CDX2, cytokeratins 7 and 20 immunoreactivity in rectal adenocarcinoma.
Appl Immunohistochem Mol Morphol. 2009 May;17(3):196-201
Authors: Saad RS, Silverman JF, Khalifa MA, Rowsell C
There are limited data regarding CDX2 expression in rectal carcinoma. The CK20/CK7 immunoprofile of colorectal adenocarcinoma has been described in studies, which have mostly lumped colonic and rectal tumors together. In this study, we investigated the diagnostic utility of immunohistochemical stains for CK7, CK20, and CDX2 in a series of rectal adenocarcinoma. Fifty-five specimens of rectal adenocarcinomas were retrieved and immunostained for CK7 (Dako-M7018), CK20 (NovoCastra NCL-L-CK20), and CDX2 (NovoCastra NCL-CDX2). Thirty cases of pancreatic adenocarcinoma and 15 cholangiocarcinomas were also studied as a comparison group. CK7 was expressed in 12/55 (22%) and CK20 in 48/55 (87%) cases of rectal adenocarcinoma. The CK7-/CK20+ immunophenotype was identified in 36/55 (65%), CK7+/CK20+ in 12/55 (22%), and CK7-/CK20- in 7/55 (13%) rectal adenocarcinoma. CDX2 showed moderate-strong positivity in all cases and was not related to tumor differentiation. Benign rectal mucosa was available in 37 cases and showed the following results: CK7-/CK20+ in 25/37 (67%), CK7+/CK20+ in 8/37 (22%) and CK7-/CK20- in 4/37 (11%) cases. In pancreatic adenocarcinomas and cholangiocarcinomas, 29/45 (64%) were CK7+/CK20+ and 16/45 (36%) were CK7+/CK20-. CDX2 was positive in only 3/45 (7%) of these cases; all were pancreatic adenocarcinomas. In conclusion, CK7 can be expressed in rectal adenocarcinoma, and should not be used as the sole basis for excluding a rectal primary. CDX2 is a sensitive marker for rectal origin of adenocarcinoma. It can be helpful in cases with metastatic rectal carcinoma, especially those with CK7+/CK20+ or CK20-/CK7- immunophenotype. In this study, CDX2 expression was not influenced by the grade (differentiation) of rectal adenocarcinoma.
PMID: 19098678 [PubMed - indexed for MEDLINE]
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Primary sclerosing cholangitis in Turkish patients: characteristic features and prognosis.
Fetched: June 9th, 2009, 9:00pm EDT
Related Articles Primary sclerosing cholangitis in Turkish patients: characteristic features and prognosis.
Hepatobiliary Pancreat Dis Int. 2009 Jun;8(3):312-5
Authors: Ataseven H, Parlak E, Yüksel I, Başar O, Ertuğrul I, Saşmaz N, Sahin B
BACKGROUND: Primary sclerosing cholangitis (PSC) is a chronic cholestatic liver disease characterized by destruction and fibrosis of the bile ducts. This study aimed to demonstrate the hepatic and extrahepatic characteristic findings and prognostic outcomes of Turkish patients with PSC. METHODS: The medical records of 35 consecutive patients with PSC from January 1988 to June 2007 were recorded prospectively. From the time of diagnosis, clinical features and laboratory data were collected. RESULTS: The mean age of the 35 patients was 41.69 years (range 15-80 years) at the time of diagnosis; 14 (40%) were female, and 21 (60%) were male. The mean duration of follow-up was 58.86 months (1-180 months). Twenty (57.1%) of the patients with PSC were asymptomatic and 22 (62.9%) had inflammatory bowel disease. At the time of diagnosis, 20 (57.1%) of the patients had both intra- and extra-hepatic PSC. Twenty-one (60%) of the patients, who had undergone ERCP for stent placement, had dominant bile duct stenosis. Cholangiocarcinoma was found in 2 (5.7%) of the patients and cirrhosis was detected in 7 (20%); 5 (14.3%) underwent liver transplantation. The median follow-up time after liver transplantation was 23 months and all are still alive. Six (17.1%) patients died. CONCLUSIONS: PSC has a clinical course varied from advanced liver disease requiring liver transplantation within a short time to being asymptomatic for decades. The prognosis of Turkish patients with PSC is also disappointing as described in other studies.
PMID: 19502174 [PubMed - in process]
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Percutaneous Treatment of Malignant Jaundice Due to Extrahepatic Cholangiocarcinoma: Covered Viabil Stent Versus Uncovered Wallstents.
Fetched: June 6th, 2009, 9:00pm EDT
Related Articles Percutaneous Treatment of Malignant Jaundice Due to Extrahepatic Cholangiocarcinoma: Covered Viabil Stent Versus Uncovered Wallstents.
