<b>Outcomes after resection of occupational cholangiocarcinoma</b>

Kubo, Shoji; Takemura, Shigekazu; Tanaka, Shogo; Shinkawa, Hiroji; Kinoshita, Masahiko; Hamano, Genya; Ito, Tokuji; Koda, Masaki; Aota, Takanori; Yamamoto, Takatsugu; Terajima, Hiroaki; Tachiyama, Gorou; Yamada, Terumasa; Nakamori, Shoji; Arimoto, Akira; Fujikawa, Masahiro; Tomimaru, Yoshito; Sugawara, Yasuhiko; Nakagawa, Kazuhiko; Unno, Michiaki; Mizuguchi, Toru; Takenaka, Katsuto; Kimura, Koichi; Shirabe, Ken; Saiura, Akio; Uesaka, Katsuhiko; Taniguchi, Hiroki; Fukuda, Akira; Chong, Ja Mun; Kuwae, Yuko; Ohsawa, Masahiko; Sato, Yasunori; Nakanuma, Yasuni

doi:10.1002/jhbp.373

Cited by 15 publications

(12 citation statements)

References 19 publications

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“…Now, ASCOT study (adjuvant S-1 versus surgery alone, phase III study) has been ongoing for resected biliary tract cancer since 2013 [18]. We explained to him and his family that there was no clear evidence of adjuvant chemotherapy in multiple and resected biliary tract cancer, and it is limited in case series [19]. Then, he and his family desired to take an oral S-1 as an adjuvant chemotherapy.…”

Section: Discussionmentioning

confidence: 99%

Multiple cholangiocarcinomas in the intrahepatic and extrahepatic biliary tree due to dichloromethane exposure: a case report

et al. 2020

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Background: An outbreak of cholangiocarcinoma in Japan has led to widespread concern among workers in printing plants. In March 2013, the Japanese Ministry of Health, Labour and Welfare, confirmed a causal relationship between cholangiocarcinoma and long-term exposure to dichloromethane (DCM) and 1,2-dichloropropane (DCP), which were widely used in printing plants. We herein report a rare case of successful radical resection of multiple cholangiocarcinomas in the intrahepatic and extrahepatic bile ducts caused by past exposure to DCM. Case presentation: A 54-year-old man developed brown urine 22 years after his last exposure to DCP and DCM. He had an 11-year history of working at a printing plant from the age of 21 to 31 years and dealt with organic solvents during his employment. Enhanced computed tomography revealed a thickened distal bile duct wall with upstream biliary dilatation and multiple intrahepatic cholangiocarcinomas located in liver segments III, VI, and VIII. Biopsy of the distal bile duct wall revealed adenocarcinoma, and a diagnosis of distal cholangiocarcinoma was made. Tumor marker levels were within the reference range (carcinoembryonic antigen, 3.3 ng/mL; carbohydrate antigen 19-9, 25.4 U/mL; SPAN-1, 13 U/mL; and DUPAN-2, 33 U/mL). The multiple intrahepatic and extrahepatic bile duct cancers were treated by subtotal stomach-preserving pancreatoduodenectomy and partial hepatectomy of segments III, VI, and VIII. Pathological examination of the surgical specimens revealed multiple cholangiocarcinomas with well-differentiated adenocarcinoma in the biliary tree. The patient was still alive without recurrence 17 months after the operation. Conclusions: We experienced a rare case of multiple cholangiocarcinomas in the intrahepatic and extrahepatic bile ducts that developed 22 years after the patient's last exposure to DCP and DCM. Long-term and careful follow-up is required for workers with an occupational history of exposure to organic solvents because of the risk of development of cholangiocarcinoma.

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Section: Discussionmentioning

confidence: 99%

Multiple cholangiocarcinomas in the intrahepatic and extrahepatic biliary tree due to dichloromethane exposure: a case report

et al. 2020

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“…The coexistence of precancerous/preinvasive lesions of cholangiocarcinoma, such as BilIN and/or IPNB, was recorded in these cases. Details of the patients have been described previously, 2 and the cases used in this study correspond to the patient numbers 2,7,8,10,11,12,15,16, and 17 in that article. From these cases, unstained sections including the foci of cholangiocarcinoma (invasive adenocarcinoma), BilIN, and IPNB were available from 10, 7, and 4 cases, respectively.…”

Section: Specimensmentioning

confidence: 99%

“…3 Clinical and pathological features of occupational cholangiocarcinoma are currently being analyzed. [4][5][6][7][8][9][10] Common pathological findings of occupational cholangiocarcinoma include the presence of precancerous/preinvasive lesions of cholangiocarcinoma such as biliary intraepithelial neoplasia (BilIN) and intraductal papillary neoplasm of the bile duct (IPNB), indicating the occurrence of a multistep carcinogenic process. 2,4,5 DNA damage in the biliary epithelial cells is considered to be related to the carcinogenic process.…”

