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Stacey Cochrane is planning her funeral at just 37 - Dunfermline Press

Posted: January 13th, 2023, 2:47pm GMT

Stacey Cochrane is planning her funeral at just 37 Dunfermline Press
Pancreatic Cancer Symptoms in Males: Treatments and More - Healthgrades

Posted: January 13th, 2023, 12:13pm GMT

Pancreatic Cancer Symptoms in Males: Treatments and More Healthgrades
Dry January's health & wellness benefits with expert tips for success - Naples Daily News

Posted: January 13th, 2023, 8:04am GMT

Dry January's health & wellness benefits with expert tips for success Naples Daily News
School officials, hospital co-workers remember Jennifer Halladay - Farmville Herald

Posted: January 13th, 2023, 4:42am GMT

School officials, hospital co-workers remember Jennifer Halladay Farmville Herald
Obesity at age 20 and weight gain during adulthood increase risk of ... - BioMed Central

Posted: January 13th, 2023, 4:33am GMT

Obesity at age 20 and weight gain during adulthood increase risk of ... BioMed Central
Lanarkshire surgeon given incurable cancer diagnosis after noticing ... - Daily Record

Posted: January 12th, 2023, 6:10pm GMT

Lanarkshire surgeon given incurable cancer diagnosis after noticing ... Daily Record
Bydureon BCise (Exenatide) - Subcutaneous: Uses, Dosage - Verywell Health

Posted: January 12th, 2023, 5:55pm GMT

Bydureon BCise (Exenatide) - Subcutaneous: Uses, Dosage Verywell Health
Lanarkshire boy raises cash for charity after mum was diagnosed ... - Daily Record

Posted: January 12th, 2023, 7:50am GMT

Lanarkshire boy raises cash for charity after mum was diagnosed ... Daily Record
Al Roker feels ‘blessed to be alive’ after life-threatening medical ordeal - Yahoo News

Posted: January 11th, 2023, 4:22pm GMT

Al Roker feels ‘blessed to be alive’ after life-threatening medical ordeal Yahoo News
Lanarkshire mum discovers tot has rare cancer - as she changed his ... - Daily Record

Posted: January 11th, 2023, 3:50pm GMT

Lanarkshire mum discovers tot has rare cancer - as she changed his ... Daily Record
Schrenk, Portia - KMVT

Posted: January 10th, 2023, 3:10pm GMT

Schrenk, Portia KMVT
FedEx to further trim Sunday deliveries - Yahoo Finance

Posted: January 10th, 2023, 2:59pm GMT

FedEx to further trim Sunday deliveries Yahoo Finance
Lorraine Kirkham Obituary (1949 - 2023) - Legacy.com

Posted: January 10th, 2023, 10:45pm GMT

Lorraine Kirkham Obituary (1949 - 2023) Legacy.com
Obesity and Breast Cancer: Connection, Risk, Treatment - Verywell Health

Posted: January 6th, 2023, 9:01pm GMT

Obesity and Breast Cancer: Connection, Risk, Treatment Verywell Health
Al Roker Thanks NewYork-Presbyterian for Saving His Life - Health Matters

Posted: January 6th, 2023, 5:21pm GMT

Al Roker Thanks NewYork-Presbyterian for Saving His Life Health Matters
For Humble man, gallstones lead to heart failure diagnosis - Houston Chronicle

Posted: January 6th, 2023, 3:33pm GMT

For Humble man, gallstones lead to heart failure diagnosis Houston Chronicle
Patricia Reichenbach Obituary (1951 - 2023) - Legacy.com

Posted: January 6th, 2023, 11:22am GMT

Patricia Reichenbach Obituary (1951 - 2023) Legacy.com
Biking the Globe for C2C4C - Yahoo Finance

Posted: January 5th, 2023, 6:35pm GMT

Biking the Globe for C2C4C Yahoo Finance
Rhod Gilbert reschedules UK tour dates following health setback: “I ... - NME

Posted: January 5th, 2023, 6:00am GMT

Rhod Gilbert reschedules UK tour dates following health setback: “I ... NME
Atypical Chest Pain: Symptoms, Causes, Treatment, and Outlook - Healthline

Posted: January 5th, 2023, 10:24pm GMT

Atypical Chest Pain: Symptoms, Causes, Treatment, and Outlook Healthline
Cholangiocarcinoma: New Hope for a Rare and Aggressive Cancer - Curetoday.com

Posted: December 30th, 2022, 6:00am GMT

Cholangiocarcinoma: New Hope for a Rare and Aggressive Cancer Curetoday.com
The epidemiological trends of biliary tract cancers in the United ... - BMC Gastroenterology

Posted: December 29th, 2022, 6:00am GMT

The epidemiological trends of biliary tract cancers in the United ... BMC Gastroenterology
Zanidatamab Shows Promise in HER2-Expressing Biliary Tract ... - Cancer Network

Posted: December 28th, 2022, 6:00am GMT

Zanidatamab Shows Promise in HER2-Expressing Biliary Tract ... Cancer Network
Imfinzi plus Imjudo approved in Japan for advanced liver and non ... - AstraZeneca

Posted: December 28th, 2022, 6:00am GMT

Imfinzi plus Imjudo approved in Japan for advanced liver and non ... AstraZeneca
EU approves AZ's Imfinzi plus chemo for advanced biliary tract ... - pharmaphorum

Posted: December 22nd, 2022, 6:00am GMT

EU approves AZ's Imfinzi plus chemo for advanced biliary tract ... pharmaphorum
Imfinzi plus chemotherapy approved in the EU as first ... - AstraZeneca

Posted: December 21st, 2022, 6:00am GMT

Imfinzi plus chemotherapy approved in the EU as first ... AstraZeneca
$4 million award funds new Center for Native American Cancer ... - NAU News

Posted: December 21st, 2022, 6:00am GMT

$4 million award funds new Center for Native American Cancer ... NAU News
Bile Duct Cancer: What an Expert Wants You to Know - Everyday Health

Posted: December 20th, 2022, 6:00am GMT

Bile Duct Cancer: What an Expert Wants You to Know Everyday Health
Zanidatamab Elicits Responses in Previously Treated HER2 ... - OncLive

Posted: December 20th, 2022, 6:00am GMT

Zanidatamab Elicits Responses in Previously Treated HER2 ... OncLive
Rhod Gilbert postpones shows for surgery after Cancer treatment - BBC

Posted: December 20th, 2022, 6:00am GMT

Rhod Gilbert postpones shows for surgery after Cancer treatment BBC
Study Finds Folfirinox is Well Tolerated, Potentially Effective in First ... - Pharmacy Times

Posted: December 19th, 2022, 6:00am GMT

Study Finds Folfirinox is Well Tolerated, Potentially Effective in First ... Pharmacy Times
Immunotherapy Is Buying More Time for Patients With ... - Curetoday.com

Posted: December 19th, 2022, 6:00am GMT

Immunotherapy Is Buying More Time for Patients With ... Curetoday.com
Presentation, Imaging, and Management of a Rare Case of ... - American College of Surgeons

Posted: December 16th, 2022, 6:00am GMT

Presentation, Imaging, and Management of a Rare Case of ... American College of Surgeons
Colonic Obstruction and Perforation Due to Gallstone Ileus - American College of Surgeons

Posted: December 16th, 2022, 6:00am GMT

Colonic Obstruction and Perforation Due to Gallstone Ileus American College of Surgeons
What Is Bile Duct Cancer? Symptoms, Causes, Treatments, and More - Everyday Health

Posted: December 14th, 2022, 6:00am GMT

What Is Bile Duct Cancer? Symptoms, Causes, Treatments, and More Everyday Health
Pastor learns firsthand that miracles do happen - City of Hope

Posted: November 23rd, 2022, 6:00am GMT

Pastor learns firsthand that miracles do happen City of Hope
Gallbladder Disease Facts and Statistics: What You Need to Know - Verywell Health

Posted: November 16th, 2022, 6:00am GMT

Gallbladder Disease Facts and Statistics: What You Need to Know Verywell Health
Swedish Study Finds Increasing Prevalence of Biliary Tract Cancers ... - AJMC.com Managed Markets Network

Posted: October 24th, 2022, 5:00am GMT

Swedish Study Finds Increasing Prevalence of Biliary Tract Cancers ... AJMC.com Managed Markets Network
Durvalumab Plus Standard-of-Care Chemotherapy Shakes Up First ... - OncLive

Posted: October 17th, 2022, 5:00am GMT

Durvalumab Plus Standard-of-Care Chemotherapy Shakes Up First ... OncLive
Targeted Therapy Generates Early Excitement in Biliary Tract Cancer - OncLive

Posted: September 30th, 2022, 5:00am GMT

Targeted Therapy Generates Early Excitement in Biliary Tract Cancer OncLive
Addition of Durvalumab to First-Line Chemotherapy in Advanced ... - NEJM Journal Watch

Posted: July 7th, 2022, 5:00am GMT

Addition of Durvalumab to First-Line Chemotherapy in Advanced ... NEJM Journal Watch
Gallstones May Precede Pancreatic Cancer - Verywell Health

Posted: May 24th, 2022, 5:00am GMT

Gallstones May Precede Pancreatic Cancer Verywell Health
Gallstones May Be a Sign of Pancreatic Cancer - Healthline

Posted: May 15th, 2022, 5:00am GMT

Gallstones May Be a Sign of Pancreatic Cancer Healthline

PubMed - Gall Bladder Cancer

Development and validation of circulating protein signatures as diagnostic biomarkers for biliary tract cancer

Fetched: January 27th, 2023, 5:01am GMT by Troels D Christensen

JHEP Rep. 2022 Dec 13;5(3):100648. doi: 10.1016/j.jhepr.2022.100648. eCollection 2023 Mar.

ABSTRACT

BACKGROUND & AIMS: Biliary tract cancer (BTC) is associated with a dismal prognosis, partly because it is typically diagnosed late, highlighting the need for diagnostic biomarkers. The purpose of this project was to identify and validate multiprotein signatures that could differentiate patients with BTC from non-cancer controls.

METHODS: In this study, we included treatment-naïve patients with BTC, healthy controls, and patients with benign conditions including benign biliary tract disease. Participants were divided into three non-overlapping cohorts: a case-control-based discovery cohort (BTC = 186, controls = 249); a case-control-based validation cohort (validation cohort 1: BTC = 113, controls = 241); and a cohort study-based validation cohort including participants (BTC = 8, controls = 132) referred for diagnostic work-up for suspected cancer (validation cohort 2). Immuno-Oncology (I-O)-related proteins were measured in serum and plasma using a proximity extension assay (Olink Proteomics). Lasso and Ridge regressions were used to generate protein signatures of I-O-related proteins and carbohydrate antigen 19-9 (CA19-9) in the discovery cohort.

