Extrahepatic cholangiocarcinoma: Current status of endoscopic approach and additional therapies

Tanțău, Alina; Mandrutiu, Alina; Pop, Anamaria; Zaharie, Roxana; Crişan, Dana; Preda, Carmen Monica; Tanţău, Marcel; Mercea, Voicu

doi:10.4254/wjh.v13.i2.166

Cited by 8 publications

(7 citation statements)

References 132 publications

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“…To date, surgical resection remains to be the most efficient treatment for eBTC. However, fewer than 50% of GBC patients and 35–68% of eCCA patients are eligible for surgical resection [ 5 – 7 ]. Early eCCA and GBC are hard to detect due to a lack of specific symptoms.…”

Section: Introductionmentioning

confidence: 99%

Establishment and drug screening of patient-derived extrahepatic biliary tract carcinoma organoids

et al. 2021

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Background Patient-derived organoids (PDO) have been proposed as a novel in vitro method of drug screening for different types of cancer. However, to date, extrahepatic biliary tract carcinoma (eBTC) PDOs have not yet been fully established. Methods We collected six samples of gallbladder carcinoma (GBC) and one sample of extrahepatic cholangiocarcinoma (eCCA) from seven patients to attempt to establish eBTC PDOs for drug screening. We successfully established five GBC and one eCCA PDOs. Histological staining was used to compare structural features between the original tissues and cancer PDOs. Whole exome sequencing (WES) was performed to analyze the genetic profiles of original tissues and cancer PDOs. Drug screening, including gemcitabine, 5-fluorouracil, cisplatin, paclitaxel, infigratinib, and ivosidenib, was measured and verified by clinical effects in certain cases. Results Different PDOs exhibited diverse growth rates during in vitro culture. Hematoxylin and eosin staining demonstrated that the structures of most cancer PDOs retained the original structures of adenocarcinoma. Immunohistological and periodic acid-schiff staining revealed that marker expression in cancer PDOs was similar to that of the original specimens. Genetic profiles from the four original specimens, as well as paired cancer PDOs, were analyzed using whole exome sequencing. Three of the four PDOs exhibited a high degree of similarity when compared to the original specimens, except for GBC2 PDO, which only had a concordance of 74% in the proportion of single nucleotide polymorphisms in the coding sequence. In general, gemcitabine was found to be the most efficient drug for eBTC treatment, as it showed moderate or significant inhibitory impact on cancer growth. Results from drug screening were confirmed to a certain extent by three clinical cases. Conclusions Our study successfully established a series of eBTC PDOs, which contributed to the field of eBTC PDOs. Additional enhancements should be explored to improve the growth rate of PDOs and to preserve their immune microenvironment.

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Section: Introductionmentioning

confidence: 99%

Establishment and drug screening of patient-derived extrahepatic biliary tract carcinoma organoids

et al. 2021

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“…The Bertuccio et al study showed that mortality from extrahepatic (ECC) levelled off or decreased [4], while the EHCC appears to be one of the most rapidly increasing tumors in China [5,6]. Although some treatment approaches were developed as therapeutics for EHCC, the prognosis of patients with unresectable or advanced EHCC is poor [7,8]. More than 50% of cases with jaundice are inoperable at the time of first diagnosis [7].…”

Section: Introductionmentioning

confidence: 99%

“…Although some treatment approaches were developed as therapeutics for EHCC, the prognosis of patients with unresectable or advanced EHCC is poor [7,8]. More than 50% of cases with jaundice are inoperable at the time of first diagnosis [7].…”

Section: Introductionmentioning

confidence: 99%

Metformin Use and Survival in Patients with Advanced Extrahepatic Cholangiocarcinoma: A Single-Center Cohort Study in Fuyang, China

