A Clinical Study of 130 Patients with Biliary Tract Cancers and Periampullary Tumors

Abstract

A retrospective review of 130 patients with peripheral-type cholangiocarcinomas (PTCC), hilar-type cholangiocarcinomas (HTCC), extrahepatic cholan-giocarcinomas (EHCC), gallbladder cancers (GBCA), and periampullary cancers (PACA), seen at National Cheng Kung University Hospital and Tainan Municipal Hospital from June 1987 to July 1993 was performed. There were 47 (36%) HTCC, 32 (25%) PACA, 24 (19%) PTCC, 17 (13%) GBCA, and 10 (8%) EHCC patients. The distribution is completely different from that reported in western countries. These cancers mainly occur in elderly patients. HTCC and GBCA were predominantly noted in female patients. Biliary cancers in Taiwan were not related to liver fluke infestation, inflammatory bowel disease or hepatitis B virus infection. However, a close association with biliary lithiasis was found. The incidence of gallstones was 67, 39,20,29 and 19% for PTCC, HTCC, EHCC, GBCA and PACA, respectively. The most common presentation for PTCC and GBCA was abdominal pain, or jaundice for HTCC, EHCC and PACA. These symptoms correlate well with the location of the tumors. Among serum tumor markers, the elevation of CA19-9 was most frequent, occurring in 86% of the patients while CA125 and CEA occurred in 47% and 30% of the patients, respectively. During the course of disease, infection developed in 61 % of the patients and was the main cause of death in 25%. Biliary tract infection and sepsis were the two leading manifestations and occurred in 49% and 32% of the patients, respectively. Overall survival was poor except in patients whose tumor could be completely resected.

Establishment and characterization of chromosomal aberrations in human cholangiocarcinoma cell lines by cross-species color banding

“…Particularly, positive immunoreactivity for CK7 and CK19 and negative immunoreactivity for CK20 were distinguished from HCC or metastatic colorectal carcinoma, as reported previously (Maeda et al, 1996;Taguchi et al, 1996;Sasaki et al, 1999;Tsuji et al, 1999). Although CA19-9 has been considered a nonspecific marker of CC, positive immmunohistologic stains and elevated serum levels of CA19-9 were shown in more than half of patients with CC (Jalanko et al, 1984;Su et al, 1996). Cho-CK was positive for CA19-9, which is consistent with serology results (Table 1).…”

Mesothelin as a Potential Therapeutic Target in Human Cholangiocarcinoma

“…A recent study demonstrates that mesothelin mediates cell adhesion through an interaction with CA125 13-15, suggesting that there may be an important role for CA125 and mesothelin in the metastatic spread of cancer in the peritoneal cavity. Serum CA125 has also been evaluated as a diagnostic biomarker for primary liver cancer 16,17.…”

A Phase II Trial of Gemcitabine in the Treatment of Advanced Bile Duct and Periampullary Carcinomas

“…Bile duct and periampullary carcinomas are uncommon tumors worldwide, but are not uncommon in Taiwan [1]. Surgery is the mainstay of treatment for resectable disease.…”