RESULTS: Sixteen protein signatures, including 2 to 82 proteins, were generated. All signatures included CA19-9 and chemokine C-C motif ligand 20. Signatures discriminated between patients with BTC vs. controls, with AUCs ranging from 0.95 to 0.99 in the discovery cohort and 0.94 to 0.97 in validation cohort 1. In validation cohort 2, AUCs ranged from 0.84 to 0.94. Nine signatures achieved a specificity of 82% to 84% while keeping a sensitivity of 100% in validation cohort 2. All signatures performed better than CA19-9, and signatures including >15 proteins showed the best performance.

CONCLUSION: The study demonstrated that it is possible to generate protein signatures that can successfully differentiate patients with BTC from non-cancer controls.

IMPACT AND IMPLICATIONS: We attempted to find blood sample-based protein profiles that could differentiate patients with biliary tract cancer from those without cancer. Several profiles were found and tested in different groups of patients. The profiles were successful at identifying most patients with biliary tract cancer, pointing towards the utility of multiprotein signatures in this context.

PMID:36699667 | PMC:PMC9867981 | DOI:10.1016/j.jhepr.2022.100648
Small Cell Type Undifferentiated Carcinoma of Gall Bladder with Pas Positive Hyaline Globule Masquerading as Liver Mass: A Case Report and Literature Review

Fetched: January 27th, 2023, 5:01am GMT by Raman K Gupta

Korean J Gastroenterol. 2023 Jan 25;81(1):40-45. doi: 10.4166/kjg.2022.100.

ABSTRACT

An undifferentiated carcinoma (UC) of the gall bladder behaves aggressively and has a grave prognosis. Small cell type undifferentiated carcinoma of the gall bladder is a rare variant. This paper reports a case of UC of gall bladder with PAS-positive diastase- resistant eosinophilic hyaline globules present as liver mass (on imaging) in a male patient. The microscopic findings of the liver and gall bladder after a right tri-segmentectomy showed an un-differentiated malignant neoplasm composed of cells with round to oval nuclei, prominent nucleoli, and scanty neoplasm. No definite cell pattern was identified with these neoplastic cells. A section from the gall bladder revealed a tumor arising from the lining epithelium and infiltrating through the muscularis. This tumor was infiltrating the adherent liver tissue directly and forming a mass of undifferentiated malignant cells. The focal area within the tumor mass showed the presence of PAS-positive, diastase-resistant, eosinophilic hyaline globules within the neoplastic cells. The immunohistochemistry test was diffusely positive for perinuclear anti-neutrophil cytoplasmic antibodies and negative for chromogranin, vimentin, Desmin, alpha-fetoprotein, leukocyte common antigen, CD34, and bcl2. When the clinical and radiological data are inconclusive, careful analysis of the histological and immunophenotypic features is needed to make the final diagnosis of UC of the gall bladder. The biological behavior and prognosis of this tumor remain unclear because of its rarity. Further studies will be needed to understand the characteristics of this deadly tumor and to establish an effective therapy for it.

PMID:36695066 | DOI:10.4166/kjg.2022.100
Incidental gall bladder cancer in the laparoscopic treatment and magnetic resonance imaging era: A single institution experience

Fetched: January 26th, 2023, 5:01am GMT by Zhou Yong

J Minim Access Surg. 2023 Jan 9. doi: 10.4103/jmas.jmas_117_22. Online ahead of print.

ABSTRACT

BACKGROUND: Incidental gall bladder cancer (IGBC) is often discovered unexpectedly in patients after cholecystectomy. Currently, magnetic resonance imaging (MRI) has been widely applied in the pre-operative diagnosis of gall bladder diseases as laparoscopic cholecystectomy developed into the preferred method.

AIMS AND OBJECTIVES: This study aimed to evaluate the pre-operative MRI application and laparoscopic management in the IGBCs.

MATERIALS AND METHODS: Between January 2011 and January 2020, a total of 7917 patients with gall bladder diseases treated by laparoscopy were enrolled in this study.

RESULTS: Amongst 49 patients diagnosed with IGBCs, the incidence of IGBCs in polypoid lesions, biliary pancreatitis, cholecystitis, cholecystocholedocholithiasis and gall bladder stones was 0.42%, 1.19%, 0.62%, 1.20% and 0.49%, respectively. MRI evaluation showed more remarkable pre-operative imaging as compared to ultrasonographic evaluation (40.8 vs. 26.5, P < 0.05). Furthermore, 14 patients were diagnosed with gall bladder cancer through intraoperative histological examination and 11 received laparoscopic extensive resection after cholecystectomy. MRI findings with diffuse thickening of the gall bladder detected IGBCs with 6.1% sensitivity, 96.02 specificity, 0.95% positive predictive values and 99.4% negative predictive values; diffuse thickening of the gall bladder with suspicion of malignancy detected IGBCs with 12.2% sensitivity, 99.1% specificity, 7.6% positive predictive values and 99.5% negative predictive values; focal thickening of the gall bladder detected IGBCs with 16% sensitivity, 99.8% specificity, 32% positive predictive values and 99.5% negative predictive values; moreover, suspicious lesion detected IGBCs with 6.1% sensitivity, 99.6% specificity, 8.8% positive predictive values and 99.4% negative predictive values.

CONCLUSIONS: Patients with biliary pancreatitis and cholecystocholedocholithiasis have a higher incidence of IGBC. MRI evaluation could provide more accurate information for the IGBCs, which should be recommended for patients accepting cholecystectomy. MRI findings exhibited an unsatisfactory sensitivity when detecting IGBCs, but they represented high specificity. Pre-operative MRI evaluation and intraoperative histological examination may help some IGBCs to achieve one-stage laparoscopic extensive resection.

PMID:36695237 | DOI:10.4103/jmas.jmas_117_22
A-Kinase Anchor Protein 95 Is Involved in ERK1/2-Elk-1 Signal Transduction in Colon Cancer

Fetched: January 26th, 2023, 5:01am GMT by Xiangyu Kong

Anal Cell Pathol (Amst). 2023 Jan 14;2023:8242646. doi: 10.1155/2023/8242646. eCollection 2023.

ABSTRACT

OBJECTIVES: To assess A-kinase anchor protein 95 (AKAP95), B-Raf, extracellular regulated protein kinases 1/2 (ERK1/2), and Elk-1 expression in colon cancer tissue, and characterize AKAP95 associations with B-Raf, ERK1/2, Elk-1, and colon cancer clinicopathological indices.

METHODS: The immunohistochemistry streptavidin-perosidase (SP) method was used to determine protein expression levels in 64 colon cancer and 32 para-carcinoma tissue specimens.

RESULTS: (1) Positive AKAP95 expression rates in colon cancer tissue were higher when compared with para-carcinoma tissue (92.19% vs. 59.38%, P < 0.05). Similar findings were determined for B-Raf (76.56% vs. 25%, P < 0.05), ERK1/2 (90.63% vs. 31.25%, P < 0.05), and Elk-1 levels (92.19% vs. 40.63%, P < 0.05). (2) No significant associations were identified between AKAP95, B-Raf, ERK1/2, and Elk-1 protein expression and degree of differentiation, histological type, and lymph node metastasis in colon cancer samples (P > 0.05); however, in The Cancer Genome Atlas and Gene Expression Omnibus datasets, AKAP95 was closely related to immune infiltration, and highly expressed AKAP95 was negatively associated with overall survival and relapse free survival rates in colon cancer patients. (3) Correlations were observed between AKAP95 and ERK1/2, AKAP95 and Elk-1, B-Raf and ERK1/2, B-Raf and Elk-1, and ERK1/2 and Elk-1 (all P < 0.05), but no correlation was observed between AKAP95 and B-Raf (P > 0.05).

CONCLUSIONS: AKAP95 may affect immune infiltration levels in colon cancer by participating in ERK1/2-Elk-1 signal transduction.

PMID:36691407 | PMC:PMC9867590 | DOI:10.1155/2023/8242646
High predictive ability of apparent diffusion coefficient value for wall-invasion pattern of advanced gallbladder carcinoma

Fetched: January 25th, 2023, 5:01am GMT by Takehiko Koga

Abdom Radiol (NY). 2023 Jan 24. doi: 10.1007/s00261-023-03805-4. Online ahead of print.

ABSTRACT

PURPOSE: The wall-invasion pattern classification of advanced gallbladder carcinoma (GBC) has been reported. However, its association with clinical findings remains unclear. We aimed to clarify relationships between clinicopathological characteristics, prognosis, and apparent diffusion coefficient (ADC) values of advanced GBC based on the wall-invasion pattern.

METHODS: We reviewed the data of 37 patients who had undergone advanced GBC cholecystectomy at our institution between 2009 and 2021. Clinicopathological findings, prognosis, and ADC values were retrospectively analyzed.

RESULTS: Based on the wall-invasion pattern, patients were classified into infiltrative growth (IG) type (n = 22) and destructive growth (DG) type (n = 15). In the DG-type, the incidence of venous invasion (P = 0.027), neural invasion (P = 0.008), and lymph node metastasis (P = 0.047) was significantly higher than in the IG-type, and recurrent-free survival (RFS) was significantly shorter (P = 0.015); the median RFS was 11.4 months (95% confidence interval, 6.3-16.5 months) in the DG-type and not reached in the IG-type. The ADC value in the DG-type was significantly lower than in the IG-type (median, 1.19 × 10^-3 mm²/s vs. 1.86 × 10^-3 mm²/s, P < 0.001). The area under the receiver operating characteristic curve for the ADC values to differentiate wall-invasion patterns was 0.95 (95% confidence interval, 0.87-1.00). The optimal cutoff ADC value was 1.45 × 10^-3 mm²/s (sensitivity, 92.9%; specificity, 90.9%).

CONCLUSIONS: The wall-invasion pattern of advanced GBC is associated with its aggressiveness and prognosis, and can be predicted by ADC values with high accuracy.

PMID:36694054 | DOI:10.1007/s00261-023-03805-4
Role of laparoscopic surgery in the management of gallbladder cancer: Systematic review & meta-analysis

Fetched: January 25th, 2023, 5:01am GMT by Syeda Hoorulain Ahmed

Am J Surg. 2023 Jan 11:S0002-9610(23)00008-9. doi: 10.1016/j.amjsurg.2023.01.008. Online ahead of print.

ABSTRACT

BACKGROUND: This meta-analysis evaluates the safety and short-term oncological outcomes of laparoscopic vs. open surgery for gallbladder carcinoma(GBC).

METHODS: Meta-analysis was performed on laparoscopic(LG) and open group(OG) studies. Data for survival outcomes were extracted from Kaplan-Meier curves and combined with Tierney's method to estimate hazard ratios(HRs) and 95% CIs.

