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Google - Gall Bladder Cancer

Soon an NGO in Mann Kaur’s name - The Tribune India

Posted: September 16th, 2021, 1:47am GMT

Soon an NGO in Mann Kaur’s name The Tribune India
NuCana Announces Enrollment of Required Number of Patients to Conduct First Interim Analysis in the Phase III Biliary Tract Cancer Study - StreetInsider.com

Posted: September 15th, 2021, 5:13pm GMT

NuCana Announces Enrollment of Required Number of Patients to Conduct First Interim Analysis in the Phase III Biliary Tract Cancer Study StreetInsider.com
'Nobody's Talking About It': Atlanta Radio DJ SiMan Baby and His Cousin Were Both Diagnosed with Stage 4 Pancreatic Cancer. Now They're Helping to Bring Awareness. - Atlanta Black Star

Posted: September 15th, 2021, 4:31pm GMT

'Nobody's Talking About It': Atlanta Radio DJ SiMan Baby and His Cousin Were Both Diagnosed with Stage 4 Pancreatic Cancer. Now They're Helping to Bring Awareness. Atlanta Black Star
Colorectal Surgical Devices Market Size, Industry Report Analysis, Global Growth, Future Trends, Latest Innovation and Technology| – Stillwater Current - Stillwater Current

Posted: September 15th, 2021, 1:20pm GMT

Colorectal Surgical Devices Market Size, Industry Report Analysis, Global Growth, Future Trends, Latest Innovation and Technology| – Stillwater Current Stillwater Current
Type-2-diabetes and cancer risk - DocWire News

Posted: September 15th, 2021, 1:01pm GMT

Type-2-diabetes and cancer risk DocWire News
How Do Your Hormones Affect Your Weight? - Healthline

Posted: September 15th, 2021, 11:08am GMT

How Do Your Hormones Affect Your Weight? Healthline
NuCana Announces Enrollment of Required Number of Patients - GlobeNewswire

Posted: September 15th, 2021, 10:00am GMT

NuCana Announces Enrollment of Required Number of Patients GlobeNewswire
Effect of lymphadenectomy on the prognosis for N0 gallbladder carcinoma patients: A study based on SEER database - MD Linx

Posted: September 15th, 2021, 6:28am GMT

Effect of lymphadenectomy on the prognosis for N0 gallbladder carcinoma patients: A study based on SEER database MD Linx
5 Best Surgeons in Baltimore, MD - Kev's Best

Posted: September 14th, 2021, 9:11pm GMT

5 Best Surgeons in Baltimore, MD Kev's Best
Doctors Near Columbus: Search for Top Doctors in 2021 by Specialty in Central Ohio - Columbus Monthly

Posted: September 14th, 2021, 6:12pm GMT

Doctors Near Columbus: Search for Top Doctors in 2021 by Specialty in Central Ohio Columbus Monthly
Ugly Side Effects of the American Diet, Say Dietitians | Eat This Not That - Eat This, Not That

Posted: September 14th, 2021, 4:03pm GMT

Ugly Side Effects of the American Diet, Say Dietitians | Eat This Not That Eat This, Not That
Campylobacter spp. in bovine raw meat | IDR - Dove Medical Press

Posted: September 14th, 2021, 3:33pm GMT

Campylobacter spp. in bovine raw meat | IDR Dove Medical Press
Beyond Cannabis: What Other Plants Contain Cannabinoids? - Benzinga

Posted: September 14th, 2021, 12:05pm GMT

Beyond Cannabis: What Other Plants Contain Cannabinoids? Benzinga
Dubai: Largest gallstone in UAE removed from 52-year-old patient - Khaleej Times

Posted: September 14th, 2021, 11:28am GMT

Dubai: Largest gallstone in UAE removed from 52-year-old patient Khaleej Times
Obesity: High fat diet may influence body clock - Medical News Today

Posted: September 14th, 2021, 10:32am GMT

Obesity: High fat diet may influence body clock Medical News Today
‘Maddening’: With Idaho hospitals full of COVID-19 patients, needed care gets delayed - Idaho Statesman

Posted: September 14th, 2021, 8:00am GMT

‘Maddening’: With Idaho hospitals full of COVID-19 patients, needed care gets delayed Idaho Statesman
Fujifilm launches project to verify effectiveness of AI technology assisting diagnostic imaging - Express Healthcare

Posted: September 14th, 2021, 4:50am GMT

Fujifilm launches project to verify effectiveness of AI technology assisting diagnostic imaging Express Healthcare
Carol Vorderman health: The star's illness that kills someone every 2.8 seconds - symptoms - Daily Express

Posted: September 13th, 2021, 1:52pm GMT

Carol Vorderman health: The star's illness that kills someone every 2.8 seconds - symptoms Daily Express
Researchers discover factors that two aggressive cancers have in common - Medical Xpress

Posted: September 13th, 2021, 12:30pm GMT

Researchers discover factors that two aggressive cancers have in common Medical Xpress
Gastrointestinal Therapeutics Market Research Report 2021, Size, Share, Trends and Forecast to 2026 - Global Banking And Finance Review

Posted: September 13th, 2021, 8:49am GMT

Gastrointestinal Therapeutics Market Research Report 2021, Size, Share, Trends and Forecast to 2026 Global Banking And Finance Review
Building on Prior Research, Wilmot Makes Progress on Vexing Liver Cancer - URMC

Posted: September 13th, 2021, 8:15am GMT

Building on Prior Research, Wilmot Makes Progress on Vexing Liver Cancer URMC
To protect yourself from cancer, do these yogasanas daily - India TV News

Posted: September 13th, 2021, 2:07am GMT

To protect yourself from cancer, do these yogasanas daily India TV News
Health disparities, race, and the global pandemic of COVID‐19: The demise of Black Americans - Wiley

Posted: September 12th, 2021, 5:00am GMT

Health disparities, race, and the global pandemic of COVID‐19: The demise of Black Americans Wiley
Health disparities, race, and the global pandemic of COVID‐19: The demise of Black Americans - Wiley

Posted: September 12th, 2021, 5:00am GMT

Health disparities, race, and the global pandemic of COVID‐19: The demise of Black Americans Wiley
What to know about surgery during the pandemic - El Dorado News-Times

Posted: September 12th, 2021, 3:03am GMT

What to know about surgery during the pandemic El Dorado News-Times
Fujifilm launches project to verify effectiveness of AI technology in medical services - Medical Dialogues

Posted: September 12th, 2021, 1:30am GMT

Fujifilm launches project to verify effectiveness of AI technology in medical services Medical Dialogues
STING agonists, galectin and deep sea bacteria - Brain Tumour Research

Posted: September 11th, 2021, 10:09pm GMT

STING agonists, galectin and deep sea bacteria Brain Tumour Research
NHS waiting list hits record high with 5.6million suffering without medical treatment | UK | News - Toys Matrix

Posted: September 10th, 2021, 8:59am GMT

NHS waiting list hits record high with 5.6million suffering without medical treatment | UK | News Toys Matrix
Neuroendocrine small cell lung cancer: Stage 4 and more - Medical News Today

Posted: September 10th, 2021, 8:12am GMT

Neuroendocrine small cell lung cancer: Stage 4 and more Medical News Today
LiveSmart: The Relationship Between Obesity and Cancer - St. Peter's Health Partners

Posted: September 9th, 2021, 7:04pm GMT

LiveSmart: The Relationship Between Obesity and Cancer St. Peter's Health Partners
Myovant Sciences and Pfizer Announce FDA Acceptance of Supplemental New Drug Application for MYFEMBREE® for the Management of Moderate to Severe Pain Associated With Endometriosis - Pfizer

Posted: September 9th, 2021, 9:58am GMT

Myovant Sciences and Pfizer Announce FDA Acceptance of Supplemental New Drug Application for MYFEMBREE® for the Management of Moderate to Severe Pain Associated With Endometriosis Pfizer
UPDATE: Deadly Twin Cities Accident Victim Was From Faribault - KROC-AM

Posted: September 9th, 2021, 9:43am GMT

UPDATE: Deadly Twin Cities Accident Victim Was From Faribault KROC-AM
Record 5.6m people in England waiting for hospital treatment - The Guardian

Posted: September 9th, 2021, 7:17am GMT

Record 5.6m people in England waiting for hospital treatment The Guardian
The First Choice of Dietary Supplements for Modern People - YPEPRO Cynarae Scol. Sicc Tunera Diffusa Tablets - PRNewswire

Posted: September 9th, 2021, 12:52am GMT

The First Choice of Dietary Supplements for Modern People - YPEPRO Cynarae Scol. Sicc Tunera Diffusa Tablets PRNewswire
Obituaries 09-08-2021 - Revere Journal

Posted: September 8th, 2021, 5:45pm GMT

Obituaries 09-08-2021 Revere Journal
A Leading Surgeon Helps Patients with Pancreatic Cancer Overcome Steep Odds - NYU Langone Health

Posted: September 8th, 2021, 3:01pm GMT

A Leading Surgeon Helps Patients with Pancreatic Cancer Overcome Steep Odds NYU Langone Health
Getting Heart Palpitations After Eating? Learn About When to Be Concerned and What Foods to Avoid - One Green Planet

Posted: September 8th, 2021, 12:37pm GMT

Getting Heart Palpitations After Eating? Learn About When to Be Concerned and What Foods to Avoid One Green Planet
Anticancer Potential of Maslinic Acid and its Derivatives | DDDT - Dove Medical Press

Posted: September 8th, 2021, 11:52am GMT

Anticancer Potential of Maslinic Acid and its Derivatives | DDDT Dove Medical Press
Glucose to lymphocyte ratio with acute pancreatitis | IJGM - Dove Medical Press

Posted: September 8th, 2021, 5:41am GMT

Glucose to lymphocyte ratio with acute pancreatitis | IJGM Dove Medical Press
Loco for Coconut Oil - The New Indian Express

Posted: September 8th, 2021, 3:28am GMT

Loco for Coconut Oil The New Indian Express
Legendary radio host diagnosed with pancreatic Cancer | News | cbs46.com - CBS46 News Atlanta

Posted: September 8th, 2021, 10:34pm GMT

Legendary radio host diagnosed with pancreatic Cancer | News | cbs46.com CBS46 News Atlanta
Building on Success in the Covid Era – An Interview With Intuitive's CEO Gary Guthart - Robotics Business Review

Posted: September 7th, 2021, 8:00pm GMT

Building on Success in the Covid Era – An Interview With Intuitive's CEO Gary Guthart Robotics Business Review
Stomach Pain and Nausea: Causes, Symptoms, and Treatments - Healthline

Posted: September 7th, 2021, 4:38pm GMT

Stomach Pain and Nausea: Causes, Symptoms, and Treatments Healthline
Today in History - Sept. 7 - Calgary Herald

Posted: September 7th, 2021, 2:06pm GMT

Today in History - Sept. 7 Calgary Herald
Primary liver sarcomatoid carcinoma: case series and review | JHC - Dove Medical Press

Posted: September 7th, 2021, 5:05am GMT

Primary liver sarcomatoid carcinoma: case series and review | JHC Dove Medical Press
Veteran radio host Silas 'SiMan Baby' Alexander diagnosed with pancreatic cancer - 11Alive.com WXIA

