Clinical outcome after resection of early-stage hilar cholangiocarcinoma

Stremitzer, Stefan; Jones, Robert; Quinn, Leonard; Fenwick, Stephen; Díaz-Nieto, Rafael; Poston, Graeme J.; Malik, Hassan

doi:10.1016/j.ejso.2018.09.008

Cited by 21 publications

(12 citation statements)

References 19 publications

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“…For patients with type III, it is often necessary to remove the extrahepatic bile duct, the caudate lobe, and the corresponding left or right liver. However, for patients with type IV, it is necessary to combine hepatectomy and the reconstruction of the portal vein and hepatic artery, and also to eliminate the residual cancer cells at each margin to achieve radical resection[ 6 ]. Surgical resection alone is not the best method for the treatment of hilar CC[ 7 , 8 ].…”

Section: Discussionmentioning

confidence: 99%

Novel brachytherapy drainage tube loaded with double ¹²⁵I strands for hilar cholangiocarcinoma: A case report

Lei¹,

Jiao²,

Han³

2020

WJCC

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BACKGROUND Hilar cholangiocarcinoma (CC) is a common malignant tumor with high malignancy and poor prognosis. Most patients have lost the opportunity to undergo radical surgery when diagnosed. Although palliative drainage or biliary stent placement is a preferable choice, the tumor cannot be controlled. This study aimed to develop a novel brachytherapy drainage tube for low-dose-rate brachytherapy with an effective drainage, thereby prolonging the survival time of patients. CASE SUMMARY A 54-year-old male patient had undergone choledochal stent implantation due to obstructive jaundice. He was admitted to the hospital because of the recurrence of jaundice. Preoperative imaging and pathological biopsy revealed hilar CC (Bismuth-Corlette type IIIa). First, the patient underwent percutaneous transhepatic cholangial drainage and the symptoms of jaundice gradually relieved. To further treat hilar CC and remove the biliary drainage tube as far as possible, the patient chose to use the novel brachytherapy drainage tube after a multi-disciplinary consultation. After 1 mo of brachytherapy, the re-examination revealed that the obstructive lesions disappeared, and the drainage tube was finally removed. During the following 10 mo of follow-up, the patient's hilar CC did not recur. CONCLUSION The novel brachytherapy drainage tube may be a new choice for patients with unresectable hilar CC.

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Section: Discussionmentioning

confidence: 99%

Novel brachytherapy drainage tube loaded with double ¹²⁵I strands for hilar cholangiocarcinoma: A case report

Lei¹,

Jiao²,

Han³

2020

WJCC

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“…However, larger clinical trials have shown that disease recurrence after tumor resection is observed in up to 60% of cases, leading to a 5-year survival rate of less than 50%, even for patients who received adjuvant chemotherapy [ 2 ]. Importantly, the decision for or against tumor resection is mostly based on surgical resectability and the patients’ performance status, while aspects of the individual BTC tumor biology are not considered [ 3 ]. In order to identify subgroups of patients that will particularly benefit from surgical tumor resection, novel easily accessible biomarkers are urgently needed to improve the outcomes for this highly aggressive GI malignancy.…”

Section: Introductionmentioning

confidence: 99%

Serum Levels of CXCL13 Are an Independent Predictor of Survival Following Resection of Biliary Tract Cancer

Loosen

Ulmer

Labuhn

et al. 2022

Cancers

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Background: The prognosis of biliary tract cancer (BTC) has remained very poor. Although tumor resection represents a potentially curative therapy for selected patients, tumor recurrence is common, and 5-year survival rates have remained below 50%. As stratification algorithms comprising the parameters of individual tumor biology are missing, the identification of ideal patients for extensive tumor surgery is often challenging. The CXC chemokine family exerts decisive functions in cell–cell interactions and has only recently been associated with cancer, but little is known about their function in BTC. Here, we aim to evaluate a potential role of circulating CXCL1, CXCL10 and CXCL13 in patients with resectable BTC. Methods: Serum levels of CXCL1, CXCL10 and CXCL13 were measured by multiplex immunoassay in a cohort of 119 BTC patients undergoing tumor resection and 50 control samples. Results: Circulating levels of CXCL1, CXCL10 and CXCL13 were all significantly elevated in BTC patients compared to healthy controls and increased the diagnostic power of established tumor markers such as CA19-9 when used in combination. Importantly, elevated levels of CXCL13 both before and after tumor resection identified a subgroup of patients with significantly impaired outcomes following tumor resection. As such, BTC patients with initial CXCL13 levels above the ideal prognostic cut-off value (25.01 pg/mL) had a median overall survival (OS) of 290 days compared to 969 days for patients with low initial CXCL13 levels. The prognostic value of circulating CXCL13 was further confirmed by uni- and multivariate Cox regression analyses. Finally, the individual kinetics of CXCL13 before and after tumor resection were also indicative of patient outcomes. Conclusion: Our data support a fundamental role of the CXC chemokine family in BTC and identified circulating levels of CXCL13 as a previously unrecognized marker for predicting outcomes following the resection of BTC.

