Prognostic Factors After Surgical Resection for Intrahepatic, Hilar, and Distal Cholangiocarcinoma

Murakami, Yoshiaki; Uemura, Kenichiro; Sudo, Takeshi; Hashimoto, Yasushi; Nakashima, Akira; Kondo, Naru; Sakabe, Ryutaro; Ohge, Hiroki; Sueda, Taijiro

doi:10.1245/s10434-010-1325-4

Cited by 216 publications

(189 citation statements)

References 37 publications

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“…Previous studies of survival in CCA patients have focused on specific subgroups-such as those at advanced stage (Park et al, 2009), receiving surgical resection (Murakami et al, 2011;Pattanathien et al, 2013;Sriputtha et al, 2013) or adjuvant therapy (Knüppel et al, 2012), or specific tumour locations (Cheng et al, 2007;Hasegawa et al, 2007;Nakagohri et al, 2008;Guglielmi et al, 2009;Bunsiripaiboon et al, 2010;Cho et al, 2010;Nuzzo et al, 2010;Li et al, 2011). In addition, most studies were retrospective, only one prospective study (Mihalache et al, 2010) has been reported, and there are none from Asian countries.…”

Section: Introductionmentioning

confidence: 99%

Factors Affecting Survival Time of Cholangiocarcinoma Patients: A Prospective Study in Northeast Thailand

Woradet¹,

Promthet²,

Songserm³

et al. 2013

Asian Pacific Journal of Cancer Prevention

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Section: Introductionmentioning

confidence: 99%

Factors Affecting Survival Time of Cholangiocarcinoma Patients: A Prospective Study in Northeast Thailand

Woradet¹,

Promthet²,

Songserm³

et al. 2013

Asian Pacific Journal of Cancer Prevention

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“…99 Postoperative survival rate for DCC has been reported between 18%-54%. 101 Twenty-three percent 5-year survival rate and median survival of 18 months were reported in a series of 563 patients. 102 Surgical mortality in large published series has been less than 3%.…”

Section: Distal Cholangiocarcinomamentioning

confidence: 98%

Comprehensive management of cholangiocarcinoma: Part II. Treatment

Papafragkakis

Lee

2017

Int J Gastrointest Interv

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Cholangioarcinoma is a rare but dreadful malignancy which poses much difficulties in the management. If detected early with only localized disease, curative resection is possible. However, most patients present in the late stages of the disease, which are managed with endoscopic biliary drainage and/or chemoradiation. Liver transplantation offers a possibility for cure in the distal and the perihilar tumors for selected candidates. Local treatments, such as hepatic artery-based therapies, brachytherapy, and photodynamic therapy, may offer some benefit in cases of the advanced disease. In this review, we will assess the role of preoperative biliary drainage, how best to drain biliary obstruction, and the intricate details of various treatments that are currently available. Management of Cholangiocarcinoma Preoperative biliary drainagePreoperative biliary drainage (PBD) is achieved with endoscopic or percutaneous approach. The topic is controversial and the review of the literature revealed conflicting results. PBD of the future remnant hepatic lobe is supposed to decrease hepatic dysfunction and liver failure postoperatively.1 The meta-analysis found no difference in mortality between patients with and without PBD and the authors advised that such procedure should not be performed routinely.2 Another meta-analysis of almost 5,000 patients with distal obstruction (425 with distal cholangiocarcinoma [DCC]) did not find any evidence that PBD (without distinguishing between endoscopic or percutaneous approach) increases morbidity or mortality. However it was associated with significant bacterial infection of the bile and possibly adverse outcomes after surgery.3 Other studies showed that PBD reduced jaundice, which positively affected outcomes, but not survival, and that it might be associated with more intraoperative blood loss, but less reoperation rates compared to non-drained cases. 4,5 The prospective randomized study of almost 200 patients with cancer of the head of the pancreas demonstrated that PBD was associated with more non-surgical adverse events compared to those managed only with surgery (46% vs 2%, respectively). Surgical adverse events were also more in the PBD group (47% vs 37%). The high incidence of cholangitis in those treated with PBD may be associated with the long lag time between PBD and surgery (5 weeks) and the high occlusion rate of plastic stents (PSs) (15%), prompting other authors to suggest that use of short, self-expandable metal stents (SEMS) may result in better outcomes for distal bile duct strictures. In accordance with other studies, there was no effect of PBD on mortality.6,7 In perihilar cholangiocarcinoma (PCC), the systematic review of 700 patients with and without PBD suggested that there is higher incidence of postoperative infections (18%-52% vs 0%-27%) and overall adverse events (36%-100% vs 29%-72%) in the PBD compared to the non-PBD group. There was no difference in mortality in the two groups. 8 Other studies favor the use of PBD in the preoperative management of PCC. ...

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“…The statistically significant favorable parameters were higher degree of differentiation, a more favorable primary tumor factor by TNM staging, absence of LN metastases and R0 surgical margins. 36 …”

Section: Distal Cholangiocarcinomamentioning

confidence: 99%

Comprehensive management of cholangiocarcinoma: Part I. Diagnosis

Papafragkakis

Lee

2017

Int J Gastrointest Interv

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A B S T R A C TCholangiocarcinoma is the second most common primary hepatic malignancy and its incidence is increasing worldwide. Classification and staging of intrahepatic, perihilar, and distal cholangiocarcinomas provide useful prognostic information and further guide in their management. Establishing diagnosis is frequently challenging and may require a multi-modality approach that includes advanced radiological imaging studies and procedures for tissue acquisition; the endoscopic procedures that have been utilized in the management of cholangiocarcinoma comprise endoscopic retrograde cholangiopancreatography with brushing and biopsy, endoscopic ultrasound-guided fine needle aspiration, cholangioscopy with targeted biopsy, and intraductal confocal endomicroscopy. In this review, we will examine the strengths and limitations of each diagnostic tool and assess the serum and bile tumor markers.

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Prognostic Factors After Surgical Resection for Intrahepatic, Hilar, and Distal Cholangiocarcinoma

Abstract: R0 resection and adjuvant chemotherapy may be mandatory to achieve long-term survival for patients with cholangiocarcinoma.

Cited by 216 publications

References 37 publications

Factors Affecting Survival Time of Cholangiocarcinoma Patients: A Prospective Study in Northeast Thailand

Factors Affecting Survival Time of Cholangiocarcinoma Patients: A Prospective Study in Northeast Thailand

Comprehensive management of cholangiocarcinoma: Part II. Treatment

Comprehensive management of cholangiocarcinoma: Part I. Diagnosis

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