Biliary tract cancer treatment: results from the Biliary Tract Cancer Statistics Registry in Japan

Abstract

Considering the survival results according to specific lymph nodes involved, we concluded that the Japanese classification of lymph nodes, particularly hepatoduodenal ligament lymph nodes, should be reexamined, while another procedure to remove such lymph nodes completely should be developed.

Lymph node spread of gallbladder cancer from the perspective of embryologically-based anatomy and significance of the lymphatic basin along the embryonic right hepatic artery

“…As the standard surgical treatment in colorectal cancer, intestinal resection and regional lymphadenectomy, including feeding arteries, is considered essential (13,14). In GBC up to stage IIa, the frequency of lymph node metastasis in the pericholedochal area has been reported to be higher compared to that of lymph node metastasis around the hepatic artery (2,3). The lymphatic pathway of PPLNs has been called 'the right route of lymphatic drainage of the gallbladder' in Japan and has been considered as the main lymphatic route requiring resection in the treatment of GBC (12,15,16).…”

“…The 5-year survival rate following surgical resection has been reported to be 65% for patients with no lymph node metastases and <30% for those with regional lymph node metastases (pN1) (1). In the pN1 group, lymph node metastases characteristically arise in the pericholedochal area or the posterosuperior pancreaticoduodenal region, rather than around the hepatic artery (2,3). However, no feeding arteries are present around the pericholedochal lymph nodes and posterosuperior pancreaticoduodenal lymph nodes (PPLNs), although lymph nodes and lymphatic vessels generally exist along a feeding artery (4)(5)(6)(7).…”

Cyclooxygenase-2 Is Involved in the Up-Regulation of Matrix Metalloproteinase-9 in Cholangiocarcinoma Induced by Tumor Necrosis Factor-α

“…Cholangiocarcinoma (CC) arising from the intrahepatic, hilar, and extrahepatic bile ducts shows a dismal prognosis even after a complete surgical resection, [1][2][3] and the early invasion and metastasis of CC limit the efficacy of surgery. There have been many reports regarding the pathological factors that relate to the prognosis of CC patients, such as the TNM stage, and papillary phenotype and histological grade of the CC.…”

“…There have been many reports regarding the pathological factors that relate to the prognosis of CC patients, such as the TNM stage, and papillary phenotype and histological grade of the CC. [1][2][3][4][5][6] Recently, much attention has been given to the endogenous factors within malignant tumors, which are directly or indirectly responsible for tumor progression. [7][8][9][10] Among them, matrix metalloproteinase (MMP), cyclooxygenase (COX), and prostaglandin E2 (PGE2) are representative endogenous factors.…”

Depth of invasion determines the postresectional prognosis for patients with T1 extrahepatic cholangiocarcinoma

“…[8][9][10][11][12][13] The Japanese Society of Biliary Surgery has defined ''early'' cholangiocarcinoma as a pT1 (or pTis) tumor based on favorable postresectional survival. 24 However, in our experience, some patients with pT1 tumors have died of tumor recurrence despite undergoing a potentially curative resection. This prompted us to conduct the current study, which is the first to demonstrate clearly that the depth of invasion affects long-term outcomes after resection among patients with pT1 EHC, and that patients with tumors that have invaded the fibromuscular layer do not necessarily have a favorable prognosis after resection.…”