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confidence: 99%

The PD‐1/PD‐L1 axis may be aberrantly activated in occupational cholangiocarcinoma

Sato

Kinoshita

Takemura

et al. 2017

Pathology International

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An outbreak of cholangiocarcinoma in a printing company was reported in Japan, and these cases were regarded as an occupational disease (occupational cholangiocarcinoma). This study examined the expression status of programmed death-1 (PD-1) and programmed death-ligand 1 (PD-L1) in occupational cholangiocarcinoma. Immunostaining of PD-1, PD-L1, CD3, CD8, and CD163 was performed using tissue sections of occupational cholangiocarcinoma (n = 10), and the results were compared with those of control cases consisting of intrahepatic (n = 23) and extrahepatic (n = 45) cholangiocarcinoma. Carcinoma cells expressed PD-L1 in all cases of occupational cholangiocarcinoma, whereas the detection of PD-L1 expression in cholangiocarcinoma cells was limited to a low number of cases (less than 10%) in the control subjects. In cases of occupational cholangiocarcinoma, occasional PD-L1 expression was also noted in precancerous/preinvasive lesions such as biliary intraepithelial neoplasia and intraductal papillary neoplasm of the bile duct. Additionally, tumor-associated macrophages and tumor-infiltrating T cells expressed PD-L1 and PD-1, respectively. The number of PD-L1-positive mononuclear cells, PD-1-positive lymphocytes, and CD8-positive lymphocytes infiltrating within the tumor was significantly higher in occupational cholangiocarcinoma compared with that in control cases. These results indicate that immune escape via the PD-1/PD-L1 axis may be occurring in occupational cholangiocarcinoma.

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“…Of the 18 patients from the printing company in Osaka, 13 underwent surgical resection; outcomes in 17 of the 18 patients were previously reported . Curative resection could not be carried out for four of the 13 patients because of extensive tumor invasion and the presence of precancerous/preinvasive lesions in the resected stump of the bile ducts.…”

Section: Treatments and Prognosismentioning

confidence: 99%

Occupational cholangiocarcinoma caused by exposure to 1,2‐dichloropropane and/or dichloromethane

Kubo

Takemura

Tanaka

et al. 2017

Annals of Gastroent Surgery

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A cluster of cholangiocarcinoma among printing company workers who were exposed to 1,2‐dichloropropane and/or dichloromethane was classified by the Ministry of Health, Labour and Welfare of Japan on 1 October 2013 as “occupational cholangiocarcinoma”. At the time of the diagnosis of cholangiocarcinoma, levels of γ‐glutamyl transferase, and aspartate and alanine aminotransferases were elevated, and had been elevated in some patients several years prior to the diagnosis. Regional dilatation of intrahepatic bile ducts without tumor‐induced obstruction was characteristic in diagnostic imaging. Pathological examination found chronic bile duct injury with DNA damage, precancerous/preinvasive lesions such as biliary intraepithelial neoplasia and intraductal papillary neoplasm of the bile duct in various sites of the large bile ducts, and invasive cholangiocarcinoma such as mass‐forming type and intraductal growth‐type intrahepatic cholangiocarcinoma and mainly papillary‐type extrahepatic cholangiocarcinoma. Whole‐exome analysis of the cancerous tissues showed hypermutation, substantial strand bias, and unique trinucleotide mutational changes. Patients seemed to suffer high incidence of postoperative complications including intra‐abdominal, which might be related to chronic bile duct injury. Postoperative recurrence from multicentric origins occurred in some patients, as DNA‐injured bile ducts have high carcinogenic potential. Aggressive treatment, including second resections for such multicentric recurrences, appeared to be effective. In 2014, the International Agency for Research on Cancer classified 1,2‐dichloropropane as Group 1 (carcinogenic to humans) and dichloromethane as Group 2A (probably carcinogenic to humans) carcinogens.

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Outcomes after resection of occupational cholangiocarcinoma

Cited by 15 publications

References 19 publications

Multiple cholangiocarcinomas in the intrahepatic and extrahepatic biliary tree due to dichloromethane exposure: a case report

Multiple cholangiocarcinomas in the intrahepatic and extrahepatic biliary tree due to dichloromethane exposure: a case report

The PD‐1/PD‐L1 axis may be aberrantly activated in occupational cholangiocarcinoma

Occupational cholangiocarcinoma caused by exposure to 1,2‐dichloropropane and/or dichloromethane

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