RESULTS: There was no significant difference in overall survival(HR: 1.01), disease-free survival(HR: 0.84), 30-day mortality(RR:1.10), overall recurrence(RR:0.93), intraoperative gallbladder violation(RR:1.17), operative time(WMD:8.32), number of patients receiving adjuvant chemotherapy(RR:1.06) and blood transfusion(RR: 0.81). A significant difference was seen in survival of T3 subgroup(HR:0.77) and number of lymph node dissections (LND)(WMD: 0.63) favoring OG, along with a decrease in postoperative complications(RR:0.65), greater incidence of R0 resections(RR:1.04), lower volume of intraoperative blood loss(WMD: 128.62), lower time in removing drainage tube(WMD: 1.35), shorter diet recovery time(WMD: 1.88), shorter hospital stay(WMD: 3.51), lower incidence of 90-day mortality(RR:0.49) favoring LG. A higher incidence of port-site recurrence(RR:1.99) was reported in LG.

CONCLUSION: Laparoscopic surgery is non-inferior to the open approach in terms of oncological outcomes and has an improved rate of postoperative complications.

PMID:36693774 | DOI:10.1016/j.amjsurg.2023.01.008
Development and validation of a nomogram prediction model based on albumin-to-alkaline phosphatase ratio for predicting the prognosis of gallbladder carcinoma

Fetched: January 25th, 2023, 5:01am GMT by Zizheng Fan

Pathol Oncol Res. 2023 Jan 4;28:1610818. doi: 10.3389/pore.2022.1610818. eCollection 2022.

ABSTRACT

Gallbladder carcinoma (GBC) is a rare biliary tract cancer with a high recurrence rate and a poor prognosis. Albumin-alkaline phosphatase ratio (AAPR) has been demonstrated to be a prognostic predictor for several cancers, but its predictive value for GBC patients remains unknown. The aim of this study was to investigate the predictive role of AAPR in GBC patients and to develop a novel nomogram prediction model for GBC patients. We retrospectively collected data from 80 patients who underwent surgery at the Hospital of 81st Group Army PLA as a training cohort. Data were collected from 70 patients with the same diagnosis who underwent surgery at the First Affiliated Hospital of Hebei North University as an external verification cohort. The optimal cut-off value of AAPR was determined using X-tile software. A nomogram for the overall survival (OS) based on multivariate Cox regression analysis was developed and validated using calibration curves, Harrell's concordance index, the receiver operating characteristic curves, and decisive curve analyses. The optimal cut-off value of AAPR was .20. Univariate and multivariate Cox regression analyses demonstrated that BMI (p = .043), R0 resection (p = .001), TNM stage (p = .005), and AAPR (p = .017) were independent risk factors for GBC patients. In terms of consistency, discrimination, and net benefit, the nomogram incorporating these four independent risk factors performed admirably. AAPR is an independent predictor of GBC patients undergoing surgery, and a novel nomogram prediction model based on AAPR showed superior predictive ability.

PMID:36685104 | PMC:PMC9845243 | DOI:10.3389/pore.2022.1610818
Adjuvant S-1 compared with observation in resected biliary tract cancer (JCOG1202, ASCOT): a multicentre, open-label, randomised, controlled, phase 3 trial

Fetched: January 25th, 2023, 5:01am GMT by Kohei Nakachi

Lancet. 2023 Jan 21;401(10372):195-203. doi: 10.1016/S0140-6736(22)02038-4.

ABSTRACT

BACKGROUND: S-1 has shown promising efficacy with a mild toxicity profile in patients with advanced biliary tract cancer. The aim of this study was to evaluate whether adjuvant S-1 improved overall survival compared with observation for resected biliary tract cancer.

METHODS: This open-label, multicentre, randomised phase 3 trial was conducted in 38 Japanese hospitals. Patients aged 20-80 years who had histologically confirmed extrahepatic cholangiocarcinoma, gallbladder carcinoma, ampullary carcinoma, or intrahepatic cholangiocarcinoma in a resected specimen and had undergone no local residual tumour resection or microscopic residual tumour resection were randomly assigned (1:1) to undergo observation or to receive S-1 (ie, 40 mg, 50 mg, or 60 mg according to body surface area, orally administered twice daily for 4 weeks, followed by 2 weeks of rest for four cycles). Randomisation was performed by the minimisation method, using institution, primary tumour site, and lymph node metastasis as adjustment factors. The primary endpoint was overall survival and was assessed for all randomly assigned patients on an intention-to-treat basis. Safety was assessed in all eligible patients. For the S-1 group, all patients who began the protocol treatment were eligible for a safety assessment. This trial is registered with the University hospital Medical Information Network Clinical Trials Registry (UMIN000011688).

FINDINGS: Between Sept 9, 2013, and June 22, 2018, 440 patients were enrolled (observation group n=222 and S-1 group n=218). The data cutoff date was June 23, 2021. Median duration of follow-up was 45·4 months. In the primary analysis, the 3-year overall survival was 67·6% (95% CI 61·0-73·3%) in the observation group compared with 77·1% (70·9-82·1%) in the S-1 group (adjusted hazard ratio [HR] 0·69, 95% CI 0·51-0·94; one-sided p=0·0080). The 3-year relapse-free survival was 50·9% (95% CI 44·1-57·2%) in the observation group compared with 62·4% (55·6-68·4%) in the S-1 group (HR 0·80, 95% CI 0·61-1·04; two-sided p=0·088). The main grade 3-4 adverse events in the S-1 group were decreased neutrophil count (29 [14%]) and biliary tract infection (15 [7%]).

INTERPRETATION: Although long-term clinical benefit would be needed for a definitive conclusion, a significant improvement in survival suggested adjuvant S-1 could be considered a standard of care for resected biliary tract cancer in Asian patients.

FUNDING: The National Cancer Center Research and the Ministry of Health, Labour, and Welfare of Japan.

PMID:36681415 | DOI:10.1016/S0140-6736(22)02038-4
Risk and timing of venous thromboembolism in patients with gastrointestinal cancer: a nationwide Danish cohort study

Fetched: January 24th, 2023, 5:01am GMT by Jacob Tønnesen

BMJ Open. 2023 Jan 19;13(1):e062768. doi: 10.1136/bmjopen-2022-062768.

ABSTRACT

AIMS: Cancer is a well-known risk factor of venous thromboembolism (VTE). Some cancers are believed to be more thrombogenic. The purpose of this study was to investigate the characteristics of patients with incident gastrointestinal cancers (GI) and their associated 1-year risk and timing of venous thromboembolic events and the 1-year mortality.

METHODS: This study was a retrospective cohort study. Through Danish nationwide registries, all patients with first-time GI cancer diagnosis from 2008 to 2018 were identified. Incident VTE events were identified within a 1-year follow-up after GI cancer diagnosis using the Aalen-Johansen estimator. Cox proportional-hazard models were applied to investigate risk factors for VTE events and the impact of VTE on mortality.

RESULTS: A total of 87 069 patients were included and stratified by cancer types: liver (5.8%), pancreatic (12.0%), gastric (6.9%), small intestinal (1.9%), colorectal (61.8%), oesophageal (7.3%) and gallbladder (3%). Most VTE events happened close to onset of the cancer diagnosis with declining events by time. The 1-year cumulative incidence of VTE differed according to cancer type with pancreatic cancer being most thrombogenic (7.8%), and colorectal and liver cancer being the least (3.6%). Prior VTE, heart failure, chronic obstructive pulmonary disease (COPD), liver disease, chronic kidney disease (CKD) and diabetes increased the VTE risk. Overall, the patients with GI cancer had high 1-year mortality of 33.3% with patients with pancreatic cancer having the highest mortality (70.3%).

CONCLUSION: We found that most VTE events happen close to onset of the GI cancer diagnosis and thrombogenicity differed by type of GI cancer, ranging from 7.8% in patients with pancreatic cancer to 3.6% in colorectal and patients with liver cancer. Prior VTE, heart failure, COPD, liver disease, CKD and DM were associated with increased risk of VTE.

PMID:36657765 | PMC:PMC9853257 | DOI:10.1136/bmjopen-2022-062768
Circulating microRNAs in gallbladder cancer: Is serum assay of diagnostic value?

Fetched: January 23rd, 2023, 5:01am GMT by Pallavi Srivastava

Pathol Res Pract. 2023 Jan 16;242:154320. doi: 10.1016/j.prp.2023.154320. Online ahead of print.

ABSTRACT

The microRNAs (miRNAs) in circulation could serve as biomarkers for cancer detection. Gallbladder carcinoma (GBC) is mostly asymptomatic; therefore, using microRNAs (miRNAs) as an early diagnostic biomarker could be a valuable tool. We aimed to identify the tumor-associated miR-1, miR130, miR-146, miR-182, and miR-21expression in serum as a biomarker for early detection of GBC and identify their possible diagnostic role. The study group comprised of paired serum and tissue samples from 34 GBC, 19 cholecystitis (CC), 21 normal controls (uninflamed gall bladder), and additional 29 serum-only samples of GBC. Total RNA was isolated using a commercially available RNA isolation kit (Applied Biosystem, USA) and reverse transcribed using Advanced Taqman MicroRNA reverse transcription kit. The relative expression of miRNAs was analyzed using Quantitative real-time polymerase chain reaction. The diagnostic potential of these miRNAs was assessed by ROC analysis. In paired samples, the trend towards up and down regulation for miR-182, miR-21, miR-1, miR-130, and miR-146 was similar in both tissue and sera of GBC. The expression pattern of serum miR-1, miR130, and miR-146 gradually decreased from normal control (NC) to CC to GBC, while miR-21 and miR-182 gradually increased from NC to CC to GBC. The miR-1, miR-121, miR-182, and miR-146 significantly differed between CC vs. early stage and early stage vs. NC. Among these miRNAs, the sensitivity of miR-1 (85.71 %) was the highest, and the specificity of miR-21 was the highest (92.73 %). The combined sensitivity for miRNAs ranged from 73.13 % (CI: 60.90-83.24 %) to 98.63 % (CI: 89.0-99.61 %); however, the specificity was lower. In stage I&II vs. III&IV discrimination, the diagnostic sensitivity of miR-1 was highest (89.36 %, CI: 76.90-96.45). The two miRNAs, in combination, increase the diagnostic sensitivity. Circulating serum miRNAs may provide a new approach for clinical application. Panels of specific circulating miRNA, which require further validation, could be potential non-invasive diagnostic biomarkers for GBC in combination with abnormal radio diagnostic scans.

PMID:36682281 | DOI:10.1016/j.prp.2023.154320
Immunohistochemical appraisal of epithelial mesenchymal transition type III in gall bladder cancer

Fetched: January 20th, 2023, 5:01am GMT by Kamini Yadav

Indian J Pathol Microbiol. 2023 Jan-Mar;66(1):44-53. doi: 10.4103/ijpm.ijpm_876_21.

