Clinicopathological features and prognosis of advanced biliary carcinoma centered in the cystic duct

Nakanishi, Yoshitsugu; Tsuchikawa, Takahiro; Okamura, Keisuke; Nakamura, Tõru; Noji, Takehiro; Asano, Tomohiko; Tanaka, Kimitaka; Shichinohe, Toshiaki; Mitsuhashi, Tomoko; Hirano, Satoshi

doi:10.1016/j.hpb.2017.08.014

Cited by 8 publications

(23 citation statements)

References 9 publications

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“…Finally, the cystic duct margin should be reported as part of the resection margin, as involvement would suggest need for reresection. Neoplasia in the cystic duct or isolated cystic duct cancers are extremely rare and not considered as part of gallbladder cancer management in this review.…”

Section: Resultsmentioning

confidence: 99%

Systematic review of management of incidental gallbladder cancer after cholecystectomy

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Guest

Harrison

et al. 2019

Journal of British Surgery

112

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Background Gallbladder cancer is rare, but cancers detected incidentally after cholecystectomy are increasing. The aim of this study was to review the available data for current best practice for optimal management of incidental gallbladder cancer. Methods A systematic PubMed search of the English literature to May 2018 was conducted. Results The search identified 12 systematic reviews and meta‐analyses, in addition to several consensus reports, multi‐institutional series and national audits. Some 0·25–0·89 per cent of all cholecystectomy specimens had incidental gallbladder cancer on pathological examination. Most patients were staged with pT2 (about half) or pT1 (about one‐third) cancers. Patients with cancers confined to the mucosa (T1a or less) had 5‐year survival rates of up to 100 per cent after cholecystectomy alone. For cancers invading the muscle layer of the gallbladder wall (T1b or above), reresection is recommended. The type, extent and timing of reresection remain controversial. Observation time may be used for new cross‐sectional imaging with CT and MRI. Perforation at initial surgery had a higher risk of disease dissemination. Gallbladder cancers are PET‐avid, and PET may detect residual disease and thus prevent unnecessary surgery. Routine laparoscopic staging before reresection is not warranted for all stages. Risk of peritoneal carcinomatosis increases with each T category. The incidence of port‐site metastases is about 10 per cent. Routine resection of port sites has no effect on survival. Adjuvant chemotherapy is poorly documented and probably underused. Conclusion Management of incidental gallbladder cancer continues to evolve, with more refined suggestions for subgroups at risk and a selective approach to reresection.

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Section: Resultsmentioning

confidence: 99%

Systematic review of management of incidental gallbladder cancer after cholecystectomy

Søreide

Guest

Harrison

et al. 2019

Journal of British Surgery

112

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“…In the present study, we analyzed the comprehensive transcriptome and genome of GBCs in addition to HBDCs, which are anatomically close to and sometimes difficult to discriminate from CDCs or GBCs [13]. As a result, no large differences were observed between the transcriptomic profiles of GBCs and HBDCs ( Figure S1).…”

Section: Discussionmentioning

confidence: 99%

“…It is sometimes difficult to discriminate between the anatomical location of GBC and a tumor developed in the upper common bile duct or hepatic bile duct, even after pathological examination following resection [13]. First, to explore the molecular differences between gallbladder body and neck cancer (GBBC) and cystic duct cancer (CDC), which are anatomically defined as GBCs, and hilar bile duct cancer (HBDC), we performed RNA-seq of frozen surgical specimens of 20 GBBCs, 16 CDCs, and 8 HBDCs located very closed to the junction of cystic and common hepatic ducts, as evaluated by pathological examination of resected samples.…”

Section: Rna-sequencing (Rna-seq) and Clustering Analysis Revealed Twmentioning

confidence: 99%

Molecular Classification and Tumor Microenvironment Characterization of Gallbladder Cancer by Comprehensive Genomic and Transcriptomic Analysis

Ebata

Fujita

Sasagawa

et al. 2021

Cancers

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Gallbladder cancer (GBC), a rare but lethal disease, is often diagnosed at advanced stages. So far, molecular characterization of GBC is insufficient, and a comprehensive molecular portrait is warranted to uncover new targets and classify GBC. We performed a transcriptome analysis of both coding and non-coding RNAs from 36 GBC fresh-frozen samples. The results were integrated with those of comprehensive mutation profiling based on whole-genome or exome sequencing. The clustering analysis of RNA-seq data facilitated the classification of GBCs into two subclasses, characterized by high or low expression levels of TME (tumor microenvironment) genes. A correlation was observed between gene expression and pathological immunostaining. TME-rich tumors showed significantly poor prognosis and higher recurrence rate than TME-poor tumors. TME-rich tumors showed overexpression of genes involved in epithelial-to-mesenchymal transition (EMT) and inflammation or immune suppression, which was validated by immunostaining. One non-coding RNA, miR125B1, exhibited elevated expression in stroma-rich tumors, and miR125B1 knockout in GBC cell lines decreased its invasion ability and altered the EMT pathway. Mutation profiles revealed TP53 (47%) as the most commonly mutated gene, followed by ELF3 (13%) and ARID1A (11%). Mutations of ARID1A, ERBB3, and the genes related to the TGF-β signaling pathway were enriched in TME-rich tumors. This comprehensive analysis demonstrated that TME, EMT, and TGF-β pathway alterations are the main drivers of GBC and provides a new classification of GBCs that may be useful for therapeutic decision-making.

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“…Despite the low incidence, CDC carries the worst prognosis among all biliary tumors (12,25). The median OS of patients with CDC is only 23 months, which is much lower than that of hilar cholangiocarcinoma or gallbladder carcinoma (26). Surgery is the only radical treatment for CDC, thus highlighting the importance of predicting resectability and prognosis in patients with CDC.…”

Section: Discussionmentioning

confidence: 99%

Cystic Duct Carcinoma: A New Classification System and the Clinicopathological Features of 62 Patients

et al. 2021

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BackgroundCystic duct carcinoma (CDC) is a rare biliary malignancy with a low incidence and poor prognosis. However, the clinical landscape of the disease has not been clarified and no widely applicable classification system has been developed.MethodsSixty-two patients with CDC were included in this retrospective study, and a new classification system was established using imaging data. Blood indices, radiological characteristics, pathological features, surgical procedures, and overall survival data were collected. The efficacy of the new classification in predicting resectability was evaluated using receiver operating characteristic (ROC) curves, and K-means clustering and t-distributed stochastic neighbor embedding were applied to verify the conclusion.ResultsThe pT stage of patients with type II CDC was significantly worse than that of type I. Patients with type II CDC were more likely to experience distant metastasis and invasion of the nervous system, vascular system, and liver. The resectability of patients with type II CDC was significantly worse than that of patients with type I CDC. Patients with type II CDC had worse prognoses. ROC curve analysis and K-means clustering revealed that the new classification could better categorize patients with CDC than currently available systems.ConclusionPatients with type II CDC have significantly worse clinicopathological outcomes. The new classification system has better accuracy in grouping patients with CDC.

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Clinicopathological features and prognosis of advanced biliary carcinoma centered in the cystic duct

Abstract: These findings suggest that advanced BCCD is appropriately classified as a subtype of GBC because it can grow through the serosa.

Cited by 8 publications

References 9 publications

Systematic review of management of incidental gallbladder cancer after cholecystectomy

Systematic review of management of incidental gallbladder cancer after cholecystectomy

Molecular Classification and Tumor Microenvironment Characterization of Gallbladder Cancer by Comprehensive Genomic and Transcriptomic Analysis

Cystic Duct Carcinoma: A New Classification System and the Clinicopathological Features of 62 Patients

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