Einführung eines interdisziplinären Tumorboards führt zur Verbesserung der Behandlungsergebnisse von Cholangio- und Gallenblasenkarzinomen

Juratli, Mazen A.; Hofmann, K. Th.; Balaban, Ümniye; Youzouri, Hanan El; Pession, Ursula; Heise, Michael; Mekicar, Jernej; Schreckenbach, Teresa; Trojan, J; Waidmann, Oliver; Walter, Dirk; Vogl, T. J.; Eichler, Katrin; Wild, Peter J.; Schulze, Falko; Brandts, Christian; Bechstein, Wolf O.; Schnitzbauer, Andreas A.; Mönch, Christian

doi:10.1007/s00104-019-01100-x

Cited by 2 publications

(1 citation statement)

References 26 publications

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“…Patients should be presented in a multidisciplinary tumor board since treatment modalities range from surgery, locoregional treatment, systemic therapy, and can often involve a combinatorial approach. Implementation of multidisciplinary tumor boards has been shown to prolong life, improve patient-reported quality of life outcomes, and increase clinical trial awareness and evaluation [ 35 ]. Multidisciplinary patient care also should extend to involving dieticians for nutrition needs, palliative care for symptom management and serious illness conversations, and interventionalists for endobiliary decompression, as indicated.…”

Section: Presentation Diagnosis and Multidisciplinary Reviewmentioning

confidence: 99%

Current Standards, Multidisciplinary Approaches, and Future Directions in the Management of Extrahepatic Cholangiocarcinoma

Wheless,

Agarwal,

Goff

et al. 2024

Curr. Treat. Options in Oncol.

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Opinion statementBiliary tract cancers are molecularly and anatomically diverse cancers which include intrahepatic cholangiocarcinoma, extrahepatic (perihilar and distal) cholangiocarcinoma, and gallbladder cancer. While recognized as distinct entities, the rarer incidence of these cancers combined with diagnostic challenges in classifying anatomic origin has resulted in clinical trials and guideline recommended strategies being generalized patients with all types of biliary tract cancer. In this review, we delve into the unique aspects, subtype-specific clinical trial outcomes, and multidisciplinary management of patients with extrahepatic cholangiocarcinoma. When resectable, definitive surgery followed by adjuvant chemotherapy (sometimes with selective radiation/chemoradiation) is current standard of care. Due to high recurrence rates, there is growing interest in the use of upfront/neoadjuvant therapy to improve surgical outcomes and to downstage patients who may not initially be resectable. Select patients with perihilar cholangiocarcinoma are being successfully treated with novel approaches such as liver transplant. In the advanced disease setting, combination gemcitabine and cisplatin remains the standard base for systemic therapy and was recently improved upon with the addition of immune checkpoint blockade to the chemotherapy doublet in the recently reported TOPAZ-1 and KEYNOTE-966 trials. Second-line all-comer treatments for these patients remain limited in both options and efficacy, so clinical trial participation should be strongly considered. With increased use of molecular testing, detection of actionable mutations and opportunities to receive indicated targeted therapies are on the rise and are the most significant driver of improved survival for patients with advanced stage disease. Though these targeted therapies are currently reserved for the second or later line, future trials are looking at moving these to earlier treatment settings and use in combination with chemotherapy and immunotherapy. In addition to cross-disciplinary management with surgical, medical, and radiation oncology, patient-centered care should also include collaboration with advanced endoscopists, palliative care specialists, and nutritionists to improve global patient outcomes.

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Section: Presentation Diagnosis and Multidisciplinary Reviewmentioning

confidence: 99%

Current Standards, Multidisciplinary Approaches, and Future Directions in the Management of Extrahepatic Cholangiocarcinoma

Wheless,

Agarwal,

Goff

et al. 2024

Curr. Treat. Options in Oncol.

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Surgical Treatment of Distal Cholangiocarcinoma

Gorji¹,

Beal

2022

Current Oncology

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Distal cholangiocarcinoma (dCCA) is a rare malignancy arising from the epithelial cells of the distal biliary tract and has a poor prognosis. dCCA is often clinically silent and patients commonly present with locally advanced and/or distant disease. For patients identified with early stage, resectable disease, surgical resection with negative margins remains the only curative treatment strategy available. However, despite appropriate treatment and diligent surveillance, risk of recurrence remains high with nearly 50% of patients experiencing recurrence at 5 years subsequent to surgical resection; therefore, it is prudent to continue to optimize neoadjuvant and adjuvant therapies in order to reduce the risk of recurrence and improve overall survival. In this review, we discuss the clinical presentation, workup and surgical treatment of dCCA.

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Einführung eines interdisziplinären Tumorboards führt zur Verbesserung der Behandlungsergebnisse von Cholangio- und Gallenblasenkarzinomen

Cited by 2 publications

References 26 publications

Current Standards, Multidisciplinary Approaches, and Future Directions in the Management of Extrahepatic Cholangiocarcinoma

Current Standards, Multidisciplinary Approaches, and Future Directions in the Management of Extrahepatic Cholangiocarcinoma

Surgical Treatment of Distal Cholangiocarcinoma

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