ABSTRACT

BACKGROUND: Epithelial-mesenchymal transition (EMT) is the heart of invasion. EMT associated with cancer progression and metastasis is known as type III EMT. Beta-catenin, E-cadherin, and MMP9 markers of EMT are routinely employed for diagnostic purposes.

AIMS: We employed these markers to study EMT by immunohistochemistry (IHC) in gall bladder cancer (GBC) with respect to depth of tumor invasion, clinical outcome, and disease-free survival.

SETTINGS AND DESIGN: This was a prospective case-control study.

MATERIAL AND METHODS: Seventy gall bladders were included (50 GBC and 20 CC). After detailed histology, immunoexpression was studied in terms of percentage and strength of expression.

STATISTICS ANALYSIS USED: Expression was compared between CC and GBC by Student t test and analysis of variance. Kaplan-Meier was used for survival analysis, and the extent of agreement ("Kappa") was calculated.

RESULTS AND CONCLUSIONS: The age of incidence of GBC was 49.40 (+11.6) years with female predominance (F:M = 4:1). In 88% (44/50) of GBC, the fundus was involved. Moderately differentiated adenocarcinoma was most frequent [54%; 27/50]. Significant downregulation of E-cadherin (P = 0.022) and beta-catenin (P < 0.001) and upregulation in MMP9 (P < 0.001) were seen in GBC with respect to CC with significant association among them. MMP9 expression was significantly associated with higher tumor stage but with chemotherapeutic response. Our results display that epithelial-mesenchymal transition type III plays a role in GBC invasion. MMP9 overexpression and loss of membranous beta-catenin may be considered a marker for poor clinical outcomes and advanced disease.

PMID:36656209 | DOI:10.4103/ijpm.ijpm_876_21
Porcelain gallbladder with suspected gallbladder cancer. Case report and review of the literature

Fetched: January 19th, 2023, 5:02am GMT by Konrad Pielaciński

Pol Merkur Lekarski. 2022 Dec 22;50(300):384-387.

ABSTRACT

Gallbladder calcification known as porcelain gallbladder (PGB) is most often asymptomatic disease developing in consequence of chronic inflammatory process in the course of other gallbladder diseases (gallstone disease). In the past PGB was reported to be associated with carcinoma of gallbladder, with the incidence of 30%, nowadays recent studies suggesting a rate of 6%. Patients with PGB due to malignancy risk undergo , prophylactic cholecystectomy although as recent studies show part of them could avoid it.

AIM: Presentation of a case of a patient with calcification of the gallbladder wall and suspicion of gallbladder cancer and a review of the literature.

A CASE REPORT: A 66-year-old woman was admitted with a diagnosis of PGB and concomitant diseases with a high risk of adverse events. PGB was detected through incidentally 4 months earlier, during the diagnosis of abdominal pain caused by the sigmoid volvulus. Computed tomography revealed enlarged (125mm x 57mm) PGB and abnormal tissue components into the fundus of gallbladder- suspected malignancy. No detected lymphadenopathy and growing cancer into liver, or invading, nearby organs. The patient underwent open extended (radical) cholecystectomy. Gallbladder was excised with fused part of greater omentum and adjacent, wedge-shaped part of liver parenchyma. Lymphadenectomy of the hepatoduodenal ligament and resection of cystic duct stump was also performed. There was no postoperative complication, patient was discharged six days after the surgery. No gallbladder cancer was found in the histopathological examination. There were fund cholecystolithiasis, chronic cholecystitis with hyalinization and calcification of the wall, chronic limphadenitis and glandular epithelium in the stump of the cystic duct.

RESULTS: Patient with PGB and suspicion of gallbladder cancer was treated with open extended cholecystectomy. Histopathological examination has not revealed gallbladder cancer.

CONCLUSIONS: Open extended cholecystectomy has proven to be an effective and safe treatment for a patient with a porcelain gallbladder at high risk of cancer.

PMID:36645686
Identification of gallbladder cancer by direct near-infrared measurement of raw bile combined with two-trace two-dimensional correlation analysis

Fetched: January 18th, 2023, 5:01am GMT by Eunjin Jang

Analyst. 2023 Jan 16;148(2):374-380. doi: 10.1039/d2an01795d.

ABSTRACT

We demonstrated the utility of direct near-infrared (NIR) bile analysis for the identification of gallbladder (GB) cancer by employing two-trace two-dimensional (2T2D) correlation analysis to recognize dissimilar spectral features among diverse bile samples for potential improvement of discrimination accuracy. To represent more diverse clinical cases for reliable assessment, bile samples obtained from five normal, 44 gallstone, 25 GB polyp, six hepatocellular cancer (HCC), and eight GB cancer subjects were analyzed. Due to the altered metabolic pathways by carcinogenesis, the NIR spectral features of GB cancer samples, including intensity ratios of main peaks, were different from those of other sample groups. The differentiation of GB cancer in the principal component (PC) score domain was mediocre and subsequent discrimination accuracy based on linear discriminant analysis (LDA) was 88.5%. When 2T2D slice spectra were obtained using a reference spectrum constructed by the linear combination of the spectra of five pure representative bile metabolites and employed, the accuracy was improved to 95.6%. The sensitive recognition of dissimilar spectral features in GB cancer by 2T2D correlation analysis was responsible for the enhanced discrimination.

PMID:36533854 | DOI:10.1039/d2an01795d
Arsenic may be a carcinogenic determinant of a subset of gallbladder cancer: A pilot study

Fetched: January 18th, 2023, 5:01am GMT by Giuseppe De Palma

Environ Res. 2023 Feb 15;219:115030. doi: 10.1016/j.envres.2022.115030. Epub 2022 Dec 9.

ABSTRACT

Gallbladder cancer (GBC) is one of the deadliest malignancy and treatment options are deplorably limited. Better strategies of prevention are urgently needed but knowledge on risk factors remains scarce. Recent data suggested that arsenic (As) may be involved in GBC carcinogenesis but the question remains debated. To date, there are no data on As measurement in GBC samples. This pilot study aimed to measure As concentrations in tissue samples from patients with GBC compared to non-cancerous gallbladder (NCGB). Included patients underwent cholecystectomy at Hospital Clinico Universidad de Chile, Santiago in Chile, a country with high As exposure, between 2001 and 2020. Tissue samples were preserved in formalin-fixed, paraffin-embedded blocks. Selected samples were retrieved, processed and submitted to inductively coupled plasma mass spectrometry (ICP-MS) to determine As concentrations. A total of 77 patients were included, including 35 GBC and 42 NCGB. The two groups were comparable, except for age (68 vs. 49 years, p < 0.001). Measured in 11 GBC and 38 NCGB, total As was detected in 5 GBC (14%) compared to 0 NCGB samples (p < 0.001). GBC group also showed higher median values of As compared to NCGB (p < 0.001). This pilot study provided a proof-of-concept to measure As concentrations in gallbladder samples and showed higher level of As in GBC samples compared to NCGB, paving the way for future studies aiming to investigate the impact of As on GBC, which may contribute to the prevention of this deadly disease.

PMID:36509118 | DOI:10.1016/j.envres.2022.115030
Epigenetic regulation of autophagy by non-coding RNAs in gastrointestinal tumors: Biological functions and therapeutic perspectives

Fetched: January 18th, 2023, 5:01am GMT by Mohammad Arad Zandieh

Pharmacol Res. 2023 Jan;187:106582. doi: 10.1016/j.phrs.2022.106582. Epub 2022 Nov 24.

ABSTRACT

Cancer is the manifestation of changes and mutations in genetic and epigenetic levels. Non-coding RNAs (ncRNAs) are commonly dysregulated in disease pathogenesis, and their role in cancer has been well-documented. The ncRNAs regulate various molecular pathways and mechanisms in cancer that can lead to induction/inhibition of carcinogenesis. Autophagy is a molecular "self-digestion" mechanism its function can be pro-survival or pro-death in tumor cells. The aim of the present review is to evaluate the role of ncRNAs in regulating autophagy in gastrointestinal tumors. The role of the ncRNA/autophagy axis in affecting the progression of gastric, liver, colorectal, pancreatic, esophageal, and gallbladder cancers is investigated. Both ncRNAs and autophagy mechanisms can function as oncogenic or onco-suppressor and this interaction can determine the growth, invasion, and therapy response of gastrointestinal tumors. ncRNA/autophagy axis can reduce/increase the proliferation of gastrointestinal tumors via the glycolysis mechanism. Furthermore, related molecular pathways of metastasis, such as EMT and MMPs, are affected by the ncRNA/autophagy axis. The response of gastrointestinal tumors to chemotherapy and radiotherapy can be suppressed by pro-survival autophagy, and ncRNAs are essential regulators of this mechanism. miRNAs can regulate related genes and proteins of autophagy, such as ATGs and Beclin-1. Furthermore, lncRNAs and circRNAs down-regulate miRNA expression via sponging to modulate the autophagy mechanism. Moreover, anti-cancer agents can affect the expression level of ncRNAs regulating autophagy in gastrointestinal tumors. Therefore, translating these findings into clinics can improve the prognosis of patients.

PMID:36436707 | DOI:10.1016/j.phrs.2022.106582
The diagnostic value of staging laparoscopy in gallbladder cancer: a nationwide cohort study

Fetched: January 15th, 2023, 5:01am GMT by Mike van Dooren

World J Surg Oncol. 2023 Jan 14;21(1):6. doi: 10.1186/s12957-022-02880-z.

ABSTRACT

BACKGROUND: Disseminated disease (DD) is often found at (re-)exploration in gallbladder cancer (GBC) patients. We aimed to assess the yield of staging laparoscopy (SL) and identify predictors for DD.

METHODS: This retrospective study included patients from all Dutch academic centres with primary GBC (pGBC) and incidentally diagnosed GBC (iGBC) planned for (re-)resection. The yield of SL was determined. In iGBC, predictive factors for DD were assessed.

RESULTS: In total, 290 patients were included. Of 183 included pGBC patients, 143 underwent laparotomy without SL, and 42 (29%) showed DD perioperatively. SL, conducted in 40 patients, identified DD in eight. DD was found in nine of 32 patients who underwent laparotomy after SL. Of 107 included iGBC patients, 100 underwent laparotomy without SL, and 19 showed DD perioperatively. SL, conducted in seven patients, identified DD in one. Cholecystitis (OR = 4.25; 95% CI 1.51-11.91) and primary R1/R2 resection (OR = 3.94; 95% CI 1.39-11.19) were independent predictive factors for DD.

CONCLUSIONS: In pGBC patients, SL may identify DD in up to 20% of patients and should be part of standard management. In iGBC patients, SL is indicated after primary resection for cholecystitis and after initial R1/R2 resection due to the association of these factors with DD.

