Surveillance in cholangiocellular carcinoma

Wirth, Thomas; Vogel, Arndt

doi:10.1016/j.bpg.2016.11.001

Cited by 26 publications

(26 citation statements)

References 117 publications

(94 reference statements)

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“…This is in accordance with current follow-up recommendations for patients who are at a high risk of cholangiocarcinoma such as primary sclerosing cholangitis. 67 The cut-off value of CA19-9 in patients with primary sclerosing cholangitis for suspected carcinoma is 129 U/mL. 67 Other studies confirmed a sensitivity and specificity of 100 and 94% for cholangiocarcinoma using a cut-off level of 186 IU/mL.…”

Section: Follow-up Data and Suggested Protocolmentioning

confidence: 99%

“…67 The cut-off value of CA19-9 in patients with primary sclerosing cholangitis for suspected carcinoma is 129 U/mL. 67 Other studies confirmed a sensitivity and specificity of 100 and 94% for cholangiocarcinoma using a cut-off level of 186 IU/mL. 67 However, elevated CA19-9 levels were also found in patients with pancreatic and gastric malignancy, as well as in cholestatic patients without malignancy.…”

Section: Follow-up Data and Suggested Protocolmentioning

confidence: 99%

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Choledochal Cyst and Malignancy: A Plea for Lifelong Follow-Up

et al. 2017

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Previous research has confirmed that patients with choledochal cyst have an elevated risk of cholangiocarcinoma and gallbladder carcinoma. Current data suggest a risk of malignancy of 6 to 30% in adults with choledochal cyst. Malignancy has also occasionally been identified in children and adolescents. Multiple factors, including the age of the patient, cyst type, histological findings, and localization, have an impact on the prognosis. Information on long-term outcomes after cyst excision is limited. However, recent data suggest a lifelong elevated risk of up to 4% of cancer development following operation. This paper presents a review of the literature on cancer in patients with choledochal cyst before and after excision. A postoperative follow-up concept that consists of annual controls of CA19-9 and abdominal ultrasound is introduced.

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Section: Follow-up Data and Suggested Protocolmentioning

confidence: 99%

Section: Follow-up Data and Suggested Protocolmentioning

confidence: 99%

Choledochal Cyst and Malignancy: A Plea for Lifelong Follow-Up

et al. 2017

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“…Surgery with curative intent is the current standard of care, providing the opportunity for long-term survival (8). However, due to frequent recurrence of ICC, less than half of the postsurgery patients have been reported to survive for more than 5 years (9).…”

Section: Introductionmentioning

confidence: 99%

Latent Risk Intrahepatic Cholangiocarcinoma Susceptible to Adjuvant Treatment After Resection: A Clinical Deep Learning Approach

Jeong

Chen

et al. 2020

Front. Oncol.

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Background: Artificial Intelligence (AI) frameworks have emerged as a novel approach in medicine. However, information regarding its applicability and effectiveness in a clinical prognostic factor setting remains unclear.Methods: The AI framework was derived from a pooled dataset of intrahepatic cholangiocarcinoma (ICC) patients from three clinical centers (n = 1,421) by applying the TensorFlow deep learning algorithm to Cox-indicated pathologic (four), serologic (six), and etiologic (two) factors; this algorithm was validated using a dataset of ICC patients from an independent clinical center (n = 234). The model was compared to the commonly used staging system (American Joint Committee on Cancer; AJCC) and methodology (Cox regression) by evaluating the brier score (BS), integrated discrimination improvement (IDI), net reclassification improvement (NRI), and area under curve (AUC) values.Results: The framework (BS, 0.17; AUC, 0.78) was found to be more accurate than the AJCC stage (BS, 0.48; AUC, 0.60; IDI, 0.29; NRI, 11.85; P < 0.001) and the Cox model (BS, 0.49; AUC, 0.70; IDI, 0.46; NRI, 46.11; P < 0.001). Furthermore, hazard ratios greater than three were identified in both overall survival (HR; 3.190; 95% confidence interval [CI], 2.150-4.733; P < 0.001) and disease-free survival (HR, 3.559; 95% CI, 2.500-5.067; P < 0.001) between latent risk and stable groups in validation. In addition, the latent risk subgroup was found to be significantly benefited from adjuvant treatment (HR, 0.459; 95% CI, 0.360-0.586; P < 0.001).Jeong et al. Latent Risk Intrahepatic CholangiocarcinomaConclusions: The AI framework seems promising in the prognostic estimation and stratification of susceptible individuals for adjuvant treatment in patients with ICC after resection. Future prospective validations are needed for the framework to be applied in clinical practice.

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“…Currently, there are no curative systemic medical therapies for ICC,4 and even in those cases where curative‐intent hepatic tumor resection is an option, recurrence rates have been reported to range between 40% and 80% 5. Moreover, considering the insidious onset of ICC and the fact that a majority of patients with ICC do not meet the criteria for curative‐intent resection because of advanced disease at the time of diagnosis, there is a critical need to identify and validate biomarker signatures associated with increased ICC aggressiveness.…”

Section: Introductionmentioning

confidence: 99%

Overexpression of periostin and distinct mesothelin forms predict malignant progression in a rat cholangiocarcinoma model

Manzanares

Campbell

Maldonado

et al. 2017

Hepatology Communications

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Periostin and mesothelin have each been suggested to be predictors of poor survival for patients with intrahepatic cholangiocarcinoma, although the clinical prognostic value of both of these biomarkers remains uncertain. The aim of the current study was to investigate these biomarkers for their potential to act as tumor progression factors when assessed in orthotopic tumor and three‐dimensional culture models of rat cholangiocarcinoma progression. Using our orthotopic model, we demonstrated a strong positive correlation between tumor and serum periostin and mesothelin and increasing liver tumor mass and associated peritoneal metastases that also reflected differences in cholangiocarcinoma cell aggressiveness and malignant grade. Periostin immunostaining was most prominent in the desmoplastic stroma of larger sized more aggressive liver tumors and peritoneal metastases. In comparison, mesothelin was more highly expressed in the cholangiocarcinoma cells; the slower growing more highly differentiated liver tumors exhibited a luminal cancer cell surface immunostaining for this biomarker, and the rapidly growing less differentiated liver and metastatic tumor masses largely showed cytoplasmic mesothelin immunoreactivity. Two molecular weight forms of mesothelin were identified, one at ∼40 kDa and the other, a more heavily glycosylated form, at ∼50 kDa. Increased expression of the 40‐kDa mesothelin over that of the 50 kDa form predicted increased malignant progression in both the orthotopic liver tumors and in cholangiocarcinoma cells of different malignant potential in three‐dimensional culture. Moreover, coculturing of cancer‐associated myofibroblasts with cholangiocarcinoma cells promoted overexpression of the 40‐kDa mesothelin, which correlated with enhanced malignant progression in vitro. Conclusion: Periostin and mesothelin are useful predictors of tumor progression in our rat desmoplastic cholangiocarcinoma models. This supports their relevance to human intrahepatic cholangiocarcinoma. (Hepatology Communications 2018;2:155–172)

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Surveillance in cholangiocellular carcinoma

Cited by 26 publications

References 117 publications

Choledochal Cyst and Malignancy: A Plea for Lifelong Follow-Up

Choledochal Cyst and Malignancy: A Plea for Lifelong Follow-Up

Latent Risk Intrahepatic Cholangiocarcinoma Susceptible to Adjuvant Treatment After Resection: A Clinical Deep Learning Approach

Overexpression of periostin and distinct mesothelin forms predict malignant progression in a rat cholangiocarcinoma model

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