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“…Importantly, tumor resection is only feasible if BTC is diagnosed at an early disease stage and also in these patients, prediction of postoperative outcome in terms of disease recurrence represents a major challenge. In this context, it is important to note that the decision regarding tumor resection or alternative therapeutic approaches such as chemotherapy is currently mainly based on surgical resectability and clinical aspects [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Golgi Protein 73 (GP73) Serum Levels Predict Outcome after Resection of Biliary Tract Cancer

Loosen

Halpaap

Labuhn

et al. 2022

Cancers

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Background: Tumor resection represents the only potentially curative therapy for patients with biliary tract cancer. Nevertheless, disease recurrence is observed in about 50% of patients, leading to a 5-years survival rate of less than 50%. The Golgi protein 73 (GP73), a type II Golgi transmembrane protein, exerts important functions of intracellular protein processing and transportation. Circulating GP73 has recently been suggested as a prognostic marker following resection of hepatocellular carcinoma (HCC) but its role in the context of BTC has remained unknown. In this study, we evaluate a potential role of circulating GP73 as a novel biomarker in patients with resectable BTC. Methods: GP73 serum levels were measured by immunoassay in n = 97 BTC and n = 40 HCC patients as well as n = 31 healthy controls. Results were correlated with clinical data. Results: Serum GP73 levels were significantly elevated in BTC patients compared to healthy controls but lower compared to HCC patients. The combination of GP73/CA19-9 showed a sensitivity and specificity of 83.5% and 90.3% regarding the differentiation of BTC patients and healthy controls. BTC patients with baseline GP73 levels above the ideal cut-off value (42.47 ng/mL) showed a significantly reduced median overall survival (193 days) compared to patients with preoperative GP73 levels below this cut-off (882 days). These results were confirmed in uni- and multivariate Cox-regression analysis including several clinicopathological parameters such as age, ECOG performance status, tumor stage as well as established tumor markers and parameters of liver and kidney function. Conclusions: GP73 represents a previously unrecognized biomarker in the patients with resectable BTC that identifies patients with an impaired postoperative outcome. If larger clinical trials confirmed these findings, measurement of GP73 serum levels might become a novel tool in the challenging preoperative stratification process of patients with resectable BTC.

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Clinical outcome after resection of early-stage hilar cholangiocarcinoma

Cited by 21 publications

References 19 publications

Novel brachytherapy drainage tube loaded with double ¹²⁵I strands for hilar cholangiocarcinoma: A case report

Novel brachytherapy drainage tube loaded with double ¹²⁵I strands for hilar cholangiocarcinoma: A case report

Serum Levels of CXCL13 Are an Independent Predictor of Survival Following Resection of Biliary Tract Cancer

Golgi Protein 73 (GP73) Serum Levels Predict Outcome after Resection of Biliary Tract Cancer

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Clinical outcome after resection of early-stage hilar cholangiocarcinoma

Cited by 21 publications

References 19 publications

Novel brachytherapy drainage tube loaded with double 125I strands for hilar cholangiocarcinoma: A case report

Novel brachytherapy drainage tube loaded with double 125I strands for hilar cholangiocarcinoma: A case report

Serum Levels of CXCL13 Are an Independent Predictor of Survival Following Resection of Biliary Tract Cancer

Golgi Protein 73 (GP73) Serum Levels Predict Outcome after Resection of Biliary Tract Cancer

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Novel brachytherapy drainage tube loaded with double ¹²⁵I strands for hilar cholangiocarcinoma: A case report

Novel brachytherapy drainage tube loaded with double ¹²⁵I strands for hilar cholangiocarcinoma: A case report