A retrospective analysis of the clinical effects of neoadjuvant combination therapy with full-dose gemcitabine and radiation therapy in patients with biliary tract cancer

Kobayashi, Shogo; Tomokuni, Akira; Gotoh, Kunihito; Takahashi, Hidenori; Akita, Hirofumi; Marubashi, Shigeru; Yamada, Terumasa; Teshima, Teruki; Fukui, Kiichi; Fujiwara, Yoshiyuki; Sakon, Masato

doi:10.1016/j.ejso.2016.12.008

Cited by 38 publications

(27 citation statements)

References 35 publications

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“…T A B L E 4 (Continued) in patients with biliary tract cancer. [18][19][20][21] If neoadjuvant therapy is selected, the preoperative waiting period will be extended compared with that in the case of upfront surgery. Management of ENBD is complicated for patients during neoadjuvant therapy.…”

Section: Discussionmentioning

confidence: 99%

Risk factors for dysfunction of preoperative endoscopic biliary drainage for malignant hilar biliary obstruction

Sugiura

Kuwatani

Kato

et al. 2020

J Hepato Biliary Pancreat

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Background: Few studies have focused on the risk factors for dysfunction of endoscopic biliary drainage (EBD) in preoperative patients with malignant hilar biliary obstruction (MHBO). Methods: We searched the database between February 2011 and December 2018 and identified patients with MHBO who underwent radical operation. The rate of dysfunction of the initial EBD, risk factors for dysfunction of the initial EBD and survival after surgery were retrospectively evaluated. Results: We analyzed a total of 131 patients [95 males (72.5%); mean age, 69.5 (±7.3) years; Bismuth-Corlette classification (BC) I/II/IIIa/IIIb/IV, 50/26/22/17/16; hilar cholangiocarcinoma/gall bladder cancer, 115/16]. Dysfunction of the initial EBD occurred in 28 patients (21.4%). The cumulative incidences of dysfunction of the initial EBD in all patients were 18.4%, 38.2% and 47.0% at 30, 60 and 90 days, respectively (Kaplan-Meier method). The rate of dysfunction of the initial EBD increased in patients with BC-IV (P = .03). Multivariate analysis showed that BC-IV and pre-EBD cholangitis were significantly associated with the occurrence of dysfunction of the initial EBD. Survival rates were not significantly different according to the initial biliary drainage methods and presence/absence of the initial EBD dysfunction. Conclusions: Dysfunction of the initial EBD frequently occurs in patients with the BC-IV and those with pre-EBD cholangitis. K E Y W O R D S endoscopic biliary drainage, preoperative biliary drainage, malignant hilar biliary obstruction, hilar cholangiocarcinoma, gall bladder cancer How to cite this article: Sugiura R, Kuwatani M, Kato S, et al. Risk factors for dysfunction of preoperative endoscopic biliary drainage for malignant hilar biliary obstruction.

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Section: Discussionmentioning

confidence: 99%

Risk factors for dysfunction of preoperative endoscopic biliary drainage for malignant hilar biliary obstruction

Sugiura

Kuwatani

Kato

et al. 2020

J Hepato Biliary Pancreat

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“…Guidelines for the treatment of localized GBC are mainly based on retrospective evidence and expert opinion due to the minimal availability of randomized evidence. Previous studies investigating GBC have typically been conducted in high-volume, non-Western centers and included patients with various biliary tract cancers [15,18,19]. Due to presumed different etiologies, results in GBC may differ from those in other biliary tract tumors [20].…”

Section: Introductionmentioning

confidence: 99%

Trends in Treatment and Survival of Gallbladder Cancer in the Netherlands; Identifying Gaps and Opportunities from a Nation-Wide Cohort