PMID:36641472 | PMC:PMC9840315 | DOI:10.1186/s12957-022-02880-z
Malignant lymphoma diagnosed by gallbladder wall thickness in an autoimmune hepatitis patient

Fetched: January 13th, 2023, 2:07pm GMT by Yuichiro Kemmoto

Nihon Shokakibyo Gakkai Zasshi. 2023;120(1):87-95. doi: 10.11405/nisshoshi.120.87.

ABSTRACT

A 77-year-old female patient was undergoing steroid treatment for cirrhosis with autoimmune hepatitis. Periodic imaging acquisitions revealed both irregular gallbladder wall thickness and an isovascular tumor in segment one of the liver. After cholecystectomy and segmental hepatectomy, the pathological diagnosis was diffuse large B-cell lymphoma in both organs. Accordingly, she received chemotherapy but the disease rapidly spread;she died five months after surgery. Malignant lymphoma of the gallbladder is an uncommon disease;we consider that autoimmunity factors were associated with this pathogenesis.

PMID:36631121 | DOI:10.11405/nisshoshi.120.87
Incidental gallbladder cancer: what is the prevalence and how do we perform cholecystectomy for presumably benign biliary disease?

Fetched: January 13th, 2023, 2:07pm GMT by Diego Arley Gomes DA Silva

Rev Col Bras Cir. 2023 Jan 6;49:e20223417. doi: 10.1590/0100-6991e-20223417-en. eCollection 2023.

ABSTRACT

OBJECTIVE: to determine the prevalence of incidental gallbladder cancer (IGBC) in cholecystectomies performed in a tertiary public hospital and to describe technical and epidemiological aspects of performing cholecystectomies for presumably benign disease.

METHOD: descriptive, retrospective observational study, based on analysis of medical records of patients undergoing cholecystectomy with preoperative hypothesis of benign disease between January 2018 and January 2022.

RESULTS: prevalence of gallbladder adenocarcinoma in our sample was 0.16%, similar to data in the literature. Technical aspects during cholecystectomy were also described with a frequency similar to that found in the literature.

CONCLUSION: despite a rare disease, IGBC is relevant in the routine of the General Surgeon. Its diagnosis, staging and treatment directly affect the prognosis. Technical aspects during cholecystectomy are not always remembered by surgeons and can interfere with the prognosis and subsequent treatment of the patient.

PMID:36629721 | DOI:10.1590/0100-6991e-20223417-en
Clinical value of serum AFP and PIVKA-II for diagnosis, treatment and prognosis of hepatocellular carcinoma

Fetched: January 13th, 2023, 2:07pm GMT by Shan Tian

J Clin Lab Anal. 2023 Jan;37(1):e24823. doi: 10.1002/jcla.24823. Epub 2022 Dec 29.

ABSTRACT

BACKGROUND: The accuracy of alpha-fetoprotein (AFP) as a diagnostic marker for hepatocellular carcinoma (HCC) is insufficient, and the application of abnormal prothrombin (PIVKA-II) in HCC is still controversial.

METHODS: Serum AFP and PIVKA-II levels were analyzed in 145 cases of HCC, 57 of benign liver disease, 55 of cholangiocarcinoma and gallbladder carcinoma, 112 of other gastrointestinal tumors with liver metastasis, and 101 healthy controls. Receiver operating characteristic curve and area under the curve were used to evaluate the diagnostic value of AFP and PIVKA-II for HCC. The changes in serum AFP and PIVKA-II levels before and after treatment in 47 HCC patients who underwent surgery and 77 who received interventional treatment were used to evaluate treatment efficacy and prognosis in HCC.

RESULTS: The concentrations of AFP and PIVKA-II in the HCC group were significantly higher than those in other groups (p < 0.01). The diagnostic value of PIVKA-II in HCC was better than that of AFP, and combined detection improved the diagnostic sensitivity and specificity. The levels of AFP and PIVKA-II after liver cancer surgery were significantly lower than those before surgery. Elevated levels of PIVKA-II before surgery predicted disease progression, and patients who remained positive for PIVKA-II after surgery had worse prognosis than those who became negative after surgery.

CONCLUSIONS: Combined detection of AFP and PIVKA-II is superior to both tests alone. We found that higher serum level of PIVKA-II indicates more severe HCC, with worse prognosis, while the level of AFP had no correlation with the prognosis.

PMID:36579611 | PMC:PMC9833986 | DOI:10.1002/jcla.24823
GBCdb: RNA expression landscapes and ncRNA-mRNA interactions in gallbladder carcinoma

Fetched: January 12th, 2023, 5:01am GMT by Li Guo

BMC Bioinformatics. 2023 Jan 9;24(1):12. doi: 10.1186/s12859-023-05133-2.

ABSTRACT

Gallbladder carcinoma (GBC), an aggressive malignant tumor of the biliary system, is characterized by high cellular heterogeneity and poor prognosis. Fewer data have been reported in GBC than other common cancer types. Multi-omics data will contribute to the understanding of the molecular mechanisms of cancer, cancer diagnosis and prognosis. Herein, to provide better understanding of the molecular events in GBC pathogenesis, we developed GBCdb ( [tmliang.cn] ), a user-friendly interface for the query and browsing of GBC-associated genes and RNA interaction networks using published multi-omics data, which also included experimentally supported data from different molecular levels. GBCdb will help to elucidate the potential biological roles of different RNAs and allow for the exploration of RNA interactions in GBC. These resources will provide an opportunity for unraveling the potential molecular features of Gallbladder carcinoma.

PMID:36624399 | PMC:PMC9830852 | DOI:10.1186/s12859-023-05133-2
Effect of Preoperative Duloxetine Hydrochloride on Reducing Postoperative Morphine Requirement after Open Radical Cholecystectomy in Cancer Patients: A Randomized Controlled Study

Fetched: January 10th, 2023, 5:01am GMT by Nida Haider

Anesth Essays Res. 2022 Jul-Sep;16(3):316-320. doi: 10.4103/aer.aer_75_22. Epub 2022 Dec 9.

ABSTRACT

BACKGROUND: Recently, opoids are linked with cancer recurrence. Duloxetine hydrochloride (DH), an anxiolytic may reduce total opoid requirement after cancer surgery.

AIMS: We assessed the efficacy of a single dose of DH in reducing the total morphine requirement after open radical cholecystectomy. We also calculated the Visual Analog Scale (VAS) score, patient satisfaction score (PSS), and time taken to the use of the first rescue analgesic.

SETTING AND DESIGNES: This is a prospective, randomized, double blind, controlled study conducted in the patients aged 20-70 years (American Society of Anaesthesiologists classes I-III) undergoing open radical cholecystectomy under general anesthesia for carcinoma gall bladder.

MATERIALS AND METHODS: The patients were divided into two groups of 32 patients each by computer-generated randomization. Group A received oral DH (60 mg); Group B received identical placebo capsules 2 h before surgery with a sip of water. Postoperatively, intravenous morphine was given using a patient-controlled analgesia pump. After 24 h, total morphine consumption, the VAS score, time to the first rescue analgesia, and PSS were recorded.

STATISTICAL ANALYSIS: Statistical Package for the Social Sciences software (SPSS version 22.0, IBM Corp., Chicago, IL, USA 2013). P value < 0.05 or 0.001 was considered statistically significant.

RESULTS: The total morphine consumption and VAS score were significantly lower in Group A. No significant effects was observed on PSS.

CONCLUSION: A single 60 mg dose of DH administered 2 h before open radical cholecystectomy reduced total morphine consumption and improved VAS score postoperatively with no effect on PSS.

PMID:36620122 | PMC:PMC9813995 | DOI:10.4103/aer.aer_75_22
Contrast-Enhanced CT and Ultrasonography Features of Intracholecystic Papillary Neoplasm with or without associated Invasive Carcinoma

Fetched: January 10th, 2023, 5:01am GMT by Jae Hyun Kim

Korean J Radiol. 2023 Jan;24(1):39-50. doi: 10.3348/kjr.2022.0577.

ABSTRACT

OBJECTIVE: To assess the contrast-enhanced CT and ultrasonography (US) findings of intracholecystic papillary neoplasm (ICPN) and determine the imaging features predicting ICPN associated with invasive carcinoma (ICPN-IC).

MATERIALS AND METHODS: In this retrospective study, we enrolled 119 consecutive patients, including 60 male and 59 female, with a mean age ± standard deviation of 63.3 ± 12.1 years, who had pathologically confirmed ICPN (low-grade dysplasia [DP] = 34, high-grade DP = 35, IC = 50) and underwent preoperative CT or US. Two radiologists independently assessed the CT and US findings, focusing on wall and polypoid lesion characteristics. The likelihood of ICPN-IC was graded on a 5-point scale. Univariable and multivariable logistic regression analyses were performed to identify significant predictors of ICPN-IC separately for wall and polypoid lesion findings. The performances of CT and US in distinguishing ICPN-IC from ICPN with DP (ICPN-DP) was evaluated using the area under the receiver operating characteristic curve (AUC).

RESULTS: For wall characteristics, the maximum wall thickness (adjusted odds ratio [aOR] = 1.4; 95% confidence interval [CI]: 1.1-1.9) and mucosal discontinuity (aOR = 5.6; 95% CI: 1.3-23.4) on CT were independently associated with ICPN-IC. Among 119 ICPNs, 110 (92.4%) showed polypoid lesions. Regarding polypoid lesion findings, multiplicity (aOR = 4.0; 95% CI: 1.6-10.4), lesion base wall thickening (aOR = 6.0; 95% CI: 2.3-15.8) on CT, and polyp size (aOR = 1.1; 95% CI: 1.0-1.2) on US were independently associated with ICPN-IC. CT showed a higher diagnostic performance than US in predicting ICPN-IC (AUC = 0.793 vs. 0.676; p = 0.002).

CONCLUSION: ICPN showed polypoid lesions and/or wall thickening on CT or US. A thick wall, multiplicity, presence of wall thickening in the polypoid lesion base, and large polyp size are imaging findings independently associated with invasive cancer and may be useful for differentiating ICPN-IC from ICPN-DP.

PMID:36606619 | PMC:PMC9830145 | DOI:10.3348/kjr.2022.0577
Invasive Papillary Adenocarcinoma of Gallbladder: A Case Report

Fetched: January 5th, 2023, 5:01am GMT by S N Karim

Mymensingh Med J. 2023 Jan;32(1):268-271.

ABSTRACT

Papillary gallbladder adenocarcinoma (PGA) represents 5.0% of all malignant tumor of gallbladder. An early diagnosis is essential as this malignancy progresses silently with a late diagnosis, often proving fatal. A 63 year old female presented with right upper quadrant pain, palpable gallbladder on clinical examination and hypoechoic shadow suggestive of gall stone inside on ultrasound. But during an attempt to open cholecystectomy surgeons found tiny papillary growth involving whole fundus and part of the body on June 2020 at an outside hospital, Khulna, Bangladesh. Radical cholecystectomy was done by the surgeon with enlarged portal lymph node dissection and a small portion of hepatic resection. Histopathology demonstrated a well-differentiated invasive papillary adenocarcinoma with muscle invasion. There was no metastasis in the liver and lymph nodes show reactive hyperplasia.