Cardiovasc Intervent Radiol. 2009 Jun 4;
Authors: Krokidis M, Fanelli F, Orgera G, Bezzi M, Passariello R, Hatzidakis A
To compare clinical effectiveness of Viabil-covered stents versus uncovered metallic Wallstents, for palliation of malignant jaundice due to extrahepatic cholangiocarcinoma, 60 patients were enrolled in a prospective and randomized study. In half of the patients a bare Wallstent was used, and in the other half a Viabil biliary stent. Patients were followed up until death. Primary patency, survival, complication rates, and mean cost were calculated in both groups. Stent dysfunction occurred in 9 (30%) patients in the bare stent group after a mean period of 133.1 days and in 4 (13.3%) patients in the covered stent group after a mean of 179.5 days. The incidence of stent dysfunction was significantly lower in the covered stent group (P = 0.046). Tumor ingrowth occurred exclusively in the bare stent group (P = 0.007). Median survival was 180.5 days for the Wallstent and 243.5 days for the Viabil group (P = 0.039). Complications and mean cost were similar in the two groups. Viabil stent-grafts proved to be significantly superior to Wallstents for the palliation of malignant jaundice due to extrahepatic cholangiocarcinoma, with comparable cost and complication rates. Appropriate patient selection should be performed prior to stent placement.
PMID: 19495871 [PubMed - as supplied by publisher]
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Regional chemotherapy for unresectable primary liver cancer: results of a phase II clinical trial and assessment of DCE-MRI as a biomarker of survival.
Fetched: June 6th, 2009, 9:00pm EDT
Related Articles Regional chemotherapy for unresectable primary liver cancer: results of a phase II clinical trial and assessment of DCE-MRI as a biomarker of survival.
Ann Oncol. 2009 Jun 2;
Authors: Jarnagin WR, Schwartz LH, Gultekin DH, Gönen M, Haviland D, Shia J, D'Angelica M, Fong Y, Dematteo R, Tse A, Blumgart LH, Kemeny N
BACKGROUND: This study reports the results of hepatic arterial infusion (HAI) with floxuridine (FUDR) and dexamethasone (dex) in patients with unresectable intrahepatic cholangiocarcinoma (ICC) or hepatocellular carcinoma (HCC) and investigates dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) assessment of tumor vascularity as a biomarker of outcome. PATIENTS AND METHODS: Thirty-four unresectable patients (26 ICC and eight HCC) were treated with HAI FUDR/dex. Radiologic dynamic and pharmacokinetic parameters related to tumor perfusion were analyzed and correlated with response and survival. RESULTS: Partial responses were seen in 16 patients (47.1%); time to progression and response duration were 7.4 and 11.9 months, respectively. Median follow-up and median survival were 35 and 29.5 months, respectively; 2-year survival was 67%. DCE-MRI data showed that patients with pretreatment integrated area under the concentration curve of gadolinium contrast over 180 s (AUC 180) >34.2 mM.s had a longer median survival than those with AUC 180 <34 mM.s (35.1 versus 19.1 months, P = 0.002). Decreased volume transfer exchange between the vascular space and extracellular extravascular space (-DeltaK(trans)) and the corresponding rate constant (-Deltak(ep)) on the first post-treatment scan both predicted survival. CONCLUSIONS: In patients with unresectable primary liver cancer, HAI therapy can be effective and safe. Pretreatment and early post-treatment changes in tumor perfusion characteristics may predict treatment outcome.
PMID: 19491285 [PubMed - as supplied by publisher]
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Proteomic analysis of human bile and potential applications for cancer diagnosis.
Fetched: June 6th, 2009, 9:00pm EDT
Related Articles Proteomic analysis of human bile and potential applications for cancer diagnosis.
Expert Rev Proteomics. 2009 Jun;6(3):285-301
Authors: Farina A, Dumonceau JM, Lescuyer P
Bile is a body fluid produced by the liver and drained by biliary ducts into the duodenum. It has two major functions: first, it contains bile acids, which are critical for the digestion of fats, and second, it is an excretory pathway for many endogenous and exogenous compounds. Proteomic analysis of bile is particularly difficult since this fluid contains high concentrations of various substances that strongly interfere with protein separation and identification techniques. Furthermore, owing to its deep location in the body, bile must be collected by surgical or endoscopic procedures. However, as was speculated for other body fluids, bile appears to be a promising sample for the discovery of disease biomarkers leaking from proximal tissues: the liver, pancreas or biliary tree. The interest in clinical proteomics was demonstrated by two studies that identified in bile potential biomarkers for two deadly and difficult to diagnose neoplasms, pancreatic cancer and cholangiocarcinoma.