Lohman

Bitter

Verhoeven

et al. 2020

Cancers

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Gallbladder cancer (GBC) is rare in Western populations and data about treatment and outcomes are scarce. This study aims to analyze survival and identify opportunities for improvement using population-based data from a low-incidence country. GBC patients diagnosed between 2005 and 2016 with GBC were identified from the Netherlands Cancer Registry. Patients were grouped according to time period (2005–2009/2010–2016) and disease stage. Trends in treatment and overall survival (OS) were analyzed. In total 1834 patients were included: 661 (36%) patients with resected, 278 (15%) with non-resected non-metastatic, and 895 (49%) with metastatic GBC. Use of radical versus simple cholecystectomy (12% vs. 26%, p < 0.001) in early (pT1b/T2) GBC increased. More patients with metastatic GBC received chemotherapy (11% vs. 29%, p < 0.001). OS improved from 4.8 months (2005–2009) to 6.1 months (2010–2016) (p = 0.012). Median OS increased over time (2005–2009 vs. 2010–2016) in resected (19.4 to 26.8 months, p = 0.038) and metastatic (2.3 vs. 3.4 months, p = 0.001) GBC but not in unresected, non-metastatic GBC. In early GBC, patients with radical cholecystectomy had a median OS of 76.7 compared to 18.4 months for simple cholecystectomy (p < 0.001). Palliative chemotherapy showed superior (p < 0.001) survival in metastatic (7.3 versus 2.1 months) and non-resected non-metastatic (7.7 versus 3.5 months) GBC. In conclusion, survival of GBC remains poor. Radical surgery and palliative chemotherapy appear to improve prognosis but remain under-utilized.

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“…The other ACTICCA-1 trial from Europe evaluated the efficacy of gemcitabine and cisplatin [22]. Although no patients received neoadjuvant therapy in this study, neoadjuvant therapy such as chemotherapy and chemoradiotherapy seems to be another treatment option with the rationale to downstage and downsize the tumor to enable R0 resection and eliminate microscopic distant metastases [23-25]. Up to now, although no evidence is established on the effectiveness of neoadjuvant and adjuvant treatment in PHC, future studies of multimodality therapy would be expected to develop novel treatment strategies.…”

Section: Discussionmentioning

confidence: 99%

Short- and Long-Term Outcomes of Simultaneous Hepatic Artery Resection and Reconstruction for Perihilar Cholangiocarcinoma

Shindo

Kobayashi

Wada

et al. 2020

Gastrointest Tumors

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Introduction: Because surgical resection with simultaneous hepatic artery (HA) resection and reconstruction for perihilar cholangiocarcinoma (PHC) is technically demanding, the surgical indication for this challenging procedure is controversial. Thus, this study aimed to evaluate the efficacy of simultaneous HA resection and reconstruction for PHC. Methods: Between January 2002 and January 2018, 13 patients with PHC underwent surgical intervention with simultaneous resection and reconstruction of the HA at Yamaguchi University Hospital (Ube, Japan) and Osaka University Hospital (Suita, Japan). Results: There were 2 cases (15.4%) of 90-day postoperative mortality. Nine patients (69.2%) developed major postoperative complications (Clavien-Dindo classification ≥IIIa). Curative resections (R0) were achieved in 8 cases (61.5%). The median survival time (MST) and 1- and 3-year survival rates after resection (including in-hospital deaths) were 20.9 months and 61.5 and 10.3%, respectively. The MST and 1- and 2-year survival rates of 8 patients who underwent R0 resection were significantly better than those of the other 5 patients (24.2 vs. 10.2 months, 75.0 vs. 40.0%, and 50.0 vs. 0.0%, respectively, p = 0.0228). Conclusions: Simultaneous HA resection and reconstruction is technically possible and may provide long-term survival in selected patients with locally advanced PHC.

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A retrospective analysis of the clinical effects of neoadjuvant combination therapy with full-dose gemcitabine and radiation therapy in patients with biliary tract cancer

Cited by 38 publications

References 35 publications

Risk factors for dysfunction of preoperative endoscopic biliary drainage for malignant hilar biliary obstruction

Risk factors for dysfunction of preoperative endoscopic biliary drainage for malignant hilar biliary obstruction

Trends in Treatment and Survival of Gallbladder Cancer in the Netherlands; Identifying Gaps and Opportunities from a Nation-Wide Cohort

Short- and Long-Term Outcomes of Simultaneous Hepatic Artery Resection and Reconstruction for Perihilar Cholangiocarcinoma

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