PMID:36594333
Threshold dose-response association between smoking pack-years and the risk of gallbladder cancer: A nationwide cohort study

Fetched: January 3rd, 2023, 5:01am GMT by Joo-Hyun Park

Eur J Cancer. 2023 Feb;180:99-107. doi: 10.1016/j.ejca.2022.11.031. Epub 2022 Dec 9.

ABSTRACT

BACKGROUND AND AIMS: The association between smoking and gallbladder cancer (GBC) risk is unclear. We investigated the association between smoking (including pack-years) and GBC risk. We also examined the combined effects of smoking and diabetes or prediabetes on GBC risk.

METHODS: This Korean nationwide cohort study included 9,520,629 adults without cancer who underwent national health screening in 2009 and were followed-up until 2018. Multivariable Cox proportional hazards models were used to determine risk estimates after adjusting for potential confounders.

RESULTS: During 78.4 million person-years (mean 8.2 ± 0.9 years) of follow-up, we identified 6066 patients with newly diagnosed GBC. Current and former smokers were associated with increased GBC risk (hazard ratio [HR], 95% confidence interval [CI]: 1.117, 1.029-1.212 and 1.105, 1.016-1.202, respectively). Smoking of 20 to <30 and ≥30 pack-years was independently associated with increased GBC risk compared with never smoking (HR, 95% CI; 1.241, 1.100-1.400 and 1.231, 1.107-1.370, respectively). However, smoking of <10 and 10 to <20 pack-years was not. This threshold dose-response association between smoking pack-years and GBC risk was observed regardless of the glycaemic status (all P < 0.01). Furthermore, smoking of ≥20 pack-years and hyperglycaemia had a synergistic effect on the GBC risk (all P < 0.01). Smokers with ≥20 pack-years with diabetes had the highest risk of GBC compared to never smokers with normoglycaemia (HR, 1.658; 95% CI, 1.437-1.914).

CONCLUSIONS: Smoking was associated with increased GBC risk with a threshold dose-response effect for smoking pack-years. The risk of GBC increases synergistically when smoking and hyperglycaemia coexist. More individualised cancer prevention education is required to reduce GBC risk.

PMID:36592508 | DOI:10.1016/j.ejca.2022.11.031
The epidemiological trends of biliary tract cancers in the United States of America

Fetched: January 3rd, 2023, 5:01am GMT by Yong Jiang

BMC Gastroenterol. 2022 Dec 29;22(1):546. doi: 10.1186/s12876-022-02637-8.

ABSTRACT

BACKGROUND: Biliary tract cancers (BTCs) are a series of heterogeneous malignancies that are broadly grouped based on the anatomical site where they arise into subtypes including intrahepatic cholangiocarcinoma (ICC), extrahepatic cholangiocarcinoma (ECC), gallbladder cancer (GBC), and ampulla of Vater cancer (AVC).

METHODS AND RESULTS: The present study provides an overview of the epidemiology of the various BTCs based on data from the National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) database from 2000 to 2018. Distinct differences in both incidence and mortality rates were observed for these BTCs as a function of age, sex, ethnicity, and calendar year. In 2018, BTCs emerged as the fifth most prevalent form of alimentary tract cancer in the USA. While the incidence and mortality of ICC appear to be increasing, the incidence rates of GBC, ECC, and AVC have remained stable, as have the corresponding mortality rates. The most common and deadliest BTCs in 2018 were ICC and GBC among males and females, respectively. The ethnic groups exhibiting the highest incidence rates of these different BTCs were American Indians and Alaska Natives for GBC, and Asian and Pacific Islanders for ICC, ECC, and AVC. The incidence of all of these forms of BTC rose with age. There were some variations in BTCs in terms of staging, locoregional surgical treatments, adjuvant therapies, and prognostic outcomes from 2000 to 2018.

CONCLUSIONS: The epidemiological characteristics, staging, locoregional surgical treatments, adjuvant therapies, and prognostic outcomes were distinct for each of these BTCs.

PMID:36581813 | PMC:PMC9801670 | DOI:10.1186/s12876-022-02637-8
Residual cancer is a strong predictor of survival in T3 incidental gallbladder cancer

Fetched: December 31st, 2022, 5:02am GMT by Chuan You

BMC Surg. 2022 Dec 28;22(1):443. doi: 10.1186/s12893-022-01869-5.

ABSTRACT

BACKGROUND AND PURPOSE: Index cholecystectomy is insufficient for curing T3 incidental gallbladder cancer (IGC), and once residual cancer (RC) is found, the prognosis is often poor. The purpose of this study was to investigate the effect of RC on the prognosis and the optimal choice of adjuvant therapy for R0 reresection patients with T3 IGC.

METHODS: We retrospectively reviewed data from patients with T3 IGC who underwent radical reresection from January 2013 to December 2018. RC was defined as histologically proven cancer at reresection. Demographics and tumour treatment-related variables were analysed in correlation with RC and survival. Adjuvant (Adj) chemoradiotherapy (CRT) was correlated with overall survival (OS) and disease-free survival (DFS).

RESULTS: Of the 167 patients with IGC who underwent surgery, 102 underwent radical extended resection. Thirty-two (31.4%) RCs were found. Hepatic side tumours (T3h) and both side tumours (T3h + T3p) were associated with the presence of RC. In multivariate analysis, RC and lymph node metastasis were independent prognostic factors for DFS and OS (P < 0.05). RC was associated with a significantly shorter median OS (20 vs. 53 months; P < 0.01) and DFS (11 vs. 40 months; P < 0.001) despite R0 resection. For R0 reresection patients with RC and/or lymph node metastasis, Adj CRT significantly improved OS (P = 0.024).

CONCLUSION: Residual cancer and lymphatic metastasis are important factors for the poor prognosis of T3 IGC despite R0 resection, and these patients should actively receive adjuvant therapy.

PMID:36577967 | PMC:PMC9795786 | DOI:10.1186/s12893-022-01869-5
Cholecystopathia chronica calcarea (Porcelain gall bladder): A case report from Nepal

Fetched: December 31st, 2022, 5:02am GMT by Samikshya Karki

Ann Med Surg (Lond). 2022 Nov 17;84:104947. doi: 10.1016/j.amsu.2022.104947. eCollection 2022 Dec.

ABSTRACT

INTRODUCTION AND IMPORTANCE: Porcelain gall bladder is an uncommon end-stage modification of chronic cholecystitis, with an incidence ranging from 0.06 to 0.8% along with a plausibility of malignant transformation.

CASE PRESENTATION: We present a 55-year-old female presenting with complaints of epigastric and right hypochondriac region pain who underwent prophylactic laparoscopic cholecystectomy after making a provisional diagnosis of calcified gall bladder on a computed tomography workup. On histopathological examination, she was later diagnosed with a porcelain gallbladder devoid of features suggestive of malignant transformation.

CLINICAL DISCUSSION: Porcelain gallbladder is a cholecystopathological condition in which the gallbladder wall gets calcified, either completely or partially. Though the exact pathomechanism of gallbladder calcification is unknown, it is believed to be due to chronic inflammation. Recent studies have shown that gallbladder calcification is associated with a lower risk of the development of gallbladder cancer. Imaging studies, followed by post-operative histopathological examinations, are used to diagnose the porcelain gallbladder. Though the management of asymptomatic patients is debatable, prophylactic cholecystectomy is the preferred treatment for symptomatic porcelain gallbladder patients.

CONCLUSION: Individual porcelain GB patients should be addressed based on the presenting condition, whether surgically or via clinical monitoring and follow-up, taking into consideration the advantages and limitations of both treatment modalities.

PMID:36582857 | PMC:PMC9793149 | DOI:10.1016/j.amsu.2022.104947
A Rare Case of Single Gallbladder and Multiple Pancreatic Metastases of Renal Cell Carcinoma

Fetched: December 30th, 2022, 5:02am GMT by Sana Akhtar

Cureus. 2022 Nov 24;14(11):e31861. doi: 10.7759/cureus.31861. eCollection 2022 Nov.

ABSTRACT

Renal cell carcinoma (RCC) is the most common tumor to metastasize to uncommon sites. Synchronous metastases in the gall bladder and pancreas are rare entities. In this report, we present the case of a 43-year-old male with a complaint of hematuria presenting with a left renal mass. Contrast-enhanced CT revealed an arterially enhancing mass in the left kidney, a synchronous tiny polyp in the gall bladder, and multiple focal lesions in the pancreas. The patient underwent surgery and the tumor was histopathologically labeled as a clear cell RCC with metastases to the pancreas and gall bladder. Post-surgery, the patient has been followed up.

PMID:36579299 | PMC:PMC9789789 | DOI:10.7759/cureus.31861
Synchronous Primary Adenocarcinoma of Distal Common Bile Duct and Gall bladder

Fetched: December 24th, 2022, 5:02am GMT by Tanka Prasad Bohara

J Nepal Health Res Counc. 2022 Nov 3;20(2):558-560. doi: 10.33314/jnhrc.v20i02.4033.

ABSTRACT

Synchronous primary cancer of the gall bladder and distal common bile duct is rare. There are only few case reports and case series available of these synchronous cancers. Management of this tumor is individualized in these case reports and series based upon the presentation. We present a case of a patient who had multifocal adenocarcinoma involving distal common bile duct and gall bladder. Keywords: Distal common bile duct cancer; gall bladder cancer; synchronous primary.

PMID:36550745 | DOI:10.33314/jnhrc.v20i02.4033
Long-term exposure to genistein inhibits the proliferation of gallbladder cancer by downregulating the MCM complex

Fetched: December 24th, 2022, 5:02am GMT by Yajun Geng

Sci Bull (Beijing). 2022 Apr 30;67(8):813-824. doi: 10.1016/j.scib.2022.01.011. Epub 2022 Jan 17.

ABSTRACT

Soy isoflavones are natural tyrosine kinase inhibitors closely associated with decreased morbidity and mortality of various tumors. The activation of tyrosine kinases such as ERBB2 is the mechanism by which cholecystitis transforms into gallbladder cancer (GBC), therefore, it is important to investigate the relationship between long-term exposure to soy isoflavones and the occurrence and progression of GBC. This case-control study (n = 85 pairs) found that the high level of plasma soy isoflavone-genistein (GEN) was associated with a lower risk of gallbladder cancer (≥326.00 ng/mL compared to ≤19.30 ng/mL, crude odds ratio 0.15, 95% CI 0.04-0.59; P for trend = 0.016), and that the level of GEN exposure negatively correlated with Ki67 expression in GBC tissue (n = 85). Consistent with these results, the proliferation of GBC cells was inhibited in the long-term exposure models of GEN in vitro and in vivo. The long-term exposure to GEN reduced the tyrosine kinase activity of ERBB2 and impaired the function of the PTK6-AKT-GSK3β axis, leading to downregulation of the MCM complex in GBC cells. In summary, long-term exposure to GEN associated with soy products intake might play a certain role in preventing GBC and even inhibiting the proliferation of GBC cells.