Posted: September 7th, 2021, 5:00am GMT

Veteran radio host Silas 'SiMan Baby' Alexander diagnosed with pancreatic cancer 11Alive.com WXIA
Atlanta Radio Legend SiMan Baby Has Stage 4 Cancer - Radio Facts

Posted: September 7th, 2021, 3:05am GMT

Atlanta Radio Legend SiMan Baby Has Stage 4 Cancer Radio Facts
Radio host Silas ‘SiMan Baby’ Alexander has stage 4 pancreatic cancer - Atlanta Journal Constitution

Posted: September 6th, 2021, 9:48pm GMT

Radio host Silas ‘SiMan Baby’ Alexander has stage 4 pancreatic cancer Atlanta Journal Constitution
Barbara Evans poses with a twin belly and shows an ultrasound: 'Happy' - Mediarun Search

Posted: September 6th, 2021, 8:03pm GMT

Barbara Evans poses with a twin belly and shows an ultrasound: 'Happy' Mediarun Search
SiMan Baby, Atlanta radio host and R&B deejay, has stage 4 cancer - Atlanta Journal Constitution

Posted: September 6th, 2021, 5:00am GMT

SiMan Baby, Atlanta radio host and R&B deejay, has stage 4 cancer Atlanta Journal Constitution
Lanesboro Teenager Killed in Crash Near Preston - KROC-AM

Posted: September 5th, 2021, 9:16pm GMT

Lanesboro Teenager Killed in Crash Near Preston KROC-AM
Flu shots can thwart 'twindemic' punch of COVID and influenza | HeraldNet.com - The Daily Herald

Posted: September 5th, 2021, 6:30am GMT

Flu shots can thwart 'twindemic' punch of COVID and influenza | HeraldNet.com The Daily Herald
MAUREEN MCGUNIGLE Obituary (2021) - Revere, MA - Boston Globe - Legacy.com

Posted: September 4th, 2021, 5:14pm GMT

MAUREEN MCGUNIGLE Obituary (2021) - Revere, MA - Boston Globe Legacy.com
Letters to the editor for Saturday, Sept. 4: The price of choice - The Register-Guard

Posted: September 4th, 2021, 10:03am GMT

Letters to the editor for Saturday, Sept. 4: The price of choice The Register-Guard
COVID live updates: Fauci says 3 vaccine doses likely needed for full protection - Houston Chronicle

Posted: September 4th, 2021, 2:28am GMT

COVID live updates: Fauci says 3 vaccine doses likely needed for full protection Houston Chronicle
Legendary Minnesotans: Performing 96 minutes of CPR in Goodhue - krforadio.com

Posted: September 4th, 2021, 10:07pm GMT

Legendary Minnesotans: Performing 96 minutes of CPR in Goodhue krforadio.com
'Greed' lands Wahnapitae woman in jail for four years - The Sudbury Star

Posted: September 3rd, 2021, 9:10pm GMT

'Greed' lands Wahnapitae woman in jail for four years The Sudbury Star
Patients forced to wait it out as COVID surge delays important surgeries - Houston Chronicle

Posted: September 3rd, 2021, 9:35am GMT

Patients forced to wait it out as COVID surge delays important surgeries Houston Chronicle
Gloucestershire Royal among first to use mobile robotics in surgery - ITV News

Posted: September 2nd, 2021, 3:57pm GMT

Gloucestershire Royal among first to use mobile robotics in surgery ITV News
Dubai surgeon removes largest-ever gallstone in UAE through keyhole surgery on woman - Gulf News

Posted: September 2nd, 2021, 3:11am GMT

Dubai surgeon removes largest-ever gallstone in UAE through keyhole surgery on woman Gulf News
Meet SageWest's newest general surgeon, Dr. Kakavandi - County 10

Posted: September 1st, 2021, 6:55pm GMT

Meet SageWest's newest general surgeon, Dr. Kakavandi County 10
Gallbladder: A Tiny Organ with a Big Impact - Orlando Health

Posted: September 1st, 2021, 11:54am GMT

Gallbladder: A Tiny Organ with a Big Impact Orlando Health
Who are the top doctors in Columbus? Search by specialty with Columbus Monthly's 2021 list - The Columbus Dispatch

Posted: September 1st, 2021, 7:59am GMT

Who are the top doctors in Columbus? Search by specialty with Columbus Monthly's 2021 list The Columbus Dispatch
The Case Files: Four Visits to Make an Elusive Diagnosis : Emergency Medicine News - LWW Journals

Posted: August 31st, 2021, 6:53pm GMT

The Case Files: Four Visits to Make an Elusive Diagnosis : Emergency Medicine News LWW Journals
Walter Tarrant Obituary (2021) - The Cambridge Times - Legacy.com

Posted: August 31st, 2021, 5:31pm GMT

Walter Tarrant Obituary (2021) - The Cambridge Times Legacy.com
How secret Canadian money helped forge modern China - National Post

Posted: August 31st, 2021, 8:04am GMT

How secret Canadian money helped forge modern China National Post
Ultrasound and survival for pancreatic ductal adenocarcinoma | CMAR - Dove Medical Press

Posted: August 31st, 2021, 6:20am GMT

Ultrasound and survival for pancreatic ductal adenocarcinoma | CMAR Dove Medical Press
Global Laparoscopic Power Morcellators Market By Application, By Regional Outlook, COVID-19 Impact Analysis Report and Forecast, 2021 - 2027 - Yahoo Finance

Posted: August 31st, 2021, 5:45am GMT

Global Laparoscopic Power Morcellators Market By Application, By Regional Outlook, COVID-19 Impact Analysis Report and Forecast, 2021 - 2027 Yahoo Finance
Global Laparoscopic Power Morcellators Market By Application, By Regional Outlook, COVID-19 Impact Analysis Report and Forecast, 2021 - 2027 - Yahoo Finance UK

Posted: August 31st, 2021, 5:45am GMT

Global Laparoscopic Power Morcellators Market By Application, By Regional Outlook, COVID-19 Impact Analysis Report and Forecast, 2021 - 2027 Yahoo Finance UK
Gloucestershire hospitals in £100m upgrade to improve specialist care - BBC News

Posted: August 31st, 2021, 3:25am GMT

Gloucestershire hospitals in £100m upgrade to improve specialist care BBC News
Will you go under the knife to lose weight? - Manila Bulletin

Posted: August 31st, 2021, 10:35pm GMT

Will you go under the knife to lose weight? Manila Bulletin
How High Cholesterol Levels May Impact Your Cancer Risk - Healthline

Posted: August 30th, 2021, 7:49pm GMT

How High Cholesterol Levels May Impact Your Cancer Risk Healthline
Portage Biotech : MANAGEMENT'S DISCUSSION AND ANALYSIS (Form 6-K) - Marketscreener.com

Posted: August 30th, 2021, 7:33pm GMT

Portage Biotech : MANAGEMENT'S DISCUSSION AND ANALYSIS (Form 6-K) Marketscreener.com
Devimistat With Gemcitabine and Cisplatin Advances to Phase 2 in Biliary Tract Cancer - Targeted Oncology

Posted: August 30th, 2021, 6:32pm GMT

Devimistat With Gemcitabine and Cisplatin Advances to Phase 2 in Biliary Tract Cancer Targeted Oncology
Global Colorectal Surgical Devices Market 2021 COVID-19 Impact Analysis, SWOT Analysis, Key Indicators, Industry Trends and Forecast 2028 – UNLV The Rebel Yell - UNLV The Rebel Yell

Posted: August 30th, 2021, 10:08am GMT

Global Colorectal Surgical Devices Market 2021 COVID-19 Impact Analysis, SWOT Analysis, Key Indicators, Industry Trends and Forecast 2028 – UNLV The Rebel Yell UNLV The Rebel Yell
Migraine pressure points: Locations and how to apply pressure - Medical News Today

Posted: August 30th, 2021, 5:00am GMT

Migraine pressure points: Locations and how to apply pressure Medical News Today
Radiolabeling and Preliminary Evaluation of 99mTc-Labeled DNA Cube Nanoparticles as Potential Tracers for SPECT Imaging - DocWire News

Posted: August 29th, 2021, 1:04pm GMT

Radiolabeling and Preliminary Evaluation of 99mTc-Labeled DNA Cube Nanoparticles as Potential Tracers for SPECT Imaging DocWire News
Pushing the Envelope in Search of a Cure - OncLive

Posted: August 29th, 2021, 8:09am GMT

Pushing the Envelope in Search of a Cure OncLive
5 Best Surgeons in Detroit, MI - Kev's Best

Posted: August 29th, 2021, 6:38am GMT

5 Best Surgeons in Detroit, MI Kev's Best
Christine McGuinness' mum was rushed to A&E as she couldn't breathe amid cancer hell - Daily Star

Posted: August 29th, 2021, 6:35am GMT

Christine McGuinness' mum was rushed to A&E as she couldn't breathe amid cancer hell Daily Star
McClellan: Some good news, and many thank-yous - STLtoday.com

Posted: August 28th, 2021, 4:25pm GMT

McClellan: Some good news, and many thank-yous STLtoday.com
Spicy food: is it harmful? And why are some people better at it? - radar - Aviation Analysis Wing

Posted: August 28th, 2021, 1:21pm GMT

Spicy food: is it harmful? And why are some people better at it? - radar Aviation Analysis Wing
As Utah reports another 1,200 cases of COVID-19, Intermountain warns its intensive care units are full - Salt Lake Tribune

Posted: August 27th, 2021, 6:15pm GMT

As Utah reports another 1,200 cases of COVID-19, Intermountain warns its intensive care units are full Salt Lake Tribune
A Weighty Problem Of Andaman & Nicobar Police - Outlook India

Posted: August 27th, 2021, 11:59am GMT

A Weighty Problem Of Andaman & Nicobar Police Outlook India
8 Things That Can Cause Dark Yellow or Brown Urine - msnNOW

Posted: August 27th, 2021, 11:28am GMT

8 Things That Can Cause Dark Yellow or Brown Urine msnNOW
Why Is Your Poop Green? - Health Essentials from Cleveland Clinic

Posted: August 27th, 2021, 8:45am GMT

Why Is Your Poop Green? Health Essentials from Cleveland Clinic
Safra Yolu Kanserinin Belirtileri Nelerdir? - RaillyNews

Posted: August 27th, 2021, 5:00am GMT

Safra Yolu Kanserinin Belirtileri Nelerdir? RaillyNews
Houston veteran dies of treatable illness after waiting hours for ICU bed - KPRC Click2Houston

Posted: August 27th, 2021, 5:00am GMT

Houston veteran dies of treatable illness after waiting hours for ICU bed KPRC Click2Houston
Rev. Jesse Jackson, wife remain hospitalized with COVID-19 - Richmond Free Press

Posted: August 26th, 2021, 8:00pm GMT

Rev. Jesse Jackson, wife remain hospitalized with COVID-19 Richmond Free Press
Rev. Jesse Jackson, wife remain hospitalized with COVID-19 - Richmond Free Press

Posted: August 26th, 2021, 8:00pm GMT

Rev. Jesse Jackson, wife remain hospitalized with COVID-19 Richmond Free Press
Consuming A Lot Of Turmeric For Immunity? Know About These Possible Side Effects - ABP Live

Posted: August 26th, 2021, 1:37pm GMT

Consuming A Lot Of Turmeric For Immunity? Know About These Possible Side Effects ABP Live
Fibrinogen-to-albumin ratio & all-cause mortality in cancer | IJGM - Dove Medical Press