PMID: 19489700 [PubMed - in process]
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Diagnosis of cholangiocarcinoma: a case series and literature review.
Fetched: June 6th, 2009, 9:00pm EDT
Related Articles Diagnosis of cholangiocarcinoma: a case series and literature review.
J La State Med Soc. 2009 Mar-Apr;161(2):89-94
Authors: Jabara B, Fargen KM, Beech S, Slakey DR
INTRODUCTION: Cholangiocarcinoma is a rare neoplasm of the bile ducts. Risk factors include primary sclerosing cholangitis, Caroli's disease, infection, liver flukes, and chronic typhoid. Improvements in imaging and surgical techniques may allow for earlier diagnosis and improvements in patient survival. METHODS: A retrospective review of patients referred to a single center, and a literature review. RESULTS: Of 23 patients 14 were male, 9 female; mean age 64 years. Mean survival time was 621 days. Stage I, II, III and IV patients had mean survival times of 1120.5, 117.5, 479.5, and 448.9 days, respectively. Patients with resectable disease had improved survival (964.5 days) compared to non-surgically treated (174.4 days) and unresectable patients (558.1 days). CONCLUSIONS: Despite advances in imaging techniques and surgical care, overall survival of cholangiocarcinoma remains poor. Early recognition and minimization of delay may allow for definitive surgical therapy (complete resection) and improved survival.
PMID: 19489389 [PubMed - in process]
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Characterization of apolipoprotein A-I as a potential biomarker for cholangiocarcinoma.
Fetched: June 3rd, 2009, 9:00pm EDT
Related Articles Characterization of apolipoprotein A-I as a potential biomarker for cholangiocarcinoma.
Eur J Cancer Care (Engl). 2009 May 27;
Authors: Wang X, Dai S, Zhang Z, Liu L, Wang J, Xiao X, He D, Liu B
WANG X., DAI S., LIU B., ZHANG Z., LIU L., WANG J., XIAO X. & HE D. (2009) European Journal of Cancer Care Characterization of apolipoprotein A-I as a potential biomarker for cholangiocarcinomaSerum samples from 60 cholangiocarcinoma (CC), 60 benign diseases of hepatobiliary and 53 normal individuals were analysed by SELDI-TOF-MS (Surface Enhanced Laser Desorption/Ionization Time of Flight Mass Spectrometry). It was found that a 28 k m/z peak was significantly decreased in CC and retained discriminatory value between CC and normal group, also between CC and benign groups. Then 1-D, 2-D gel electrophoresis and tandem mass spectroscopy were employed to isolate and identify the protein that correlates with observed SELDI-TOF-MS (m/z) value. The results demonstrated that 28 k m/z peak was apolipoprotein A-I (ApoA-I) and its identity was further validated by immunodepletion and Western blotting analysis. Subsequently, it was inspiring found that the decreased level of ApoA-I analysed by enzyme linked immunosorbent assay was consistent with SELDI-TOF-MS analysis. Therefore, it suggested that ApoA-I could be a potential useful biomarker for CC.
PMID: 19486127 [PubMed - as supplied by publisher]
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[Histopathology and molecular biological behaviors in human malignant neoplasms]
Fetched: June 3rd, 2009, 9:00pm EDT
Related Articles [Histopathology and molecular biological behaviors in human malignant neoplasms]
Fukuoka Igaku Zasshi. 2009 Jan;100(1):13-25
Authors: Tsuneyoshi M, Yao T, Oda Y, Tamiya S, Aishima S, Yamamoto H, Ohishi Y, Hirahashi M, Kurihara S, Kohashi K
PMID: 19378772 [PubMed - indexed for MEDLINE]
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Larger short-axis length of lymph nodes predicts malignant involvement.
Fetched: May 27th, 2009, 8:18am EDT
Related Articles Larger short-axis length of lymph nodes predicts malignant involvement.
Gastrointest Endosc. 2009 Feb;69(2):387; author reply 387-8
Authors: Matsushita M, Uchida K, Nishio A, Okazaki K
PMID: 19185700 [PubMed - indexed for MEDLINE]
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Enhancement pattern of hilar cholangiocarcinoma: Contrast-enhanced ultrasound versus contrast-enhanced computed tomography.
Fetched: May 26th, 2009, 9:00pm EDT
Related Articles Enhancement pattern of hilar cholangiocarcinoma: Contrast-enhanced ultrasound versus contrast-enhanced computed tomography.