PMID:36546234 | DOI:10.1016/j.scib.2022.01.011
Genistein suppresses gallbladder cancer tumorigenesis and progression via downregulating ERBB2 mediated PTK6/AKT/MCM pathway

Fetched: December 24th, 2022, 5:02am GMT by Zhijun Zhou

Sci Bull (Beijing). 2022 Jun 15;67(11):1112-1114. doi: 10.1016/j.scib.2022.03.011. Epub 2022 Mar 12.

NO ABSTRACT

PMID:36545974 | DOI:10.1016/j.scib.2022.03.011
Repetitive non-typhoidal Salmonella exposure is an environmental risk factor for colon cancer and tumor growth

Fetched: December 24th, 2022, 5:02am GMT by Daphne M van Elsland

Cell Rep Med. 2022 Dec 20;3(12):100852. doi: 10.1016/j.xcrm.2022.100852.

ABSTRACT

During infection, Salmonella hijacks essential host signaling pathways. These molecular manipulations disrupt cellular integrity and may induce oncogenic transformation. Systemic S. Typhi infections are linked to gallbladder cancer, whereas severe non-typhoidal Salmonella (NTS) infections are associated with colon cancer (CC). These diagnosed infections, however, represent only a small fraction of all NTS infections as many infections are mild and go unnoticed. To assess the overall impact of NTS infections, we performed a retrospective serological study on NTS exposure in patients with CC. The magnitude of exposure to NTS, as measured by serum antibody titer, is significantly positively associated with CC. Repetitively infecting mice with low NTS exposure showed similar accelerated tumor growth to that observed after high NTS exposure. At the cellular level, NTS preferably infects (pre-)transformed cells, and each infection round exponentially increases the rate of transformed cells. Thus, repetitive exposure to NTS associates with CC risk and accelerates tumor growth.

PMID:36543099 | PMC:PMC9798023 | DOI:10.1016/j.xcrm.2022.100852
Impact of early detection on cancer curability: A modified Delphi panel study

Fetched: December 24th, 2022, 5:02am GMT by Lee Schwartzberg

PLoS One. 2022 Dec 21;17(12):e0279227. doi: 10.1371/journal.pone.0279227. eCollection 2022.

ABSTRACT

Expert consensus on the potential benefits of early cancer detection does not exist for most cancer types. We convened 10 practicing oncologists using a RAND/UCLA modified Delphi panel to evaluate which of 20 solid tumors, representing >40 American Joint Committee on Cancer (AJCC)-identified cancer types and 80% of total cancer incidence, would receive potential clinical benefits from early detection. Pre-meeting, experts estimated how long cancers take to progress and rated the current curability and benefit (improvement in curability) of an annual hypothetical multi-cancer screening blood test. Post-meeting, experts rerated all questions. Cancers had varying estimates of the potential benefit of early cancer detection depending on estimates of their curability and progression by stage. Cancers rated as progressing quickly and being curable in earlier stages (stomach, esophagus, lung, urothelial tract, melanoma, ovary, sarcoma, bladder, cervix, breast, colon/rectum, kidney, uterus, anus, head and neck) were estimated to be most likely to benefit from a hypothetical screening blood test. Cancer types rated as progressing quickly but having comparatively lower cure rates in earlier stages (liver/intrahepatic bile duct, gallbladder, pancreas) were estimated to have medium likelihood of benefit from a hypothetical screening blood test. Cancer types rated as progressing more slowly and having higher curability regardless of stage (prostate, thyroid) were estimated to have limited likelihood of benefit from a hypothetical screening blood test. The panel concluded most solid tumors have a likelihood of benefit from early detection. Even among difficult-to-treat cancers (e.g., pancreas, liver/intrahepatic bile duct, gallbladder), early-stage detection was believed to be beneficial. Based on the panel consensus, broad coverage of cancers by screening blood tests would deliver the greatest potential benefits to patients.

PMID:36542647 | PMC:PMC9770338 | DOI:10.1371/journal.pone.0279227
Nomenclature and Lymphatic Drainage Patterns of Abdominal Lymph Nodes

Fetched: December 23rd, 2022, 5:01am GMT by Hyun Seok Cho

J Korean Soc Radiol. 2022 Nov;83(6):1240-1258. doi: 10.3348/jksr.2021.0189. Epub 2022 May 23.

ABSTRACT

The lymphatic system provides a route for the spread of inflammation and malignancies. The identification of nodal stations and lymphatic pathways of tumor spread is important for tumor staging, choice of therapy, and the prediction of the prognosis of patients with malignant diseases. Because lymph node metastasis is common in primary intra-abdominal malignant tumors, its detection is essential for radiologists to understand the pattern of disease spread. Using schematic pictures and color-coded CT images, this pictorial essay describes the locations and nomenclature of the abdominal lymph nodes. Furthermore, the lymphatic drainage pathways of the upper and lower gastrointestinal tracts, liver, gallbladder, bile duct, and pancreas have been highlighted. In addition, lymph nodes belonging to the regional lymph nodes in malignant tumors arising from each organ are described, and certain cases are presented with images from patients.

PMID:36545415 | PMC:PMC9748447 | DOI:10.3348/jksr.2021.0189
The efficacy of oxaliplatin, surufatinib, and camrelizumab on neuroendocrine carcinoma: a case report and literature review

Fetched: December 23rd, 2022, 5:01am GMT by Xianhua Wang

Ann Transl Med. 2022 Nov;10(22):1254. doi: 10.21037/atm-22-4789.

ABSTRACT

BACKGROUND: Extra-pulmonary neuroendocrine carcinomas (EP-NECs) are rare, accounting for ~1/100,000 of NECs, aggressive neoplasms and poor prognosis. Sometimes, a non-neuroendocrine component is also accompanying these EP-NECs. Curative surgery is suggested for early stage patients while system chemotherapy and locoregional radiotherapy are considered for advanced inoperable disease. Nonetheless, there was lack of standard second-line treatment strategy. Herein, we report a case of NEC involving a large cell neuroendocrine carcinoma (LCNEC) and adenocarcinoma of the gallbladder treated with a surufatinib-containing regimen in the second-line treatment setting and establish the efficacy of this regimen in the treatment of EP-NECs.

CASE DESCRIPTION: A 58-year-old male presented with symptoms such as distension in the upper right abdomen and a palpable mass. The abdominal magnetic resonance imaging (MRI) scan showed a giant soft tissue mass in the left lobe of the liver, and liver biopsy suggested LCNEC with a non-neuroendocrine (NNE) component. Based on the available literature, a first-line therapy of oxaliplatin + gemcitabine + camrelizumab + apatinib was started initially; however, there was rapid tumor progression. Thus, a second line of treatment was started, where apatinib was replaced with surufatinib, which was given along with oxaliplatin and camrelizumab and continued for seven complete cycles. The patient was re-examined with MRI, which showed a significant decrease in tumor size. And a partial response was achieved. Main adverse events included hand and foot numbness, hypertension, proteinuria, hematuria, and hyperthyroidism. The patient underwent surgery after the second line of treatment and the post-operative pathology report revealed the presence of LCNEC and adenocarcinoma of the gallbladder. Two months later, re-examination result showed no tumor recurrence.

CONCLUSIONS: As yet, the criteria strategy for unresectable EP-NECs to improve survival outcomes is scarce. EP-NECs are badly in need of effective second-line therapy to carry out survival benefits after resistance to first-line regimen. The case report demonstrated that a surufatinib-containing regimen including oxaliplatin and camrelizumab could be an effective treatment strategy for the second-line treatment of EP-NECs. Furthermore, this strategy is well tolerated and treatment-related toxicity are manageable. More clinical trials are warranted to further confirm the efficacy.

PMID:36544653 | PMC:PMC9761152 | DOI:10.21037/atm-22-4789
Survival analysis and prognostic factors of the carcinoma of gallbladder

Fetched: December 23rd, 2022, 5:01am GMT by Zainab Feroz

World J Surg Oncol. 2022 Dec 20;20(1):403. doi: 10.1186/s12957-022-02857-y.

ABSTRACT

BACKGROUND: The present study aims to evaluate the survival status of patients with gallbladder cancer (GBC) and explore the prognostic factors for the improvement and preventions.

METHODS: The study consists of 176 patients with clinically diagnosed gallbladder cancer; the study was conducted between 2019 and 2021 registered at Kamala Nehru Memorial Cancer Hospital, Prayagraj, India. The survival rates were analyzed by the Kaplan-Meier method; survival rate difference was analyzed by log-rank test, prognosis factors; and hazard ratio for mortality outcomes was estimated using Cox regression method.

RESULTS: The overall median survival time of patients was 5 months with the 1-year, 2-year, and 3-year survival rates of 24.4%, 8.5%, and 4.5%, respectively. The 3-year survival for patients with jaundice was 2.9%, liver infiltration (4.2%), gallstones (0.8%), and with advanced tumor grade (1.4%). Elderly GBC patients had lower survival rates (3.8%), while the 3-year overall survival for patients residing in urban areas dropped to zero. No patients in the tumor stage (T3/T4) and with distance metastasis stage survived in 3 years, while only 1.1% of patients with advanced nodal stage survived. On receiving surgery and radiation therapy, the 3-year survival rate increased to 19.5% and 35%, respectively. The results of multivariate analysis showed that urban region (HR = 1.568, p = 0.040), gallstone or not (1.571, p = 0.049), N stage (HR = 1.468, p = 0.029), and M stage (HR = 2.289, p < 0.0001) were independent risk factors for prognosis, while surgery or not (HR = 0.573, p = 0.030) was the protective factor for the prognosis of GBC.

CONCLUSION: The overall survival of GBC in the Gangetic belt is poor. The geographical region of patients, gallstones, and N and M stage was the risk factors for prognosis, while surgery or not was the protective factor for the prognosis of GBC.

PMID:36539838 | PMC:PMC9764491 | DOI:10.1186/s12957-022-02857-y
The role of NKT cells in gastrointestinal cancers

Fetched: December 20th, 2022, 5:01am GMT by Julian Burks

Oncoimmunology. 2021 Dec 30;11(1):2009666. doi: 10.1080/2162402X.2021.2009666. eCollection 2022.