Posted: August 26th, 2021, 12:12pm GMT

Fibrinogen-to-albumin ratio & all-cause mortality in cancer | IJGM Dove Medical Press
Major Highlights of Gallbladder Cancer Treatment Market in Covid-19 pandemic - The Manomet Current

Posted: August 26th, 2021, 7:52am GMT

Major Highlights of Gallbladder Cancer Treatment Market in Covid-19 pandemic The Manomet Current
SynoGut Reviews - Ingredients with Benefits or Side... - Islands' Sounder

Posted: August 26th, 2021, 6:30am GMT

SynoGut Reviews - Ingredients with Benefits or Side... Islands' Sounder
MD Anderson Research Highlights for August 25, 2021 - Newswise

Posted: August 25th, 2021, 7:10pm GMT

MD Anderson Research Highlights for August 25, 2021 Newswise
MD Anderson Research Highlights for August 25, 2021 - Newswise

Posted: August 25th, 2021, 7:10pm GMT

MD Anderson Research Highlights for August 25, 2021 Newswise
Sharp Pain In Stomach: Here's What the Sharp Pain In Your Stomach Might Mean - Parade Magazine

Posted: August 25th, 2021, 7:02pm GMT

Sharp Pain In Stomach: Here's What the Sharp Pain In Your Stomach Might Mean Parade Magazine
Why you shouldn't wait to schedule your surgery | The Globe - The Globe

Posted: August 25th, 2021, 7:00pm GMT

Why you shouldn't wait to schedule your surgery | The Globe The Globe
Expert surgical care available in Worthington | The Globe - The Globe

Posted: August 25th, 2021, 6:00pm GMT

Expert surgical care available in Worthington | The Globe The Globe
The Inside Scoop: Why my passion sometimes beats out my professional - The Southern Scoop - The Southern Scoop -

Posted: August 25th, 2021, 3:34pm GMT

The Inside Scoop: Why my passion sometimes beats out my professional - The Southern Scoop The Southern Scoop -

PubMed - Gall Bladder Cancer

Advanced Squamous Cell Carcinoma of Gall Bladder Masquerading as Liver Abscess With Review of Literature Review on Advanced Biliary Tract Cancer

Fetched: September 14th, 2021, 5:01am GMT by Syed Hamza Bin Waqar

Cureus. 2021 Aug 4;13(8):e16867. doi: 10.7759/cureus.16867. eCollection 2021 Aug.

ABSTRACT

Advanced biliary tract carcinoma (ABC) tends to have a poor prognosis, with trials done having limited data from oncologists' perspectives. Squamous cell variant of gallbladder cancer (GBC) is one of the rarest forms of cancer known in the literature, with a very aggressive course and dismal prospects. Herein, we present a case of a 67-year-old man who got diagnosed with squamous cell carcinoma, which initially masqueraded as liver abscess and was associated with severe hypercalcemia, pyrexia, jaundice, and submassive pulmonary embolism.

PMID:34513442 | PMC:PMC8412003 | DOI:10.7759/cureus.16867
Preoperative lymphocyte to C-reactive protein ratio as a new prognostic indicator in patients with resectable gallbladder cancer

Fetched: September 12th, 2021, 5:01am GMT by Wen-Yan Yao

Hepatobiliary Pancreat Dis Int. 2021 Aug 27:S1499-3872(21)00162-4. doi: 10.1016/j.hbpd.2021.08.006. Online ahead of print.

ABSTRACT

BACKGROUND: Inflammation is often related to cancer, and several inflammatory scores have been established to predict the prognosis of various types of cancer. Our study aimed to determine the prognostic value of the preoperative lymphocyte to C-reactive protein ratio (LCR) for predicting postoperative outcomes in patients with resectable gallbladder cancer (GBC).

METHODS: A retrospective analysis of 104 GBC patients who received curative surgery at Xinhua Hospital, Affiliated to Shanghai Jiao Tong University School of Medicine from January 2000 to December 2016 was performed. A time-dependent receiver operating characteristic curve was constructed to evaluate the accuracy of different markers. Univariate and multivariate Cox proportional hazard models were used to define factors associated with overall survival.

RESULTS: Among the assessed variables, the preoperative LCR showed the highest accuracy in predicting the overall survival of GBC patients (AUC: 0.736). Decreased preoperative LCR was significantly associated with advanced tumor stage, including tumor invasion (P = 0.018), lymph node metastasis (P = 0.011) and TNM stage (P = 0.022). A low preoperative LCR (cutoff threshold = 145.5) was an independent risk factor for overall survival in patients with resectable GBC (P < 0.001).

CONCLUSIONS: The preoperative LCR is a novel and valuable prognostic indicator of postoperative survival in patients with resectable GBC.

PMID:34507896 | DOI:10.1016/j.hbpd.2021.08.006
Editorial

Fetched: September 12th, 2021, 5:01am GMT by Irinel Popescu

Chirurgia (Bucur). 2021 Aug;116(4):385-386. doi: 10.21614/chirurgia.116.4.385.

ABSTRACT

Liver surgery continues to evolve, as knowledge of liver anatomy and physiology deepens, new technologies are introduced, and the experience of surgical teams increases. Internationally, liver surgery is part of a very well-defined subspecialty today, namely "hepato-biliary-pancreatic surgery". The United States has a two-year post-residency training system (Fellowship). Europe has an examination organized by UEMS in which candidates must demonstrate specific training in one or more HPB units. A two-year training certificate in hepato-biliary-pancreatic surgery was introduced in Romania, coordinated by three centers: Fundeni Clinical Institute in Bucharest, Sfantul Spiridon Hospital in Iasi and Regional Institute of Gastroenterology and Hepatology in Cluj-Napoca. The first two centers also provide training for liver transplantation. This special issue primarily reflects the experience of these three centers, to which are added newer ones, under development. One of these new centers (the Surgical Department II "Sf. Maria" Hospital in Bucharest), represented by C. Stroescu et al, presents a valuable experience in HPB surgery accumulated in the last 7 years. The importance of anatomy in liver surgery is underlined by the work of L. Simion et al, which analyzes the anatomical variants of the hepatic artery and their importance in resection and transplant surgery. Current liver surgery necessarily involves intraoperative ultrasound, which is highlighted in the excellent review by A. Bartos et al in the particular case of resections for hepatocellular carcinoma. Also, the importance of this exploration results from the experience of liver resections for metastases of stromal gastrointestinal tumors (GIST) analyzed by A. Kraft et al. An important advance in liver surgery was the minimally invasive, laparoscopic or robotic approach. M. Marino et al. present an interesting experience in robotic liver surgery. Among the other topics addressed, we retain the method called ALPPS (Associating liver partition and portal vein ligation for staged hepatectomy). Viewed with reservations at first and even met with severe criticism, ALPPS seems to have prevailed now, the results being considered convincing by most authors. This is reflected in two articles: A review article by F. Botea et al based also on an important experience both in Fundeni Hospital, but mainly in the Department of Surgery in Zurich and Kiel. The personal experience of A. Hotineanu et al. We were honored to include this article from the Republic of Moldova, especially since there is still a close connection between the surgery center at the Republican Hospital in Chisinau and the Romanian surgery. The progress made in liver transplantation is reflected in the work of Nicolaescu et al on the experience of Fundeni center in hypothermic mechanical oxygenated perfusion of liver grafts, one of the most important developments in transplantation in recent years, which contributed significantly to the continuous improvement of postoperative results. Hydatid cyst surgery could not be missed, in a country where this pathology is still widespread enough. The work of C. Molnar et al addresses a complicated form of the disease, namely multiple hydatid cyst. This special issue covers also the topic of interventional treatment, in the article of Lupascu et al about the percutaneous drainage of liver abscess. Two of the works are dedicated to bile duct surgery: A. Bartos at al. presents the personal experience on portojejunostomy in cases of complex lesions of the extrahepatic bile duct; R. Popescu et al. presents the personal experience on the management of residual gallbladder and cystic duct stump stone after cholecystectomy. The video presentations bring a special added value in a difficult and spectacular surgery, not without risks. It is worth noting first of all the video with the resection of a giant hepatic artery aneurysm (V. Brasoveanu et al), as well as the two films of complex ultrasound- guided resections of F. Botea et al. I am convinced that the video of M. Marino et al on robotic left hemihepatectomy will surely be very much appreciated by the readers of Chirurgia.

PMID:34498559 | DOI:10.21614/chirurgia.116.4.385
Perineural Invasion in Gallbladder Cancer

Fetched: September 8th, 2021, 5:01am GMT by Kumble Seetharama Madhusudhan

Radiographics. 2021 Sep-Oct;41(5):E161-E162. doi: 10.1148/rg.2021200222.

NO ABSTRACT

PMID:34469220 | DOI:10.1148/rg.2021200222
The effect of preoperative jaundice in the surgical management of gallbladder carcinoma: An updated meta-analysis

Fetched: September 8th, 2021, 5:01am GMT by Tian-Run Lv

ANZ J Surg. 2021 Jul;91(7-8):E455-E464. doi: 10.1111/ans.17000. Epub 2021 Jul 5.

ABSTRACT

BACKGROUND: An updated meta-analysis was performed on the significance of preoperative jaundice in the surgical management of gallbladder carcinoma (GBC).

METHODS: A thorough database searching was performed in PubMed, EMBASE, and the Cochrane library for comparative studies between jaundiced and non-jaundiced GBC patients. RevMan5.3 and Stata 13.0 software were used for statistical analysis. A total of nine measured outcomes were identified: resectability, R0 resection rate, concurrent bile duct resection, major hepatectomy, vital vascular reconstruction, combined adjacent organ resections, postoperative morbidities, mortalities, and overall survival (OS).

RESULTS: A total of eight studies were finally included. Newcastle- Ottawa Quality Assessment Scale was used for evaluating the quality of all included studies and the details were recorded in Table S1. Our pooled results revealed that preoperative jaundice was associated with a significantly lower resectability (p < 0.00001), a significantly lower R0 resection rate (p < 0.00001), a significantly higher concurrent bile duct resection rate (p < 0.00001), major hepatectomy rate (≥3 segments) (p < 0.00001), and vital vascular reconstruction rate (portal vein or hepatic artery) (p < 0.00001). Moreover, jaundiced patients experienced more postoperative morbidities (p < 0.00001), mortalities (p < 0.0001), and worse OS (p < 0.00001). However, jaundice was not related to combined adjacent organ resections (p = 0.58).

CONCLUSION: Preoperative jaundice in GBC patients seems to be contraindicated to curative resection and the optimal therapeutic strategies should be identified via multidisciplinary team rather than surgery alone. Candidates for curative surgery should be highly selected and experienced centers are preferred. More significant well-designed studies are required for further exploration.

PMID:34224199 | DOI:10.1111/ans.17000
Insulin-Like Growth Factor-1 Receptor Targeted Fluorescent Imaging for Gallbladder Cancer in Orthotopic Mouse Models

Fetched: September 1st, 2021, 5:01am GMT by Jung Ha Choi

Gut Liver. 2021 Sep 1. doi: 10.5009/gnl210164. Online ahead of print.

ABSTRACT

BACKGROUND/AIMS: Gallbladder cancer is fatal, but fluorescent imaging technology can facilitate timely diagnosis and improve patient outcomes. Fluorophore-conjugated insulin-like growth factor-1 receptor (IGF-1R) targeted antibodies were used to visualize gallbladder cancer in orthotopic tumor mouse models.

