18F-fluorodeoxyglucose positron emission tomography (18FDG-PET) for patients with biliary tract cancer: Systematic review and meta-analysis

Lamarca, Ángela; Barriuso, Jorge; Chander, Amarjot; McNamara, Mairéad G.; Hubner, Richard A; O’Reilly, Derek; Manoharan, Prakash; Valle, Juan W

doi:10.1016/j.jhep.2019.01.038

Cited by 94 publications

(89 citation statements)

References 109 publications

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“…If a proportion of these were due to early post-operative recurrence, it may highlight the need for better selection of patients for resection. Some recent work has been done in this area, and additional imaging prior to surgery in the form of 18 F-fluoro-2-deoxyglucose positron emission tomography/computed tomography ( 18 FDG-PET) may have a role, especially for identification of occult metastatic disease (146).…”

Section: Potential Reasons For Discrepant Resultsmentioning

confidence: 99%

Current standards and future perspectives in adjuvant treatment for biliary tract cancers

Lamarca

Edeline

McNamara

et al. 2020

Cancer Treatment Reviews

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Biliary tract cancer, including cholangiocarcinoma (CCA) and gallbladder cancer (GBC) are rare tumours with a rising incidence. Prognosis is poor, since most patients are diagnosed with advanced disease. Only ~20% of patients are diagnosed with early-stage disease, suitable for curative surgery.Despite surgery performed with potentially-curative intent, relapse rates are high, with around 60-70% of patients expected to have disease recurrence. Most relapses occur in the form of distant metastases, with a predominance of liver spread. In view of high tumour recurrence, adjuvant strategies have been explored for many years, in the form of radiotherapy, chemo-radiotherapy and chemotherapy. Historically, few randomised trials were available, including a variety of additional tumours (e.g. pancreatic and ampullary tumours) and most evidence relied on phase II and retrospective studies, with no high-quality evidence available to define the real benefit derived from adjuvant strategies.Since 2017, three randomised phase III clinical trials have been reported; all recruited patients with resected biliary tract cancer (CCA and GBC) who were randomised to observation alone, or chemotherapy in the form of gemcitabine (BCAT study; included patients diagnosed with extrahepatic CCA only), gemcitabine and oxaliplatin (PRODIGE-12/ACCORD-18; included patients diagnosed with CCA and GBC) or capecitabine (BILCAP; included patients diagnosed with CCA and GBC). While gemcitabine-based chemotherapy failed to show an impact on patient outcome (relapse-free survival (RFS) or overall survival (OS)), the BILCAP study showed a benefit from adjuvant capecitabine in terms of OS (pre-planned sensitivity analysis in the intention-to-treat population and in the per-protocol analysis), with confirmed benefit in terms of RFS. Based on the BILCAP trial, international guidelines recommend adjuvant capecitabine for a period of six months following potentially curative resection of CCA as the current standard of care for resected CCA and GBC. However, BILCAP failed to show OS benefit in the intention-to-treat (non-sensitivity analysis) population (primary end-point), and this finding, as well as some inconsistencies between studies has been criticised and has led to confusion in the biliary tract cancer medical community. This review summarises the adjuvant field in biliary tract cancer, with evidence before and after 2017, and comparison between the latest randomised phase III studies. Potential explanations are presented for differential findings, and future steps are explored.

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Section: Potential Reasons For Discrepant Resultsmentioning

confidence: 99%

Current standards and future perspectives in adjuvant treatment for biliary tract cancers

Lamarca

Edeline

McNamara

et al. 2020

Cancer Treatment Reviews

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“…These refinements might decrease the risk of misdiagnosis in HCC 98 , and have been adopted by the Liver Imaging Reporting Data System (LI-RADS) for CEUS (LI-RADS-CEUS) 99 . No evidence supports the use of 18 F-FDG PET for completion of staging, which could be of special value to exclude the presence of lymph node or distant metastases 100 .…”

Section: Clinical Presentation Diagnosismentioning

confidence: 99%

Cholangiocarcinoma 2020: the next horizon in mechanisms and management

Bañales

Marin

Lamarca

et al. 2020

Nat Rev Gastroenterol Hepatol

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Cholangiocarcinoma (CCA) constitutes a diverse group of malignancies emerging in the biliary tree. CCAs are divided into three subtypes depending on their anatomical site of origin: intrahepatic (iCCA), perihilar (pCCA) and distal (dCCA) CCA 1,2 (Fig. 1). Of note, considered as an independent entity, mixed HCC-CCA tumours are a rare type of liver malignancy sharing features of both iCCA and HCC and presenting an aggressive disease course and poor prognosis 3,4. iCCAs arise above the second-order bile ducts, whereas the point of anatomical distinction between pCCA and dCCA is the insertion of the cystic duct. pCCA and dCCA can also be collectively referred to as 'extrahepatic' (eCCA) 5. In the USA, pCCA is the single largest group, accounting for approximately 50-60% of all CCAs, followed by dCCA (20-30%) and iCCA (10-20%) 1,6,7. CCA is the second most common primary hepatic malignancy after hepatocellular carcinoma (HCC), comprising approximately 15% of all primary liver tumours and 3% of gastrointestinal cancers 1,6,7. CCAs are usually asymptomatic in early stages and, therefore, often diagnosed when the disease is already in advanced stages, which highly compromises therapeutic options, resulting in a dismal prognosis 1,8. CCA is a rare cancer, but its incidence (0.3-6 per 100,000 inhabitants per year) 1 and mortality (1-6 per 100,000 inhabitants per year, globally 9 , not taking into account specific regions with incidence >6 per 100,000 habitants such as South Korea, China and Thailand) have been increasing in the past few decades worldwide, representing a global health problem. Despite advances in

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“…The imaging modalities involved in the work‐up of suspected CCA are US, CEUS, CT, MRI and 18 FDG‐PET. Their diagnostic accuracy is influenced by anatomic location and growth patterns of CCA …”

Section: Diagnosismentioning

confidence: 99%

Clinical presentation, diagnosis and staging of cholangiocarcinoma

Forner

Vidili

Rengo

et al. 2019

Liver International

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227

179

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Cholangiocarcinoma (CCA) is a heterogeneous group of tumours, derived from cells of the biliary tree, which represent the second most frequent primary liver tumour. According to the most recent classifications, CCA can be subdivided into intrahepatic (iCCA) and extrahepatic (eCCA) which include perihilar (pCCA) and distal (dCCA) CCA. CCA are usually identified at advanced stages, when the primary tumour grows enough to produce a large liver mass or when jaundice has developed because of biliary tree obstruction. The ongoing challenges in the identification of risk factors and definition of a specific population at higher risk of developing CCA are the main challenges for the development of screening programs. Therefore, late diagnosis remains an unresolved issue in CCA. Imaging plays an important role in the detection and characterization of CCA, helping with radiological diagnosis, guiding biopsy procedures and allowing staging of the tumour. This review focuses on clinical presentations and diagnosis and staging techniques of CCA.

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18F-fluorodeoxyglucose positron emission tomography (18FDG-PET) for patients with biliary tract cancer: Systematic review and meta-analysis

Cited by 94 publications

References 109 publications

Current standards and future perspectives in adjuvant treatment for biliary tract cancers

Current standards and future perspectives in adjuvant treatment for biliary tract cancers

Cholangiocarcinoma 2020: the next horizon in mechanisms and management

Clinical presentation, diagnosis and staging of cholangiocarcinoma

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