Multimodality Management of Localized Biliary Cancer

Opinion statementBiliary tract cancers (BTCs) are a diverse group of malignancies arising from the biliary tree, including cholangiocarcinoma and gallbladder carcinoma. Patients that are candidates for surgical resection should also have lymphadenectomy. Since recurrence rates are high, after surgical resection, patients should be considered for adjuvant therapy in a multidiscipline setting. The limited availability of randomized clinical trial data makes the optimal treatment option unclear; however, chemotherapy or chemoradiation has been shown to have benefits especially in patients with R1 or R2 resections or lymph node involvement. Patients with unresectable disease should be considered for neoadjuvant therapy with chemotherapy or chemoradiation. Patients that are unable to tolerate chemotherapy should also be considered for locoregional therapies. Clinical trial enrollment is strongly recommended for all patients. Trials involving targeted or immunotherapy are currently ongoing in patients with advanced disease.
Source: Current Treatment Options in Oncology - Category: Cancer & Oncology Source Type: research

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CONCLUSIONS: Based on the very low-certainty evidence found in four trials in people with curative-intent resection for cholangiocarcinoma, we are very uncertain of the effects of postoperative adjuvant chemotherapy (mitomycin-C and 5-FU; gemcitabine; gemcitabine plus oxaliplatin; or capecitabine) versus no postoperative adjuvant chemotherapy on mortality. The effects of postoperative adjuvant chemotherapy compared with no postoperative adjuvant chemotherapy on serious adverse events are also very uncertain, but the result of the single trial showed 20% higher occurrences of haematologic adverse events. We assessed the cer...
Source: Cochrane Database of Systematic Reviews - Category: General Medicine Authors: Source Type: research
CONCLUSIONS: A small incremental benefit of 18F-FDG-PET/MRI over standard MRI of the liver was observed. However, in some cases 18F-FDG-PET/MRI may lead to false-positive findings. Overall there is seemingly limited role of 18F-FDG-PET/MRI in patients with suspected hepatobiliary malignancy.PMID:34102690 | DOI:10.1055/a-1486-3671
Source: Nuklearmedizin - Category: Radiology Authors: Source Type: research
Several malignancies can cause a hilar biliary obstruction, including cholangiocarcinoma, gallbladder cancer, hepatocellular carcinoma, and metastasis. Endoscopic biliary stenting plays an important role in the palliative management of unresectable hilar biliary obstruction. A few studies have compared the success rates and complications of bilateral and unilateral stents, but whether bilateral or unilateral stenting should be used remains unclear because of paucity of studies.
Source: Gastrointestinal Endoscopy - Category: Gastroenterology Authors: Tags: Friday, May 21, 2021 Source Type: research
This article discusses the NCCN Guidelines recommendations for HCC.PMID:34030131 | DOI:10.6004/jnccn.2021.0022
Source: Journal of the National Comprehensive Cancer Network : JNCCN - Category: Cancer & Oncology Authors: Source Type: research
AbstractBackground and AimsEndoscopic radiofrequency ablation (RFA) is an emerging technique for the palliation of inoperable malignant biliary strictures (MBSs). We aimed to systemically investigate the long ‐term outcome of RFA in a large cohort of patients.MethodsWe recruited 883 patients with various MBSs who underwent endoscopic interventions at two large ‐volume centers; 124 patients underwent RFA and stenting, whereas 759 underwent stenting alone. To overcome selection bias, we performed 1:4 propensity score matching (PSM). The main outcome was overall survival (OS).ResultsFollowing PSM, patients in the RFA grou...
Source: Journal of Hepato-Biliary-Pancreatic Sciences - Category: Gastroenterology Authors: Tags: ORIGINAL ARTICLE Source Type: research
Conclusions: Extensive genomic diversity and heterogeneity were observed among BTC patients, with contributions according to potential etiology exposures, anatomical subtypes and clinicopathological characteristics. We also demonstrated that patients with refractory BTCs who have PATs can derive considerable benefit from receiving a matched therapy, initiating further prospective clinical trials guided by molecular profiling among this aggressive cancer.
Source: Theranostics - Category: Molecular Biology Authors: Tags: Research Paper Source Type: research
BackgroundDigestive system cancers (DSCs) are associated with high morbidity and mortality. S100P has been reported as a prognostic biomarker in DSCs, but its prognostic value remains controversial. Accordingly, we conducted a meta-analysis to investigate whether S100P is correlated with overall survival (OS) of patients with DSCs. The relationship between S100P and clinicopathological features was also evaluated.MethodsWe systematically searched PubMed, Embase, Web of Science and Cochrane Library for eligible studies up to January 2020. In total, 16 publications with 1,925 patients were included.ResultsS100P overexpressio...
Source: Frontiers in Oncology - Category: Cancer & Oncology Source Type: research
AbstractWe aimed to investigate contemporary management and outcomes of bile leakage in patients who underwent hepatectomy with hepaticojejunostomy for liver malignancy. The NSQIP database was used to study clinical data of patients who underwent a hepatectomy with hepaticojejunostomy for a primary hepatobiliary cancer and developed bile leakage between 1/2014 and 12/2017. Multivariate regression analysis was performed to investigate outcomes. Five hundred patients underwent a hepatectomy with hepaticojejunostomy for a malignant primary hepatobiliary cancer (41% intrahepatic cholangiocarcinoma, 38.2% hilar cholangiocarcino...
Source: Updates in Surgery - Category: Surgery Source Type: research
This study was done to evaluate the pattern of metastatic tumors to the ovary and clinical details and to analyze the survival outcomes over a period of 5  years. Patients who had metastatic tumors to the ovary are identified from the electronic database from 1 January 2015 to 30 September 2019. Clinical details are collected from the electronic charts. Survival data is collected over the phone. The total number of ovarian cancers treated during the time period was 720, of which primary high-grade mucinous tumors contributed 9 (1.2%), and metastatic tumors to ovary 70 (10%). The highest levels of CEA were seen in carc...
Source: Indian Journal of Surgical Oncology - Category: Cancer & Oncology Source Type: research
Biliary tract cancers (BTC) are a disease entity comprising diverse epithelial tumors, which are categorized according to their anatomical location as intrahepatic (iCCA), perihilar (pCCA), distal (dCCA) cholangiocarcinomas, and gallbladder carcinomas (GBC), with distinct epidemiology, biology, and prognosis. Complete surgical resection is the mainstay in operable BTC as it is the only potentially curative treatment option. Nevertheless, even after curative (R0) resection, the 5-year survival rate ranges between 20 and 40% and the disease free survival rates (DFS) is approximately 48–65% after one year and 23–3...
Source: Frontiers in Oncology - Category: Cancer & Oncology Source Type: research
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