METHODS: Western blotting, flow cytometric analysis, and confocal microscopy detected the expression of IGF-1R in SNU-308, SNU-478, and SNU-1196 bile duct cancer cells. In vivo imaging of SNU-478 and SNU-1196 subcutaneous tumors and orthotopic gallbladder tumor models of SNU-478 were performed after injection with DyLight 650-conjugated IGF-1R antibody.

RESULTS: Western blotting and flow cytometric analysis showed that IGF-1R was expressed in bile duct cancer cells, and confocal microscopy demonstrated that IGF-1R antibody was able to bind to IGF-1R on the cell membrane. Fluorescent IGF-1R antibody injected into the mouse tail vein made subcutaneous tumors and orthotopic tumors become fluorescent. The intensity of fluorescence from the tumor was stronger than that from surrounding normal tissues. Histochemical examination confirmed that the tumor was located inside the gallbladder and adjacent liver parenchyma of mice.

CONCLUSIONS: Our study showed that a fluorescent IGF-1R-targeted antibody could help detect gallbladder tumors. Tumor-specific imaging technology can be applied to endoscopy, laparoscopy, and robotic surgery for better management of gallbladder cancer.

PMID:34462395 | DOI:10.5009/gnl210164
Diagnostic value and potential clinical significance of duodenal lipoma based on computed tomography imaging data

Fetched: September 1st, 2021, 5:01am GMT by Zhi-Wei Hu

Medicine (Baltimore). 2021 Aug 20;100(33):e26944. doi: 10.1097/MD.0000000000026944.

ABSTRACT

BACKGROUND: To explore the diagnostic value of computed tomography (CT) imaging for duodenal lipoma and the potential clinical significance of the findings.

METHODS: Clinicopathological and CT data from 57 patients, who were diagnosed with duodenal lipoma at the first affiliated Hospital of Zhengzhou University (Zhengzhou, China) between June 2014 and March 2019, were retrospectively reviewed. Data collected included location and size of the tumor, morphological manifestations (shape, density, boundary), concomitant diseases, pathology and gastroscopy results, and follow-up. Follow-up was performed via telephone, and surgical patients were followed-up for recurrence, metastasis and tumor size, and morphological changes. The follow-up period was up to January 2019.

RESULTS: Of the 57 patients with duodenal lipoma, contrast-enhanced scanning was performed in 7 cases. The tumor was located in the descending duodenum in 33 cases, the ascending in 4 cases, the horizontal in 16 cases, and the bulb in 4 cases. Mean tumor size was 13.0 ± 5.8 mm. CT morphological features of the tumor were as follows: tumor shape, round, quasi-round, or oval (n = 42); long strip (n = 3); nodular (n = 2); triangular (n = 1); and irregular lobulated (n = 9). Among the 57 patients, tumor density was homogeneous in 52 cases, inhomogeneous in 4 cases, and nodular with calcification in 1 case. The tumor boundary was classified as clear and with no capsule. Diseases concomitant with the tumor were as follows: gastritis (n = 23), gastric adenocarcinoma (n = 1), and gastric lymphoma (n = 1). Esophageal disease was found in 16 cases, including reflux esophagitis (n = 12) and esophageal cancer (n = 4). There were 13 cases of gallbladder and biliary disease, including cholecystolithiasis and cholecystitis (n = 9), common bile duct disease (n = 2), colorectal cancer (n = 4), lung cancer (n = 2), duodenal carcinoma with obstruction (n = 1), and ureteral space narrowing (n = 1).

CONCLUSION: CT was an effective, non-invasive method for diagnosis of duodenal lipoma. CT imaging could clearly discern location, size, shape, and nature of duodenal lipomas. Duodenal lipoma can be associated with digestive tract inflammatory diseases and tumors in different locations, and its diagnosis is potentially valuable for their prevention and treatment.

PMID:34414955 | PMC:PMC8376382 | DOI:10.1097/MD.0000000000026944
Case Report: Ectopic Liver (Choristoma) Discovered During Laparoscopic Cholecystectomy

Fetched: August 26th, 2021, 5:01am GMT by Leena H Moshref

Am J Case Rep. 2021 Aug 23;22:e932784. doi: 10.12659/AJCR.932784.

ABSTRACT

BACKGROUND Ectopic liver (EL) is liver tissue that is not attached to the mother liver, and is also known as choristoma and hepar succenturiatum. According to Watanabe's 1060-patient series, it has an incidence rate of less than 1% (0.47%). The absence of an anatomical attachment to the hepatic proper is a rare congenital departure from the norm, known as EL. EL is thought to be caused by abnormal hepatic tissue growth from the foregut diverticulum, particularly at cystic structures. CASE REPORT We report the successful management of a 47-year-old male patient, not known to have any medical illness, who was referred to the surgical team with a clinical picture of biliary colic. An ultrasound (US) abdomen was performed, and cholecystitis was confirmed. During a laparoscopic cholecystectomy, ET was identified by chance. He tolerated the operation well. Gallbladder histological examination revealed significant mucosal and wall ulcers, chronic inflammation, many black stones, no dysplasia or malignancy, and connected liver tissue measuring 12×5 mm. As a result, chronic calcular cholecystitis was confirmed, as was normal EL architecture and no evidence of malignancy. CONCLUSIONS We conclude that EL is a rare condition, but there have been cases reported in the literature. Imaging modalities such as US and computed tomography scans are recommended to rule out other underlying diagnoses and should be tailored to each individual when necessary. Because the presence of EL attached to the vesicle is a rare occurrence in the literature, a histological examination is required due to the elevated risk of hepatocellular carcinoma. Keeping such an abnormality in mind can help surgeons demarcate the embryological plane of dissection during cholecystitis to avoid tumor cell spillages if present.

PMID:34424891 | PMC:PMC8404163 | DOI:10.12659/AJCR.932784
Tumor location and concurrent liver resection, impact survival in T2 gallbladder cancer: a meta-analysis of the literature

Fetched: August 25th, 2021, 5:01am GMT by Sualeh Muslim Khan

Updates Surg. 2021 Aug 23. doi: 10.1007/s13304-021-01150-z. Online ahead of print.

ABSTRACT

Aim of doing this review was to give a uniform consensus on prognostic impact of tumor location (hepatic vs peritoneal), liver resection and adjuvant chemotherapy in gall bladder cancer and, to compare them with previous well-studied factors of survival. We systematically review PubMed, Scopus and Cochrane for relevant articles with no date restrictions, language was restricted to English. Those articles were included that had provided Hazard ratio (HR) of survival for T2 gall bladder cancer. We identified nine retrospective studies published between 2014 and 2020 with 2345 patients. Meta-analysis showed that T2b (hepatic) cancers had higher odds of mortality (HR 3.16 [2.11, 4.74], I² = 0%). Liver resection was associated with significantly higher odds of 5-year overall survival only in T2b (2.20 [1.33, 3.63], I² = 67%), adjuvant chemotherapy was not associated with any significant decrease in mortality risk (0.98 [0.83-1.16]. I² = 20%). Hepatic sided gall bladder tumors carry higher odds for mortality and recurrence. T2a tumors can be managed without hepatic resection. To risk stratify patients we also formulated a scoring system for mortality risk.

PMID:34426958 | DOI:10.1007/s13304-021-01150-z
Laparoscopic Surgery for a Patient With Multiple Liver Metastases of Unknown Origin Concomitant With Gallbladder Tumor

Fetched: August 24th, 2021, 5:03am GMT by Yoshihiro Hara

In Vivo. 2021 Sep-Oct;35(5):2963-2968. doi: 10.21873/invivo.12590.

ABSTRACT

BACKGROUND: The liver is the digestive organ where metastatic adenocarcinoma of unknown primary site is most often observed.

CASE REPORT: A 74-year-old man was diagnosed with a growing gallbladder tumor and multiple liver tumors limited to the left lateral sector. Liver tumors were suggested to be primary or secondary adenocarcinoma with no relation to the gallbladder tumor. Also for diagnostic purposes, laparoscopic full-thickness resection of the gallbladder, laparoscopic lateral sectionectomy and lymph node sampling were performed. The final histopathological diagnosis was hyperplastic polyp of the gallbladder and metastatic poorly differentiated adenocarcinoma of the liver. Liver tumors were suspected to originate from the stomach, duodenum, or small intestine; however, the primary sites could not be identified. The patient has been closely followed up without any chemotherapy 3 months after surgery.

CONCLUSION: Laparoscopic surgery can be strongly recommended for patients with multiple liver tumors of unknown origin concomitant with a gallbladder tumor.

PMID:34410995 | PMC:PMC8408742 | DOI:10.21873/invivo.12590
Genomic characterization of co-existing neoplasia and carcinoma lesions reveals distinct evolutionary paths of gallbladder cancer

Fetched: August 24th, 2021, 5:03am GMT by Jianzhen Lin

Nat Commun. 2021 Aug 6;12(1):4753. doi: 10.1038/s41467-021-25012-9.

ABSTRACT

Gallbladder carcinoma is the most common cancer of the biliary tract with dismal survival largely due to delayed diagnosis. Biliary tract intraepithelial neoplasia (BilIN) is the common benign tumor that is suspected to be precancerous lesions. However, the genetic and evolutionary relationships between BilIN and carcinoma remain unclear. Here we perform whole-exome sequencing of coexisting low-grade BilIN (adenoma), high-grade BilIN, and carcinoma lesions, and normal tissues from the same patients. We identify aging as a major factor contributing to accumulated mutations and a critical role of CTNNB1 mutations in these tumors. We reveal two distinct carcinoma evolutionary paths: carcinoma can either diverge earlier and evolve more independently or form through the classic adenoma/dysplasia-carcinoma sequence model. Our analysis suggests that extensive loss-of-heterozygosity and mutation events in the initial stage tend to result in a cancerous niche, leading to the subsequent BilIN-independent path. These results reframes our understanding of tumor transformation and the evolutionary trajectory of carcinogenesis in the gallbladder, laying a foundation for the early diagnosis and effective treatment of gallbladder cancer.

PMID:34362903 | PMC:PMC8346570 | DOI:10.1038/s41467-021-25012-9
Biokinetics and Dosimetry of [177Lu]Lu-Pentixather

Fetched: August 22nd, 2021, 5:01am GMT by Heribert Hänscheid

J Nucl Med. 2021 Aug 19:jnumed.121.262295. doi: 10.2967/jnumed.121.262295. Online ahead of print.