Eur J Radiol. 2009 May 21;
Authors: Xu HX, Chen LD, Xie XY, Xie XH, Xu ZF, Liu GJ, Lin MX, Wang Z, Lu MD
OBJECTIVE: To compare the enhancement pattern of hilar cholangiocarcinoma on contrast-enhanced ultrasound (CEUS) with that on contrast-enhanced computed tomography (CECT). METHODS: Thirty-two consecutive patients with pathologically proven hilar cholangiocarcinomas were evaluated by both low mechanical index CEUS and CECT. The enhancement feature of the tumor, portal vein infiltration, and lesion conspicuity on them was investigated. RESULTS: In the arterial phase, the numbers of the lesions showing hyperenhancement, isoenhancement, and hypoenhancement, were 14 (43.8%), 14 (43.8%), and 4 (12.6%), on CEUS, and 12 (37.5%), 9 (28.1%), and 11 (34.4%), on CECT (P=0.162). In portal phase, the numbers of the lesions showing hypoenhancement, isoenhancement, and hyperenhancement were 30 (93.8%), 1 (3.1%), and 1 (3.1%), on CEUS, and 23 (71.9%), 8 (25.0%), and 1 (3.1%), on CECT (P=0.046). The detection rates for portal vein infiltration were 84.2% (16/19) for baseline ultrasound, 89.5% (17/19) for CEUS, and 78.9% (15/19) for CECT (all P>0.05 between every two groups). CEUS significantly improved the lesion conspicuity in comparison with CECT. CEUS and CECT made correct diagnoses in 30 (93.8%) and 25 (78.1%) lesions prior to pathological examination (P=0.125). CONCLUSION: The enhancement pattern of hilar cholangiocarcinoma on CEUS was similar with that on CECT in arterial phase, whereas in portal phase hilar cholangiocarcinoma shows hypoenhancement more likely on CEUS. CEUS and CECT lead to similar results in evaluating portal vein infiltration and diagnosis of this entity.
PMID: 19464836 [PubMed - as supplied by publisher]
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Zoledronic acid determines S-phase arrest but fails to induce apoptosis in cholangiocarcinoma cells.
Fetched: May 26th, 2009, 9:00pm EDT
Related Articles Zoledronic acid determines S-phase arrest but fails to induce apoptosis in cholangiocarcinoma cells.
Biochem Pharmacol. 2009 Jul 15;78(2):133-41
Authors: Romani AA, Desenzani S, Morganti MM, La Monica S, Borghetti AF, Soliani P
Cholangiocarcinoma is the second most common primary hepatic neoplasia and the only curative therapy is surgical resection or liver transplantation. Biphosphonates (BPs) are an emerging class of drugs widely used to treat bone diseases and also appear to possess direct antitumor activity. In two human cholangiocarcinoma cell lines (TFK-1 and EGI-1) we investigated, for the first time, the activity of zoledronic acid by determining proliferation, cell cycle analysis and apoptosis. The results obtained indicate that zoledronic acid induces cell-narrowing and growth inhibition, both reversed by 25muM GGOH, and significantly affects the colony-forming ability of these cells. The inhibition by zoledronic acid of Rap1A prenylation was reversed in cell co-treated with GGOH. At 10-50muM zoledronic acid exerted an S-phase cell cycle arrest which was confirmed by changes in the level of cyclins and of regulators p27(KIP1) and pRb. Interestingly, the expression level of cyclin A (putative S-phase marker) shows a dose-dependent increment in contrast to the decrement of cyclin D1 (putative G1 phase marker). However, neither hypodiploid cells nor cleaved PARP or caspase-3 was detected. The lack of TP53 or loss of its function, the large constitutive expressions of anti-apoptotic proteins Bcl-xL and HSP27 together with the low level of the pro-apoptotic Bax are the likely factors which protect cells from apoptosis. In conclusion, our study indicates that zoledronic acid induces S-phase arrest and cell-narrowing, both reversed by GGOH and, by changing the delicate balance between pro- and anti-apoptotic proteins, allows survival of cholangiocarcinoma cells.
PMID: 19464430 [PubMed - in process]
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[Management of biliary tract carcinomas]
Fetched: May 26th, 2009, 9:00pm EDT
Related Articles [Management of biliary tract carcinomas]
Rev Prat. 2009 Apr 20;59(4):469-73
Authors: Delbaldo C, Laurent A, Grenier J, Cherqui D, Luciani A, Piedbois P
Biliary tract carcinomas are rare tumours, counting for less than 5% of cancer. Biliary tract carcinomas comprise gallbladder carcinoma and cholangiocarcinoma, which arise from the intrahepatic or extrahepatic bile ducts. These tumours have a poor prognosis, with a median survival of 6 months for advanced disease. Surgical resection is the only potentially curative therapy. Adjuvant treatement by chemotherapy, radiotherapy or radio-chemotherapy might be an option after surgery, however no standard therapy is define. For advanced disease, despite progress of palliative chemotherapy, there is no standard therapy.
PMID: 19462864 [PubMed - in process]