Zhou

Wang

2021

Gastroenterology Research and Practice

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Aims. Metformin is an oral antidiabetic agent that has been widely prescribed for the treatment of type II diabetes. In recent years, anticancer properties of metformin have been revealed for numerous human malignancies. However, there are few indications available regarding the feasibility and safety of these studies in an advanced extrahepatic cholangiocarcinoma (EHCC) population. This study is aimed at evaluating the feasibility, safety, and value of metformin use and survival in patients with advanced EHCC. Methods. All patients with advanced EHCC observed at Fuyang People’s Hospital between January 2015 and November 2020 were included in the study. Case data, clinical information, and imaging results were abstracted from the self-administered questionnaire and electronic medical record. All patients were divided into study subjects and control subjects, and the study subjects were given metformin, 0.5 g, three times a day, while control subjects were without metformin. The metformin use and survival time of the subjects were asked by telephone, out-patient, or door-to-door visit, after they left the hospital. Results. One hundred and thirty-three study cases and 589 controls were included in the analysis. This study showed that metformin use cannot improve the overall survival rate of patients with advanced EHCC ([95% CI]: -17.05-0.375, t = − 1.889 , P value = 0.061), but the survival time of patients with drainage treatment from control group ( n = 496 ) was significantly shorter than that of patients with drainage treatment from the study group ( n = 113 ), and the difference was statistically significant ( z = − 2.230 , P value = 0.026). There were significant differences between metformin used before or after the diagnosis of advanced EHCC (OR[95% CI], 3.432[2.617-4.502]; P value = 0.001) in survival time. And there was significant difference between the duration of metformin use and survival prognosis (OR[95% CI], 2.967[1.383-6.368]; P = 0.005 ). Conclusion. Metformin can improve the survival of advanced EHCC patients who underwent drainage treatment, especially for metformin use after diagnosis of advanced EHCC and long duration of metformin.

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“…The two most commonly used imaging techniques after the identification of the tumor are endoscopic retrograde cholangiopancreatography (ERCP) and magnetic resonance cholangiopancreatography (MRCP)[ 21 ]. MRCP is the preferred modality because it allows the accurate assessment of tumor resectability[ 26 ]. Endoscopic ultrasound (EUS) and fine needle aspiration guided by EUS have also been reported to help with the diagnosis and staging of CCA[ 26 ].…”

Section: Diagnosismentioning

confidence: 99%

Current interventional options for palliative care for patients with advanced-stage cholangiocarcinoma

Makki,

Bentaleb,

Abdulrahman

et al. 2024

World J Clin Oncol

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Primary biliary tract tumors are malignancies that originate in the liver, bile ducts, or gallbladder. These tumors often present with jaundice of unknown etiology, leading to delayed diagnosis and advanced disease. Currently, several palliative treatment options are available for primary biliary tract tumors. They include percutaneous transhepatic biliary drainage (PTBD), biliary stenting, and surgical interventions such as biliary diversion. Systemic therapy is also commonly used for the palliative treatment of primary biliary tract tumors. It involves the administration of chemotherapy drugs, such as gemcitabine and cisplatin, which have shown promising results in improving overall survival in patients with advanced biliary tract tumors. PTBD is another palliative treatment option for patients with unresectable or inoperable malignant biliary obstruction. Biliary stenting can also be used as a palliative treatment option to alleviate symptoms in patients with unresectable or inoperable malignant biliary obstruction. Surgical interventions, such as biliary diversion, have traditionally been used as palliative options for primary biliary tract tumors. However, biliary diversion only provides temporary relief and does not remove the tumor. Primary biliary tract tumors often present in advanced stages, making palliative treatment the primary option for improving the quality of life of patients.

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Extrahepatic cholangiocarcinoma: Current status of endoscopic approach and additional therapies

Cited by 8 publications

References 132 publications

Establishment and drug screening of patient-derived extrahepatic biliary tract carcinoma organoids

Establishment and drug screening of patient-derived extrahepatic biliary tract carcinoma organoids

Metformin Use and Survival in Patients with Advanced Extrahepatic Cholangiocarcinoma: A Single-Center Cohort Study in Fuyang, China

Current interventional options for palliative care for patients with advanced-stage cholangiocarcinoma

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