ABSTRACT

The chemokine receptor CXCR4, which is overexpressed in many solid and hematologic malignancies, can be targeted for radiopeptide therapy via the antagonist Pentixather®. Biokinetics and dosimetry of ¹⁷⁷Lu-Pentixather and ⁹⁰Y-Pentixather were analyzed. Methods: This retrospective study is a standardized reevaluation of data collected for treatment planning. Nineteen patients with complete sets of planar whole-body scans over at least four days and a single SPECT/CT after 200 MBq ¹⁷⁷Lu-Pentixather were included. Kinetics were measured in the whole body, in tissues with activity retention, and in 10 individuals in the blood. Time-integrated activity coefficients and tissue absorbed doses were derived. Results: Increased uptake of Pentixather was observed in kidneys, liver, spleen, and bone marrow, inducing median (minimum-maximum) absorbed doses of 0.91 (0.38-3.47), 0.71 (0.39-1.17), 0.58 (0.34-2.26), and 0.47 (0.14-2.33) Gy per GBq ¹⁷⁷Lu-Pentixather and 3.75 (1.48-12.2), 1.61 (1.14-2.97), 1.66 (0.97-6.69), and 1.06 (0.27-4.45) Gy per GBq ⁹⁰Y-Pentixather, respectively. In most tissues, activity increased during the first day after the administration of ¹⁷⁷Lu-Pentixather and afterwards decayed with mean effective half-lives of 41 ± 10 (range: 24-64) hours in kidneys and median half-lives of 109, 86, and 92 hours in liver, spleen, and bone marrow, respectively. Maximum uptake per kidney was 2.2% ± 1.0% (range: 0.6%-5.1%). In organs showing no specific uptake, absorbed doses exceeding 0.3 Gy per GBq ⁹⁰Y-Pentixather are estimated for the urinary bladder and for tissues adjacent to accumulating organs such as the adrenal glands, bone surface, and gallbladder. Dose estimates for tumors and extramedullary lesions ranged from 1.5 to 18.2 Gy per GBq ⁹⁰Y-Pentixather. Conclusion: In patients with hematologic neoplasms, absorbed doses calculated for bone marrow and extramedullary lesions are sufficient to be effective as an adjunct to high-dose chemotherapies prior to stem cell transplantation.

PMID:34413147 | DOI:10.2967/jnumed.121.262295
Degree of biliary tract violation during treatment of gallbladder adenocarcinoma is independently associated with development of peritoneal carcinomatosis

Fetched: August 20th, 2021, 5:01am GMT by Thomas L Sutton

J Surg Oncol. 2021 Sep;124(4):581-588. doi: 10.1002/jso.26569. Epub 2021 Jun 11.

ABSTRACT

BACKGROUND: Gallbladder cancer (GBC) is often incidentally diagnosed after cholecystectomy. Intra-operative biliary tract violations (BTV) have been recently associated with development of peritoneal disease (PD). The degree of BTV may be associated with PD risk, but has not been previously investigated.

METHODS: We reviewed patients with initially non-metastatic GBC treated at our institution from 2003 to 2018. Patients were grouped based on degree of BTV during their treatment: major (e.g., cholecystotomy with bile spillage, n = 27, 29%), minor (e.g., intra-operative cholangiogram, n = 18, 19%), and no violations (n = 48, 55%). Overall survival (OS) and peritoneal disease-free survival (PDFS) were evaluated with Kaplan-Meier and Cox proportional hazards modeling.

RESULTS: Ninety-three patients were identified; the median age was 64 years (range 31-87 years). Seventy-six (82%) were incidentally diagnosed. The median follow-up was 23 months; 20 (22%) patients developed PD. The 3-year PDFS for patients with major, minor, and no BTV was 52%, 83%, and 98%, respectively (major vs. none: p < 0.001; minor vs. none: p < 0.01). BTV was not associated with 5-year OS (HR 1.53, p = 0.16).

CONCLUSION: Increasing degree of BTV is associated with higher risk of peritoneal carcinomatosis in patients with GBC and should be considered during preoperative risk stratification. Reporting biliary tract violations during cholecystectomy is encouraged.

PMID:34115368 | DOI:10.1002/jso.26569
Towards standardization of management of gallbladder carcinoma with obstructive jaundice: Analysis of 113 cases over 10 years at a single institution

Fetched: August 20th, 2021, 5:01am GMT by Mahesh Goel

J Surg Oncol. 2021 Sep;124(4):572-580. doi: 10.1002/jso.26564. Epub 2021 Jun 9.

ABSTRACT

BACKGROUND: Presence of jaundice in gallbladder carcinoma (GBC) is considered a sign of inoperability with no defined treatment pathways.

METHODS: Retrospective analysis of all surgically treated GBC patients from January 2010 to December 2019 was performed for evaluating etiology of obstructive jaundice, resectability, postoperative morbidity, mortality, disease-free survival (DFS) and overall survival (OS).

RESULTS: Out of 954 patients, 521 patients (54.61%) were locally advanced gallbladder carcinoma (LAGBC: Stage III and IV) and 113 patients (11.84%) had jaundice at presentation. Thirty-four (30%) patients had benign cause of obstructive jaundice. Median OS of the whole cohort (n=113) was 22 months (16.5-27.49 months) with resectability rate of 62% (70/113). Median OS of curative resection group (n=70) was 32 months and DFS was 25 months. Treatment completion was achieved in 30% (n= 21/70) patients with median OS of 46 months and median DFS of 27 months. Isolated bile duct infiltration subgroup fared the best with median OS of 74 months with a 5-year survival of 66.7%.

CONCLUSION: Surgical resection as a part of multimodality treatment improves survival in carefully selected locally advanced gallbladder cancer patients with jaundice. Early introduction of systemic therapy is the key in the management of this disease with aggressive tumor biology.

PMID:34106475 | DOI:10.1002/jso.26564
Liver Metastatic Colorectal Tumor Cells Change Their Phenotype During Consecutive Passages on Chick Embryo Chorioallantoic Membrane: Lessons from the Lab to the Clinic

Fetched: August 20th, 2021, 5:01am GMT by Raluca Amalia Ceaușu

In Vivo. 2021 Sep-Oct;35(5):2711-2718. doi: 10.21873/invivo.12555.

ABSTRACT

BACKGROUND/AIM: Colon cancer liver metastases with desmoplastic growth pattern (dGP) have a highly heterogeneous therapy response. The aim of the study was to evaluate the dGP liver metastasis molecular profile from a chemo-naive patient by mimicking metastatic process on an experimental chick embryo chorioallantoic membrane (CAM) model.

MATERIALS AND METHODS: Three successive CAM passages of dGP human colorectal liver metastases were immunophenotyped for keratin (K) 8, and 20, CLIC1, VEGF, EGFR, CD34, podoplanin, Ki67, E-cadherin and vimentin.

RESULTS: Metastatic cells gradually lost K20 while K8, E-cadherin and vimentin heterogeneously increased during passages. VEGF, CLIC 1, EGFR expression increased in metastatic cells especially at the tumor graft periphery. Scattered proliferating and non-proliferating podoplanin-positive tumor cells, lymphatic and blood vessels were heterogeneously detected in tumor xenografts depending on passage stage.

CONCLUSION: By mimicking repetitive metastatic processes we proved that metastatic cells change their phenotype. This may explain why not all metastases have a similar response to therapy.

PMID:34410960 | PMC:PMC8408708 | DOI:10.21873/invivo.12555
Is positive histologic surgical margin associated with overall survival in patients with resectable gallbladder cancer?

Fetched: August 20th, 2021, 5:01am GMT by Michael J Littau

Surg Open Sci. 2021 Jul 21;6:15-20. doi: 10.1016/j.sopen.2021.07.003. eCollection 2021 Oct.

ABSTRACT

BACKGROUND: Achieving microscopically negative (R0) surgical margins in gallbladder cancer often requires a partial hepatectomy with associated risk of morbidity and potential to delay adjuvant therapy. Prior studies on the importance of margin status in resectable gall bladder cancer include small numbers of patients with positive (R1) resection margins and are underpowered.

METHODS: We queried the National Cancer Database to identify patients undergoing resection of gallbladder adenocarcinoma between 2004 and 2015. Patients presenting with metastatic disease, those who received neoadjuvant therapy, and those with fewer than 3 lymph nodes assessed were excluded. 1:1 propensity score matching was used to develop cohorts undergoing either R0 or R1 resection, matched for demographic, pathologic, and facility characteristics. Kaplan-Meier analysis was used to assess the association between margin status and overall survival.

RESULTS: A total of 1,439 patients met inclusion criteria; 1,285 underwent R0 and 154 underwent R1 resection. On Kaplan-Meier analysis of propensity-matched cohorts, patients undergoing R0 resection had a median overall survival that was 18 months longer than those undergoing R1 resection (34.6 ± 2.0 months vs 16.3 ± 1.7 months, P < .001).

CONCLUSION: In patients presenting with resectable gallbladder adenocarcinoma, margin-negative resection is associated with significant improvement in overall survival.

PMID:34409279 | PMC:PMC8363875 | DOI:10.1016/j.sopen.2021.07.003
Role of Mean Platelet Volume in the Prognosis of Gallbladder Carcinoma: A Tertiary Centre Experience

Fetched: August 20th, 2021, 5:01am GMT by Prakash Bv

Cureus. 2021 Jul 14;13(7):e16389. doi: 10.7759/cureus.16389. eCollection 2021 Jul.

ABSTRACT

Mean platelet volume (MPV) is an inflammatory marker indicative of platelet activation. There are several studies that suggest an association between the neoplastic process and cancer metastasis. We performed a retrospective analysis to investigate the role of MPV as a prognostic informative marker in gallbladder cancer. This study included 73 patients who underwent treatment for gallbladder cancer with curative or palliative intent. MPV was obtained and statistically analysed to investigate the association between the nodal status (N), the overall stage as per the American Joint Committee on Cancer (AJCC) staging system, perineural invasion, and differentiation of the tumor. The statistical analysis was done using SPSS Statistics, version 23 (IBM Corp., Armonk, NY). We found that the MPV values were significantly high in node-positive cases (OR = 3.623, 95% CI = 7.778-1.687, p value = -0.0001), cases in the advanced stage (OR = 3.623, 95% CI = 7.778-1.687, p value = 0.0001), cases with perineural invasion (OR = 3.396, 95% CI = 8.319-1.387, p value = -0.0001), and poor differentiation (OR = 2.327, 95% CI = 4.651-1.164, p value = -0.002 ). MPV is an inexpensive and convenient inflammatory marker that correlates with nodal positivity in the staging and prognostication of gallbladder cancer. This marker can be used to ascertain the risk status of gallbladder cancer.

PMID:34408942 | PMC:PMC8363057 | DOI:10.7759/cureus.16389
Comparison of two antibodies for measuring HER2 expression in gallbladder adenocarcinomas

Fetched: August 20th, 2021, 5:01am GMT by L L Chen

Zhonghua Bing Li Xue Za Zhi. 2021 Jul 8;50(7):805-807. doi: 10.3760/cma.j.cn112151-20210128-00090.

NO ABSTRACT

PMID:34405620 | DOI:10.3760/cma.j.cn112151-20210128-00090
Gallbladder cancer epidemiology, treatment and survival in Southern Finland - a population-based study

Fetched: August 19th, 2021, 5:01am GMT by Hanna Koppatz

Scand J Gastroenterol. 2021 Aug;56(8):929-939. doi: 10.1080/00365521.2021.1915373. Epub 2021 Jul 5.

ABSTRACT

INTRODUCTION: Gallbladder cancer (GBC) is a rare malignancy in Western population with poor prognosis. This study aimed to investigate the trends in GBC incidence, treatment pattern, and survival in Finland.

METHODS: Patients diagnosed with primary GBC in a geographically defined area (Southern Finland Regional Cancer Center) during 2006-2017 were identified.