ABSTRACT

Gastrointestinal (GI) cancers represent a complex array of cancers that affect the digestive system. This includes liver, pancreatic, colon, rectal, anal, gastric, esophageal, intestinal and gallbladder cancer. Patients diagnosed with certain GI cancers typically have low survival rates, so new therapeutic approaches are needed. A potential approach is to harness the potent immunoregulatory properties of natural killer T (NKT) cells which are true T cells, not natural killer (NK) cells, that recognize lipid instead of peptide antigens presented by the non-classical major histocompatibility (MHC) molecule CD1d. The NKT cell subpopulation is known to play a vital role in tumor immunity by bridging innate and adaptive immune responses. In GI cancers, NKT cells can contribute to either antitumor or protumor immunity depending on the cytokine profile expressed and type of cancer. This review discusses the complexities of the role of NKT cells in liver, colon, pancreatic and gastric cancers with an emphasis on type I NKT cells.

PMID:36524208 | PMC:PMC9746626 | DOI:10.1080/2162402X.2021.2009666
Comprehensive Molecular Characterization of Gallbladder Carcinoma and Potential Targets for Intervention

Fetched: December 17th, 2022, 5:01am GMT by Nicolas A Giraldo

Clin Cancer Res. 2022 Dec 15;28(24):5359-5367. doi: 10.1158/1078-0432.CCR-22-1954.

NO ABSTRACT

PMID:36228155 | PMC:PMC9772093 | DOI:10.1158/1078-0432.CCR-22-1954
Preoperative skeletal muscle fat infiltration is a strong predictor of poorer survival in gallbladder cancer underwent surgery

Fetched: December 16th, 2022, 5:01am GMT by Ryo Ashida

Clin Nutr ESPEN. 2022 Dec;52:60-67. doi: 10.1016/j.clnesp.2022.10.003. Epub 2022 Oct 13.

ABSTRACT

BACKGROUND & AIMS: Recently, a decrease in skeletal muscle, termed sarcopenia, has been reported to be associated with poorer survival of patients in several types of cancer. However, few studies have investigated the association between sarcopenia and the survival of patients with gallbladder cancer.

METHODS: A total of 88 patients undergoing curative resection for advanced gallbladder cancer were included in this study. The quality of skeletal muscle was assessed by the intramuscular adipose tissue content (IMAC), and the quantity of skeletal muscle was assessed by the psoas muscle index (PMI), measured on preoperative computed tomography. The optimum cutoff values for IMAC and PMI for predicting the overall survival in each sex were determined using a minimum p value approach. Clinicopathological factors, IMAC and PMI were retrospectively analyzed to identify the predictors of overall survival (OS).

RESULTS: The cutoff values for IMAC were -0.3 in males and 0.04 in females. The numbers of patients with low IMAC and high IMAC were 42 and 46, respectively. The cutoff values for PMI were 7.3 cm²/m² in males and 5.0 cm²/m² in females. The numbers of patients with low PMI and high PMI were 22 and 66, respectively. A multivariate analysis revealed that pT stage (pT3/4, hazard ratio [HR] = 6.72, p = 0.004), high IMAC (HR = 4.12, p < 0.001), Bile duct infiltration (present, HR = 2.82, p = 0.046), high age (≥72 years old, HR = 2.64, p = 0.010), major hepatectomy (performed, HR = 2.50, p = 0.031) and pN1/2 (HR = 2.17, p = 0.010) as independent prognostic factors.

CONCLUSION: IMAC was independent prognostic factor for resected advanced gallbladder cancer, so the quality of skeletal muscle more strongly predicted survival than the quantity of skeletal muscle.

PMID:36513487 | DOI:10.1016/j.clnesp.2022.10.003
A clinicoepidemiological and management profile of metastatic carcinoma gallbladder in the northeast part of Indian patients in a tertiary care center

Fetched: December 16th, 2022, 5:01am GMT by Anvesh Rathore

J Cancer Res Ther. 2022 Dec;18(Supplement):S428-S433. doi: 10.4103/jcrt.JCRT_1213_20.

ABSTRACT

INTRODUCTION: Metastatic gallbladder cancer (GBC) is a highly fatal malignancy and it is difficult to treat the advanced stage of GBC. In India, northern and northeastern states are the worst affected by this disease. We, hereby, report the clinicoepidemiological and management profile of 242 patients of metastatic carcinoma of GB.

MATERIALS AND METHODS: In this study, a total of 242 cases of metastatic GBC (detected either on the first presentation or during follow-up) were managed at the Department of Medical Oncology tertiary care oncology center in the northeast part of India from May 2018 to September 2019. On presentation, all patients were subjected to detailed history and clinical examination, followed by requisite investigations and were treated as per the existent guidelines.

RESULTS: One-hundred and forty-two patients were female, while 100 patients were male out of 242 patients. Female patients with metastatic GBC presented with the mean age of 54, while for males, 51.4 years. The most common presentation was pain abdomen (81.8%), while the second most common was anorexia (77.2%), followed by weight loss (62.8%) and mass per abdomen (60.7%). The most common site of metastasis recorded in our study was the liver (79.7%), followed by nonregional abdominal lymph node (69.4%) and ascites (64.4%). Out of the 242 patients, 24 patients had presented in poor Eastern Cooperative Oncology Group Performance Status (≥3) hence were deemed unfit for any oncological interventions. About 136 (56.1%) patients had presented with features of obstructive jaundice, however only 108 patients were subjected to biliary drainage procedure. After the biliary drainage procedures, only one-third (38 out of 136; 35.1%) of patients were finally able to receive chemotherapy.

CONCLUSION: In India, unfortunately, many patients present very late during the course of their illness. There is a need for the development of effective chemotherapy or targeted therapy and also there is an unmet need for patients' education. There has been an increase in the incidence of this malignancy, especially in the Northeast part of India; hence, it is the need of the hour to study various epidemiological and causative factors of the disease. Furthermore, the development of therapies for the effective management of this malignancy is really required.

PMID:36510998 | DOI:10.4103/jcrt.JCRT_1213_20

Trials - Gall Bladder Cancer

Carlizumab Plus Sovantinib in Second-line Treatment of Advanced or Metastatic Cholangiocarcinoma

Posted: January 25th, 2023, 3:00pm GMT

Condition: Cholangiocarcinoma
Interventions: Drug: Carrelizumab; Drug: Solfantinib
Sponsor: First Affiliated Hospital Xi'an Jiaotong University
Not yet recruiting
Therapeutic Assistance and Decision-making Algorithms in Hepatobiliary Tumor Boards

Posted: January 12th, 2023, 3:00pm GMT

Conditions: Hepatocellular Carcinoma; Fibrolamellar Hepatocellular Carcinoma; Cholangiocarcinoma, Perihilar; Intrahepatic Cholangiocarcinoma; Metastasis to Liver; Gallbladder Carcinoma
Intervention: Other: ADBoard
Sponsors: Charite University, Berlin, Germany; German Research Center for Artificial Intelligence
Not yet recruiting
A Prospective Study of UCAD for Diagnosing Benign or Malignant Biliary Obstruction and Follow-up

Posted: February 14th, 2022, 3:00pm GMT

Conditions: Biliary Tract Neoplasms; Pancreatic Carcinoma; Gallbladder Cancer; Pancreatic Head Carcinoma
Intervention: Diagnostic Test: The level of CIN
Sponsors: Xinhua Hospital, Shanghai Jiao Tong University School of Medicine; Shanghai Zhongshan Hospital; Ruijin Hospital; Changhai Hospital; Shanghai Changzheng Hospital; Eastern Hepatobiliary Surgery Hospital; First Affiliated Hospital Xi'an Jiaotong University; Jiangsu Provincial People's Hospital; Third Affiliated Hospital, Sun Yat-Sen University; First Affiliated Hospital of Zhejiang University; The Affiliated Nanjing Drum Tower Hospital of Nanjing University Medical School; Second Hospital of Jilin University; West China Hospital; Southwest Hospital, China; Afﬁliated Hospital of North Sichuan Medical College; Sun Yat-Sen Memorial Hospital of Sun Yat-Sen University
Recruiting
Feasibility Study to Investigate Rectal Mucus in Aero-Digestive Tract Cancer.

Posted: November 1st, 2021, 2:00pm GMT

Conditions: Non Small Cell Lung Cancer; Gastric Adenocarcinoma; Pancreatic Cancer; Gall Bladder Cancer; Bladder Cancer
Intervention: Diagnostic Test: Oricol Test
Sponsors: Origin Sciences; Royal Devon and Exeter NHS Foundation Trust; Queen Mary University of London
Recruiting
Atezolizumab Plus Tivozanib in Immunologically Cold Tumor Types

Posted: August 11th, 2021, 2:00pm GMT

Conditions: Bile Duct Cancer; Gall Bladder Cancer; Breast Cancer; Neuroendocrine Tumors; Ovarian Cancer; Pancreatic Adenocarcinoma; Soft Tissue Sarcoma; Vulvar Cancer; Prostate Cancer
Interventions: Drug: Atezolizumab; Drug: Tivozanib
Sponsors: University of Florida; Genentech, Inc.; Aveo Oncology Pharmaceuticals
Recruiting
Feasibility Study of Multi-Platform Profiling of Resected Biliary Tract Cancer

Posted: September 23rd, 2020, 2:00pm GMT

Conditions: Biliary Tract Cancer; Cholangiocarcinoma; Gallbladder Cancer; Intrahepatic Cholangiocarcinoma; Perihilar Cholangiocarcinoma; Extrahepatic Cholangiocarcinoma; Hilar Cholangiocarcinoma; Distal Bile Duct Cancer
Intervention: Diagnostic Test: Multi-Platform Profiling with Organoid Drug Sensitivity Screening and ctDNA Monitoring
Sponsors: University of Washington; Natera, Inc.; SEngine Precision Medicine, Inc.
Recruiting
Repeatability of 68-GaNOTA-Anti-HER2 VHH1 PET/CT in Breast Carcinoma Patients

Posted: April 23rd, 2019, 2:00pm GMT

Conditions: Metastatic Breast Carcinoma; Locally Advanced Breast Cancer; Cancer of Pancreas; Solid Tumor With Intermediate or High HER2 Expression; Salivary Gland Cancer; Gastric Cancer; Endometrial Cancer; Uterine Cancer; Non Small Cell Lung Cancer; Biliary Tract Cancer; Cholangiocarcinoma; Colorectal Cancer; Urothelial Carcinoma; Prostate Cancer
Intervention: Drug: 68GaNOTA-Anti-HER2 VHH1
Sponsors: Universitair Ziekenhuis Brussel; Kom Op Tegen Kanker; Agentschap voor Innovatie door Wetenschap en Technologie, Project Toegepast Biomedisch onderzoek met een primair Maatschappelijke finaliteit.
Recruiting

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Rare Cancer News & Clinical Trials » Gall Bladder Cancer

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Gall Bladder Cancer (90 unread)

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