Cholangiocarcinoma: Aggressive Surgical Intervention Remains Justified

Abstract

Cholangiocarcinoma (CCA) continues to be a difficult disease to both diagnose and treat. Optimal treatment includes resection to histologically negative margins. In recent years, advanced imaging, including magnetic resonance cholangiography and endoscopic ultrasound, has presumably improved the accuracy of determining resectability. From 2004 to 2009, a total of 61 patients with cholangiocarcinoma were evaluated for resection. The majority were men (37) and ages ranged from 29 to 87 years (mean, 67 years). Only 31 per cent were found to be obviously unresectable based on imaging alone. The remaining 69 per cent underwent exploration, at which time resection was found unfeasible in an additional 25 per cent (overall 56% unresectable). Although all resection specimens had grossly negative margins, 37 per cent were ultimately found to be microscopically positive. The overall 5-year actuarial survival for patients undergoing resection was 39.2 per cent with no survival difference between those with positive and negative margins. Despite advances in diagnostic imaging, more than half of patients with CCA presenting for surgical evaluation are ultimately found to be unresectable. However, the final determination can still only be made at the time of exploration. Even in the presence of microscopic residual disease, surgical intervention results in improved survival. An aggressive stance toward surgical intervention in patients with CCA remains justified.

Gankyrin promotes tumor growth and metastasis through activation of IL-6/STAT3 signaling in human cholangiocarcinoma

“…Efforts to elucidate the molecular mechanism underlying tumorigenicity and metastasis of CCA are urgently warranted to identify new biomarkers for prediction and intervention . Previous studies have intensively investigated the function of gankyrin as a component of proteasome complex in explaining its oncogenic activity .…”

“…Cholangiocarcinoma (CCA) is the second most common primary hepatic malignancy after hepatocellular carcinoma (HCC) . Epidemiologic studies showed that the incidence and mortality rates of CCA are increasing in several Western countries, including the U.S . Unfortunately, CCA is characterized by a poor prognosis and a very low 5‐year survival rate .…”

Koledok kistlerinden kaynaklanan kolanjiokarsinom: Olgu Sunumları

“…The patients were scheduled for chemoradiotherapy later. The prognosis for patients with cholangiocarcinoma arising in choledochal cysts is as grim as that for cholangiocarcinoma in general, with a median survival reported in the range of 6-21 months (30). Our patients in this study died one and three years, respectively, after the diagnosis.…”

EF24 inhibits tumor growth and metastasis via suppressing NF-kappaB dependent pathways in human cholangiocarcinoma

“…Cholangiocarcinoma (CCA) is the second most common hepatobiliary malignancy, and its incidence has increased in recent years, with approximately 5,000 new cases in the United States per year 1 2 . Current therapeutic options for CCA are limited, and the overall prognoses for patients with CCA remain dismal 3 4 5 6 .…”