RESULTS: Final cohort included 270 patients with GBC. The incidence was 1.32/100,000 persons, and it decreased 6.8 cases per million personyears during the study period. One hundred fifty-one (56%) patients were diagnosed at Stage IV. Fifty-one patients (19%) underwent curative-intent resection with 96% R0-resection rate. The median overall survival was 7.1 months and 5-year overall survival 11.6% for all patients, and 67.7 months and 56.8% after curative-intent resection, respectively. No improvement was noted over time in overall survival in patients with GBC, or in subgroups of different stages of GBC.

CONCLUSIONS: The incidence of GBC is slightly decreasing in Southern Finland, but survival has not improved over time.

PMID:34224306 | DOI:10.1080/00365521.2021.1915373
Conversion surgery for initially unresectable extrahepatic biliary tract cancer

Fetched: August 18th, 2021, 5:01am GMT by Moon Young Oh

Ann Hepatobiliary Pancreat Surg. 2021 Aug 31;25(3):349-357. doi: 10.14701/ahbps.2021.25.3.349.

ABSTRACT

BACKGROUNDS/AIMS: Surgical resection is the only curative treatment for biliary tract cancers; however, most patients undergo palliative chemotherapy because they are contraindicated for surgery. Conversion surgery, a treatment strategy for downsizing chemotherapy and subsequent surgical resection, is feasible for initially unresectable biliary tract cancers following the introduction of effective chemotherapeutic agents.

METHODS: Patients initially diagnosed with unresectable biliary tract cancers, and treated with conversion surgery after palliative chemotherapy between 2013 and 2019, were reviewed retrospectively.

RESULTS: Twelve patients underwent conversion surgery after palliative chemotherapy for initially unresectable biliary tract cancers. The final pathological diagnosis included six perihilar cholangiocarcinomas, four distal common bile duct cancers, and two gallbladder cancers. Different chemotherapy regimens were used, but all the patients were treated with gemcitabine at some point during their treatment. The median overall survival was 28 months, which was longer than that of patients treated with isolated palliative chemotherapy in previous studies.

CONCLUSIONS: Conversion surgery represents a therapeutic alternative for specific cases of unresectable biliary tract cancers. Palliative chemotherapy for initially unresectable biliary tract cancers is recommended for downsizing the tumor and expanding the indications for surgery. Further studies and clinical trials are required to develop new and effective chemotherapeutic regimens.

PMID:34402435 | PMC:PMC8382869 | DOI:10.14701/ahbps.2021.25.3.349
Serum LAPTM4B-35 protein as a novel diagnostic marker for hepatocellular carcinoma

Fetched: August 18th, 2021, 5:01am GMT by Y Pang

Beijing Da Xue Xue Bao Yi Xue Ban. 2021 Aug 18;53(4):710-715. doi: 10.19723/j.issn.1671-167X.2021.04.015.

ABSTRACT

OBJECTIVE: LAPTM4B-35 protein is one of the isoforms that are encoded by a cancer driver gene, LAPTM4B. This gene was primarily found and identified in our lab of Peking University School of Basic Medical Sciences. The LAPTM4B-35 protein and its encoded mRNA are significantly over-expressed in a variety of cancers, such as hepatocellular carcinoma (HCC), lung cancers (including non small-cell lung cancer and small-cell lung cancer), stomach cancer, colorectal carcinoma, pancreatic cancer, gallbladder cancer, cholangiocarcinoma, breast cancer, prostate cancer, ovarian cancer, cervical cancer, endometrial cancer, and so on. It has firmly demonstrated through lab experiments either in vivo or in vitro, as well as clinical studies that the over-expression of LAPTM4B-35 can promote cancer growth, metastasis, and multidrug resistance. Specially, the expressive level of LAPTM4B-35 is associa-ted with recurrence of HCC. The aim of this study is to identify the release of LAPTM4B-35 protein from hepatocellular carcinoma into blood of HCC patients and into the medium of cultured HCC cells, and to identify its possible form of LAPTM4B-35 protein existed in blood and cell culture medium, as well as to explore the possibility of LAPTM4B-35 protein as a novel HCC biomarker for diagnosis of HCC and prognosis of HCC patients.

METHODS: Immunobloting (Western blot) and enzyme-linked immunosorbent assay (ELISA) were used for identification of LAPTM4B-35 protein in the blood of HCC patients and normal individuals. Ultrafiltration and ultracentrifugation were used to isolate and purify exosomes from the culture medium of HCC cells.

RESULTS: LAPTM4B-35 protein existed in the blood from HCC patients and normal donors that were demonstrated through Western blot and ELISA. LAPTM4B-35 was also released into the culture medium of HCC cells in the form of exosomes. Preliminary experiments showed that the average and the median of LAPTM4B-35 protein level in the blood of HCC patients (n=43) were both significantly higher than that in the blood of normal donors (n=33) through sandwich ELISA.

CONCLUSION: It is promising that the LAPTM4B-35 protein which is released from HCC cells in the form of exosomes into their extraenvironment may be exploited as a novel cancer biomarker for HCC serological diagnosis.

PMID:34393233 | PMC:PMC8365064 | DOI:10.19723/j.issn.1671-167X.2021.04.015
Real-world efficacy and safety of nab-paclitaxel plus gemcitabine-cisplatin in patients with advanced biliary tract cancers: a multicenter retrospective analysis

Fetched: August 17th, 2021, 5:01am GMT by Jaekyung Cheon

Ther Adv Med Oncol. 2021 Aug 7;13:17588359211035983. doi: 10.1177/17588359211035983. eCollection 2021.

ABSTRACT

BACKGROUND: A recent phase II trial reported prolonged survival in patients with advanced biliary tract cancer (BTC) following treatment with nab-paclitaxel plus gemcitabine-cisplatin (Gem/Cis/nab-P). We aimed to evaluate the clinical outcomes of Gem/Cis/nab-P in Asian patients with advanced BTC in a real-world setting.

METHODS: We reviewed the data of patients who received Gem/Cis/nab-P for the management of advanced BTC between September 2019 and April 2021 at four institutes in Korea. Patients were classified into the Gem/Cis/nab-P and nab-P addition groups depending on the starting point of nab-P administration.

RESULTS: A total of 178 patients treated with Gem/Cis/nab-P were included in the study. Of these, 43.8% had intrahepatic cholangiocarcinoma (CCA), 34.8% had extrahepatic CCA, and 21.3% had gall bladder cancer. A total of 117 (65.7%) patients received Gem/Cis/nab-P as the first-line treatment, while 61 (34.3%) were treated with gemcitabine-cisplatin-based chemotherapy followed by nab-P addition. The objective response rate (ORR) and disease control rate in all patients were 42.1% and 84.8%, respectively. The ORR in the Gem/Cis/nab-P group was 47.9%, while that in the nab-P addition group was 31.1%. The median progression-free survival and overall survival were 8.5 months [95% confidence interval (CI), 6.9-10.1] and 14.6 months (95% CI, 10.2-19.0), respectively. In patients who received Gem/Cis/nab-P as initial treatment, the median PFS was 9.4 months (95% CI, 7.9-10.9) and the median OS was not-reached (95% CI, not available). Anemia (n = 42, 23.6%), neutropenia (n = 40, 22.5%), and thrombocytopenia (n = 16, 9.0%) were the most common grade 3-4 toxicities. A total of 20 patients (11.2%) had conversions from unresectable to resectable disease and underwent surgery with curative intent.

CONCLUSION: Gem/Cis/nab-P showed favorable real-life efficacy and safety outcomes in Korean patients with advanced BTC, which was consistent with the phase II trial outcomes.

PMID:34394748 | PMC:PMC8358499 | DOI:10.1177/17588359211035983
Neuroendocrine tumour of the gallbladder

Fetched: August 13th, 2021, 5:01am GMT by Harsimran Bhatia

Lancet Oncol. 2021 Aug;22(8):e377. doi: 10.1016/S1470-2045(21)00198-4.

NO ABSTRACT

PMID:34339657 | DOI:10.1016/S1470-2045(21)00198-4
Glycemic status and biliary tract cancer

Fetched: August 10th, 2021, 5:01am GMT by Joo-Hyun Park

Metabolism. 2021 Aug 6;123:154848. doi: 10.1016/j.metabol.2021.154848. Online ahead of print.

ABSTRACT

BACKGROUND & AIMS: Population-based evidence of the association between diabetes and biliary tract cancer (BTC) risk is lacking. We aimed to evaluate the association of prediabetes, diabetes, and diabetes duration with subsequent risk of BTC, including cholangiocarcinoma (CCA) and gallbladder cancer (GBC), in the Korean general population.

METHODS: This nationwide cohort study included 9,697,773 adults aged ≥20 years without cancer who underwent national health screening between January and December 2009. Subjects' glycemic status was categorized as normoglycemic, impaired fasting glucose (IFG), newly-diagnosed diabetes, diabetes duration <5 years, and diabetes duration ≥5 years. Incident BTC was identified using claims data. Follow-up continued until December 2017. Cox proportional hazard models were used to estimate multivariable-adjusted hazard ratios and 95% CIs of BTC.

RESULTS: During a median follow-up of 7.2 years, 13,022 patients were newly diagnosed with BTC. Compared with the normoglycemic group, the IFG, newly-diagnosed diabetes, diabetes duration <5 years, and diabetes duration ≥5 years groups showed the following adjusted hazard ratios (95% CIs) for BTC: 1.08 (1.04-1.12), 1.31 (1.22-1.41), 1.35 (1.27-1.43), and 1.47 (1.39-1.55), respectively. BTC risk significantly increased with deteriorating glycemic status (P for trend <0.001). These results were consistent with those of CCA and GBC analyses.

CONCLUSIONS: Both IFG and diabetes were independently associated with an increased risk of BTC, including CCA and GBC. A longer diabetes duration was associated with a further increase in BTC risk. Diabetes and even IFG may be modifiable risk factors for BTC.

PMID:34371066 | DOI:10.1016/j.metabol.2021.154848
Metastatic gallbladder cancer to the ovary presenting as primary ovarian cancer: a case report

Fetched: August 7th, 2021, 5:01am GMT by Chorong Kim

J Med Case Rep. 2021 Aug 5;15(1):413. doi: 10.1186/s13256-021-03001-2.

ABSTRACT

BACKGROUND: Krukenberg tumors are uncommon and are indicative of an ovarian metastatic carcinoma that originates from another site of primary malignancy. The majority of metastases to ovaries are derived from the stomach and colon. We present a rare case of a metastatic ovarian malignant tumor that originated from gallbladder adenocarcinoma.

CASE PRESENTATION: A 45-year-old premenopausal Korean woman presented with abdominal distension. Bilateral multiseptated ovarian tumors and a wall-thickened gallbladder were found on abdominal computed tomography. The patient was diagnosed with metastatic ovarian carcinoma arising from gallbladder adenocarcinoma and was treated with adjuvant chemotherapy.

CONCLUSIONS: Metastases to the ovaries from other sites, including the gallbladder, are rare and usually resemble primary ovarian tumors. Therefore, potential metastatic ovarian tumors of newly diagnosed pelvic masses should be considered in differential diagnoses.

PMID:34348771 | PMC:PMC8340448 | DOI:10.1186/s13256-021-03001-2
Safety and Efficacy of Modified FOLFIRINOX in Unresectable or Metastatic Gallbladder Cancer: A Phase II Pilot Study

Fetched: August 7th, 2021, 5:01am GMT by Atul Sharma

JCO Glob Oncol. 2021 Jun;7:820-826. doi: 10.1200/GO.20.00657.

ABSTRACT

PURPOSE: For unresectable gallbladder cancer (GBC), gemcitabine and platinum is standard combination; however, outcome is poor. We conducted this study to find feasibility of modified flourouracil, oxaliplatin, and irinotecan in this group.

MATERIALS AND METHODS: We conducted a prospective, phase II single-arm pilot study. Inclusion criteria were histologically proven GBC and Eastern Cooperative Oncology Group 0-1. Primary end points were overall response rates and overall survival. The following treatment was given: oxaliplatin 85 mg/m², leucovorin 400 mg/m², and irinotecan 150 mg/m², all once on day 1, fluorouracil 2,400 mg/m² continuous intra-venous infusion over 46 hours repeated every 2 weeks, and maximum 12 doses, with primary granulocyte colony-stimulating factor prophylaxis.

RESULTS: Between February 2019 and July 2020, 29 patients with unresectable GBC were enrolled. The median age was 52 years, and 18 were females. The Eastern Cooperative Oncology Group was 0 in 4. Five had bilirubin > normal, and 15 each had high serum alkaline phosphatase and carbohydrate antigen 19-9. Twenty-five patients had stage IV disease, and remaining unresectable locally advanced disease. A median of 8.5 cycles was given, and 11 completed treatment. Nine stopped chemotherapy because of progression, and one because of toxicity, and treatment is ongoing in three. Twenty-two required dose reduction. A treatment delay of 1-2 weeks was seen in 25 patients. Best response was complete response 1, partial response 13 (overall response rate 48.2%), and stable disease 9. Four patients with metastatic disease underwent R0 resection. As on cutoff date, nine are surviving (three without disease). Eighteen died of PD, and in two, cause was unknown. There was no toxic death. The median overall survival and progression-free survival were 309 and 252 days, respectively. Twenty-three patients experienced grade III or IV toxicity, and common were diarrhea (13), vomiting (12), and anemia (7).

CONCLUSION: First-line modified flourouracil, oxaliplatin, and irinotecan is feasible in unresectable GBC with encouraging responses. Toxicities are higher but manageable. Higher response rates make this an option to explore in borderline resectable cases.

PMID:34086477 | DOI:10.1200/GO.20.00657
Biliary Neuroendocrine Neoplasms: Analysis of Prognostic Factors and Development and Validation of a Nomogram

Fetched: August 7th, 2021, 5:01am GMT by Shengnan Zhou

Front Oncol. 2021 Jul 19;11:654439. doi: 10.3389/fonc.2021.654439. eCollection 2021.

ABSTRACT

BACKGROUND: For this study, we explored the prognostic profiles of biliary neuroendocrine neoplasms (NENs) patients and identified factors related to prognosis. Further, we developed and validated an effective nomogram to predict the overall survival (OS) of individual patients with biliary NENs.

METHODS: We included a total of 446 biliary NENs patients from the SEER database. We used Kaplan-Meier curves to determine survival time. We employed univariate and multivariate Cox analyses to estimate hazard ratios to identify prognostic factors. We constructed a predictive nomogram based on the results of the multivariate analyses. In addition, we included 28 biliary NENs cases from our center as an external validation cohort.

RESULTS: The median survival time of biliary NENs from the SEER database was 31 months, and the value of gallbladder NENs (23 months) was significantly shorter than that of the bile duct (45 months) and ampulla of Vater (33.5 months, p=0.023). Multivariate Cox analyses indicated that age, tumor size, pathological classification, SEER stage, and surgery were independent variables associated with survival. The constructed prognostic nomogram demonstrated good calibration and discrimination C-index values of 0.783 and 0.795 in the training and validation dataset, respectively.

CONCLUSION: Age, tumor size, pathological classification, SEER stage, and surgery were predictors for the survival of biliary NENs. We developed a nomogram that could determine the 3-year and 5-year OS rates. Through validation of our central database, the novel nomogram is a useful tool for clinicians in estimating individual survival among biliary NENs patients.

PMID:34350109 | PMC:PMC8327779 | DOI:10.3389/fonc.2021.654439
Arsenic in the geo-environment: A review of sources, geochemical processes, toxicity and removal technologies

Fetched: August 4th, 2021, 5:01am GMT by N Janardhana Raju

Environ Res. 2021 Jul 31;203:111782. doi: 10.1016/j.envres.2021.111782. Online ahead of print.

ABSTRACT

Impact of arsenic (As) contaminated groundwater on human health, through drinking and irrigation practices, is of grave-concern worldwide. This paper present the review of various sources, processes, health effects and treatment technologies available for the removal of As from arsenic contaminated water. Groundwater with high As concentration is detrimental to human health and incidents of As contamination in groundwater had been reported from different parts of the globe. More serious known As contamination problem as well as largest population at risk are found in Bangladesh, followed by West Bengal state in India along the Indo-Gangetic plains. Large scale natural As contamination of groundwater is found in two types of environment such as strongly reducing alluvial aquifers (ex. Bangladesh, India, China and Hungary) and inland basins in arid or semi-arid areas (ex. Argentina and Mexico). The provisional guideline of 10 ppb (0.0 l mg/l) has been adopted as the drinking water standard by World Health Organization (WHO). In the aquatic environment, the release, distribution and remobilization of As depend on temperature, redox potential, speciation, and interaction between liquid solution and solid phases. As predicaments in the environment is due to its mobilization under natural geogenic conditions as well as anthropogenic activities. Arsenic mineral is not present in As contaminated alluvial aquifer but As occurs adsorbed on hydrated ferric oxide (HFO) generally coat clastic grains derived from Himalayan mountains. As is released to the groundwater mainly by bio-remediated reductive dissolution of HFO with corresponding oxidation of organic matter. The development of strongly reductive dissolution of mineral oxides (Fe and Mn) at near-neutral pH may lead to desorption and ultimately release of As into the groundwater. As release through geochemical process is more important factor in alluvial aquifers causing As contamination rather than sources of arsenic. As is a toxin that dissolves in the bloodstream, rendering the victim susceptible to disease of the skin, bones, and also cancer of liver, kidney, gall bladder and the intestines. It is necessary to adopt highly successful technology to treat As contaminated water into the acceptable limit for human consumption. Universally accepted solutions are not developed/available even after the lapse of almost forty years since slow As poisoning identification in tens of millions of people especially in Bengal delta. The issue poses scientific, technical, health and societal problems even today.

PMID:34343549 | DOI:10.1016/j.envres.2021.111782
Ingestion of Nitrate and Nitrite and Risk of Stomach and Other Digestive System Cancers in the Iowa Women's Health Study

Fetched: August 4th, 2021, 5:01am GMT by Ian D Buller

Int J Environ Res Public Health. 2021 Jun 25;18(13):6822. doi: 10.3390/ijerph18136822.

ABSTRACT

Nitrate and nitrite are precursors in the endogenous formation of N-nitroso compounds (NOC) which are potent animal carcinogens for the organs of the digestive system. We evaluated dietary intakes of nitrate and nitrite, as well as nitrate ingestion from drinking water (public drinking water supplies (PWS)), in relation to the incidence (1986-2014) of cancers of the esophagus (n = 36), stomach (n = 84), small intestine (n = 32), liver (n = 31), gallbladder (n = 66), and bile duct (n = 58) in the Iowa Women's Health Study (42,000 women aged from 50 to 75 in 1986). Dietary nitrate and nitrite were estimated using a food frequency questionnaire and a database of nitrate and nitrite levels in foods. Historical nitrate measurements from PWS were linked to the enrollment address by duration. We used Cox regression to compute hazard ratios (HR) and 95% confidence intervals (CI) for exposure quartiles (Q), tertiles (T), or medians, depending on the number of cancer cases. In adjusted models, nitrite intake from processed meats was associated with an increased risk of stomach cancer (HRQ4vsQ1 = 2.2, CI: 1.2-4.3). A high intake of total dietary nitrite was inversely associated with gallbladder cancer (HRQ4vsQ1 = 0.3, CI: 0.1-0.96), driven by an inverse association with plant sources of nitrite (HRQ4vsQ1 = 0.3, CI: 0.1-0.9). Additionally, small intestine cancer was inversely associated with a high intake of animal nitrite (HRT3vsT1 = 0.2, CI: 0.1-0.7). There were no other dietary associations. Nitrate concentrations in PWS (average, years ≥ 1/2 the maximum contaminant level) were not associated with cancer incidence. Our findings for stomach cancer are consistent with prior dietary studies, and we are the first to evaluate nitrate and nitrite ingestion for certain gastrointestinal cancers.

PMID:34202037 | PMC:PMC8297261 | DOI:10.3390/ijerph18136822
MicroRNA-197 promotes proliferation and inhibits apoptosis of gallbladder cancer cells by targeting insulin-like growth factor-binding protein 3

Fetched: August 4th, 2021, 5:01am GMT by Li Tong

Adv Clin Exp Med. 2021 Jul;30(7):661-672. doi: 10.17219/acem/134833.

ABSTRACT

BACKGROUND: Gallbladder cancer (GBC) is one of the common malignant tumors of the biliary tract. There is no report that miR-197 is involved in GBC.

OBJECTIVES: The relationship between miR-197 expression and survival time of GBC patients was analyzed. Furthermore, the role and mechanism of miR-197 in GBC was explored.

MATERIAL AND METHODS: A total of 39 GBC patients (21 males, 18 females; average age 56.1 ±8.5 years) were included from December 2013 to November 2014. All patients were admitted to our hospital for surgical treatment (excluding patients with preoperative chemotherapy). The expression of miR-197 in GBC tissues was examined, and the relationship between miR-197 and patient survival time was analyzed. Cell Counting Kit-8 (CCK-8) and colony formation assays were used to detect cell proliferation. Flow cytometry and TUNEL staining were used to detect apoptosis. Expressions of proteins related with proliferation and apoptosis were detected. The target of miR-197 was predicted through bioinformatics website and verified using the dual luciferase reporter gene assay. The target gene was interfered to so that the effect of miR-197 on the regulation of GBC cell proliferation and apoptosis could be observed.

RESULTS: MiR-197 was highly expressed in GBC tissues, and the expression was closely related to the poor prognosis of GBC. Downregulation of miR-197 inhibited the proliferation and promoted the apoptosis of GBC cells; it also decreased the expressions of proliferation-related proteins p-ERK1/2 and p-AKT, and increased that of apoptosis pathway-related proteins Bax/Bcl-2 and c-caspase-3. The upregulation of miR-197 induced an opposite trend. MiR-197 directly regulated IGFBP3.

CONCLUSIONS: Our study proved that the expression of miR-197 is closely related to the poor prognosis of GBC. The miR-197-IGFBP3 axis regulates the proliferation and apoptosis of GBC cells. Downregulation of miR-197 inhibited the proliferation and promoted the apoptosis of GBC cells, indicating potential therapeutic effects.

PMID:34118139 | DOI:10.17219/acem/134833
The Role of Microbiota in Primary Sclerosing Cholangitis and Related Biliary Malignancies

Fetched: August 3rd, 2021, 5:02am GMT by Burcin Özdirik

Int J Mol Sci. 2021 Jun 28;22(13):6975. doi: 10.3390/ijms22136975.

ABSTRACT

Primary sclerosing cholangitis (PSC) is an immune-related cholangiopathy characterized by biliary inflammation, cholestasis, and multifocal bile duct strictures. It is associated with high rates of progression to end-stage liver disease as well as a significant risk of cholangiocarcinoma (CCA), gallbladder cancer, and colorectal carcinoma. Currently, no effective medical treatment with an impact on the overall survival is available, and liver transplantation is the only curative treatment option. Emerging evidence indicates that gut microbiota is associated with disease pathogenesis. Several studies analyzing fecal and mucosal samples demonstrate a distinct gut microbiome in individuals with PSC compared to healthy controls and individuals with inflammatory bowel disease (IBD) without PSC. Experimental mouse and observational human data suggest that a diverse set of microbial functions may be relevant, including microbial metabolites and bacterial processing of pharmacological agents, bile acids, or dietary compounds, altogether driving the intrahepatic inflammation. Despite critical progress in this field over the past years, further functional characterization of the role of the microbiota in PSC and related malignancies is needed. In this review, we discuss the available data on the role of the gut microbiome and elucidate important insights into underlying pathogenic mechanisms and possible microbe-altering interventions.

PMID:34203536 | PMC:PMC8268159 | DOI:10.3390/ijms22136975
Degradable magnesium implants inhibit gallbladder cancer

Fetched: August 3rd, 2021, 5:02am GMT by Hongzhou Peng

Acta Biomater. 2021 Jul 1;128:514-522. doi: 10.1016/j.actbio.2021.04.051. Epub 2021 May 5.

ABSTRACT

Gallbladder cancer can be difficult to detect in its early stages and is prone to metastasize, causing bile duct obstruction, which is usually treated by stent implantation in clinic. However, the commonly used biliary stents are non-degradable, which not only prone to secondary blockage, but also need to be removed by secondary surgery. Biodegradable magnesium (Mg) is expected to one of the promising candidates for degradable biliary stents due to its excellent physicochemical property and biocompatibility. In this work, we studied the influence of high-purity Mg wires on gallbladder cancer through in vitro and in vivo experiments and revealed that the degradation products of Mg could significantly inhibit the growth of gallbladder cancer cells and promote their apoptosis. Our findings indicate that Mg biliary stent possesses the function of draining bile and treating gallbladder cancer, suggesting that Mg has good application prospects in biliary surgery. STATEMENT OF SIGNIFICANCE: Current research and development of biomedical magnesium are mainly concentrated in the cardiovascular and orthopedics field. Degradable magnesium bile duct stents have great application prospects in the treatment of bile duct blockage caused by bile duct-related cancers. At present, the effect of magnesium implants on gallbladder cancer is not clear. Our work verified the effectiveness of magnesium wire implants in inhibiting gallbladder cancer through in vivo and in vitro experiments, and studied the effect of magnesium degradation products on gallbladder cancer cells from the perspective of cell proliferation, apoptosis and cycle. This study provided new understanding for the application of magnesium in biliary surgery.

PMID:33964481 | DOI:10.1016/j.actbio.2021.04.051
Targeted therapies for gallbladder cancer: an overview of agents in preclinical and clinical development

Fetched: August 1st, 2021, 5:01am GMT by Stefania De Lorenzo

Expert Opin Investig Drugs. 2021 Jul;30(7):759-772. doi: 10.1080/13543784.2021.1928636. Epub 2021 May 17.

ABSTRACT

Introduction: Gallbladder cancer (GC) is a rare malignancy with a dismal prognosis. When diagnosed early enough, it can be cured by surgical removal. Unfortunately, only few GC patients can be amenable to surgery, though, with a high relapse rate. Conventional chemotherapy remains the golden standard for unresectable or metastatic GC, both in the first and second-line settings, even if leading to a fair outcome improvement.Areas covered: In recent years, according to the concept of 'precision medicine', new potential molecular targets have been examined. We provided a general outline of the current first- and second-line chemotherapies. New therapeutic possibilities are also reviewed, particularly HER2, EGFR, VEGF, TKI, MEK and BRAF inhibitors, and immunotherapy. Furthermore, published clinical trials are utilized to analyze the principal drug effectiveness in GC.Expert opinion: GC is characterized by vast cancer heterogeneity and individual's efficacy to different drugs. The ongoing trials have the potentiality of reshaping the landscape of systemic treatments for GC in the very next years. Nowadays, amongst therapeutic combinations, the addition of ICIs to chemotherapy has yielded encouraging results needing confirmation. In the next future, systematic implementation of gene profiling and further explorations of combination therapies will likely change the treatment scenario.

PMID:33966562 | DOI:10.1080/13543784.2021.1928636

Trials - Gall Bladder Cancer

Study of Irinotecan Liposome Injection in Patients With Advanced Biliary Tract Cancer

Posted: August 18th, 2021, 2:00pm GMT

Conditions: Advanced Biliary Tract Cancer; Intrahepatic Cholangiocarcinoma; Extrahepatic Cholangiocarcinoma; Gallbladder Carcinoma
Interventions: Drug: Irinotecan Liposome Injection; Drug: SG001; Drug: Fluorouracil; Drug: Leucovorin
Sponsor: CSPC Ouyi Pharmaceutical Co., Ltd.
Not yet recruiting
MK-7684A With or Without Other Anticancer Therapies in Participants With Selected Solid Tumors (MK-7684A-005)

Posted: August 16th, 2021, 2:00pm GMT

Conditions: Uterine Cervical Neoplasms; Endometrial Neoplasms; Squamous Cell Carcinoma of Head and Neck; Gallbladder Neoplasms; Cholangiocarcinoma; Esophageal Neoplasms; Triple Negative Breast Neoplasms; Hepatocellular Carcinoma
Interventions: Biological: Pembrolizumab/Vibostolimab Co-Formulation; Biological: Pembrolizumab; Drug: Lenvatinib; Drug: 5-Fluorouracil; Drug: Cisplatin; Drug: Paclitaxel
Sponsor: Merck Sharp & Dohme Corp.
Not yet 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
Not yet recruiting
The ID- RFA Trial: A Trial of Intraductal Radio-frequency Ablation (ID-RFA) Plus Biliary Stenting Versus Biliary Stenting Alone for the Treatment of Malignant Biliary Obstruction.

Posted: June 28th, 2021, 2:00pm GMT

Condition: Malignant Biliary Obstruction
Interventions: Procedure: Intraductal Radio-Frequency Ablation; Device: Biliary Stent Placement
Sponsors: University Hospitals Dorset NHS Foundation Trust; Aquilant Services; The Christie NHS Foundation Trust
Not yet recruiting
Effect of Simvastatin on the Prognosis of Primary Primary Sclerosing Cholangitis (PSC)

Posted: October 21st, 2019, 2:00pm GMT

Condition: Primary Sclerosing Cholangitis
Interventions: Drug: Simvastatin 40mg; Drug: Placebo oral tablet
Sponsor: Annika Bergquist
Recruiting
Nivolumab and Ipilimumab in Treating Patients With Rare Tumors

Posted: July 15th, 2016, 2:00pm GMT

Conditions: Acinar Cell Carcinoma; Adenoid Cystic Carcinoma; Adrenal Cortex Carcinoma; Adrenal Gland Pheochromocytoma; Anal Canal Neuroendocrine Carcinoma; Anal Canal Undifferentiated Carcinoma; Angiosarcoma; Apocrine Neoplasm; Appendix Mucinous Adenocarcinoma; Bartholin Gland Transitional Cell Carcinoma; Basal Cell Carcinoma; Bladder Adenocarcinoma; Breast Metaplastic Carcinoma; Cervical Adenocarcinoma; Cholangiocarcinoma; Chordoma; Colorectal Squamous Cell Carcinoma; Desmoid Fibromatosis; Endometrial Transitional Cell Carcinoma; Endometrioid Adenocarcinoma; Esophageal Neuroendocrine Carcinoma; Esophageal Undifferentiated Carcinoma; Extrahepatic Bile Duct Carcinoma; Extramammary Paget Disease; Fallopian Tube Adenocarcinoma; Fallopian Tube Transitional Cell Carcinoma; Fibromyxoid Tumor; Gallbladder Carcinoma; Gastric Neuroendocrine Carcinoma; Gastric Squamous Cell Carcinoma; Gastric Undifferentiated Carcinoma; Gastrointestinal Stromal Tumor; Gestational Trophoblastic Tumor; Giant Cell Carcinoma; Human Papillomavirus-Independent Cervical Adenocarcinoma, Clear Cell-Type; Intestinal Neuroendocrine Carcinoma; Intrahepatic Cholangiocarcinoma; Lung Carcinoid Tumor; Lung Sarcomatoid Carcinoma; Major Salivary Gland Carcinoma; Malignant Odontogenic Neoplasm; Malignant Peripheral Nerve Sheath Tumor; Malignant Solid Neoplasm; Malignant Testicular Sex Cord-Stromal Tumor; Metastatic Malignant Neoplasm of Unknown Primary; Minimally Invasive Lung Adenocarcinoma; Mixed Mesodermal (Mullerian) Tumor; Mucinous Adenocarcinoma; Mucinous Cystadenocarcinoma; Nasal Cavity Adenocarcinoma; Nasal Cavity Carcinoma; Nasopharyngeal Carcinoma; Nasopharyngeal Papillary Adenocarcinoma; Nasopharyngeal Undifferentiated Carcinoma; Oral Cavity Carcinoma; Oropharyngeal Undifferentiated Carcinoma; Ovarian Adenocarcinoma; Ovarian Germ Cell Tumor; Ovarian Mucinous Adenocarcinoma; Ovarian Squamous Cell Carcinoma; Ovarian Transitional Cell Carcinoma; Pancreatic Acinar Cell Carcinoma; Pancreatic Neuroendocrine Carcinoma; Paraganglioma; Paranasal Sinus Adenocarcinoma; Paranasal Sinus Carcinoma; Parathyroid Gland Carcinoma; PEComa; Peritoneal Mesothelioma; Pituitary Gland Carcinoma; Placental Choriocarcinoma; Primary Peritoneal High Grade Serous Adenocarcinoma; Pseudomyxoma Peritonei; Rare Disorder; Scrotal Squamous Cell Carcinoma; Seminal Vesicle Adenocarcinoma; Seminoma; Serous Cystadenocarcinoma; Small Intestinal Adenocarcinoma; Small Intestinal Squamous Cell Carcinoma; Spindle Cell Neoplasm; Squamous Cell Carcinoma of the Penis; Teratoma With Somatic-Type Malignancy; Testicular Non-Seminomatous Germ Cell Tumor; Thyroid Gland Carcinoma; Tracheal Carcinoma; Transitional Cell Carcinoma; Ureter Adenocarcinoma; Ureter Squamous Cell Carcinoma; Urethral Adenocarcinoma; Urethral Squamous Cell Carcinoma; Vaginal Adenocarcinoma; Vaginal Squamous Cell Carcinoma, Not Otherwise Specified; Vulvar Carcinoma
Interventions: Procedure: Biospecimen Collection; Biological: Ipilimumab; Biological: Nivolumab
Sponsor: National Cancer Institute (NCI)
Recruiting
Acquisition of Blood and Tumor Tissue Samples From Patients With Gastrointestinal Cancer

Posted: March 11th, 2011, 3:00pm GMT

Conditions: Non-GI Cancers; Cancer of Gastrointestinal Tract; Gastrointestinal Cancer
Intervention:
Sponsor: National Cancer Institute (NCI)
Recruiting

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