Biliary tract neoplasms: update 2003

Malka, David; Boige, Valérie; Dromain, Clarisse; Debaere, Thierry; Pocard, Marc; Ducreux, Michel

doi:10.1097/01.cco.0000129679.49651.50

Cited by 29 publications

(32 citation statements)

References 71 publications

(17 reference statements)

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“…1,2 In this context, the survival rate is as high as 85-100% at 5 years for lesions limited to the muscle layer. 2 Nevertheless, even after extensive surgery, a considerable number of patients with stage II-IV gallbladder carcinoma develop distant or intraabominal metastases that are resistant to conventional chemotherapy. 2 Sequential morphological alterations from precancerous dysplasia or adenoma to carcinoma have been regarded as models implicated in tumorigenesis of gallbladder carcinoma.…”

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confidence: 99%

“…[1][2][3] The effective therapy to cure gallbladder carcinoma is complete surgical resection at the early stage, whereas most patients present with advanced disease and have few therapeutic options. 1,2 In this context, the survival rate is as high as 85-100% at 5 years for lesions limited to the muscle layer. 2 Nevertheless, even after extensive surgery, a considerable number of patients with stage II-IV gallbladder carcinoma develop distant or intraabominal metastases that are resistant to conventional chemotherapy.…”

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confidence: 99%

“…1,2 Among various clinicopathologic parameters, tumour, node, metastasis (TNM) stage is indisputably accepted as an adverse prognosticator in patients with gallbladder carcinoma. [1][2][3] The effective therapy to cure gallbladder carcinoma is complete surgical resection at the early stage, whereas most patients present with advanced disease and have few therapeutic options. 1,2 In this context, the survival rate is as high as 85-100% at 5 years for lesions limited to the muscle layer.…”

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Skp2 is an independent prognosticator of gallbladder carcinoma among p27Kip1-interacting cell cycle regulators: an immunohistochemical study of 62 cases by tissue microarray

Sung

et al. 2007

Modern Pathology

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Despite improvement in surgical techniques, prognosis of gallbladder carcinoma remains poor. It is desirable to identify prognostic biomarkers to aid in the development of targeted therapeutic strategies. Two SCF Skp2 ubiquitin ligase-related proteins, Skp2 and cyclin-dependent kinase subunit 1 (Cks1), are involved in posttranscriptional degradation of p27Kip1 tumor suppressor, which inhibits both cdk2/cyclin E and cdk2/cyclin A complexes and thus prevents transition to the S phase. However, the prognostic utility of p27 Kip1-interacting cell cycle regulators has not been systematically assessed in gallbladder carcinoma. Immunohistochemistry was performed for p27 Kip1 , Skp2, Cks1, cyclin E, cyclin A, and Ki-67 in tissue microarrays of 62 gallbladder carcinomas with follow-up. The data were correlated with clinicopathological features and overall survival (OS). The cumulative OS rate for all 62 cases was 42.9% at 3 years. Aberrant labeling indices (LIs) of p27 Kip1 (o20%), cyclin E (Z5%), cyclin A (Z5%), Cks1 (Z40%), and Skp2 (Z10%) were identified in 29, 58, 66, 21, and 57% of gallbladder carcinomas, respectively. By log-rank tests, downregulation of p27 Kip1 (P ¼ 0.0319) and high LIs of Skp2 (P ¼ 0.0006), Cks1 (P ¼ 0.0460), cyclin E (P ¼ 0.0070), and Ki-67 (P ¼ 0.0037) were predictive of inferior OS. Furthermore, the combined expression status of Skp2 and Ki-67 robustly defined three prognostically different groups (P ¼ 0.0001). In multivariate comparison, Skp2 overexpression represented the strongest independent adverse prognosticator (P ¼ 0.004, risk ratio (RR): 5.538), followed by Ki-67 LI Z50% (P ¼ 0.016, RR: 3.254) and American Joint Committee on Cancer stages II-IV (P ¼ 0.013, RR: 3.163). In conclusion, aberrations of p27 Kip1 -interacting cell cycle regulators are common in gallbladder carcinomas. Skp2 overexpression is highly representative of biological aggressiveness and independently associated with poor OS, suggesting that it is a promising novel target for therapeutic intervention in aggressive cases. The combined assessment of Skp2 and Ki-67 LIs effectively risk-stratifies gallbladder carcinomas with different prognosis, which is worth being prospectively validated in future study.

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Skp2 is an independent prognosticator of gallbladder carcinoma among p27Kip1-interacting cell cycle regulators: an immunohistochemical study of 62 cases by tissue microarray

Sung

et al. 2007

Modern Pathology

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“…The significance of chemotherapy in cholangiocarcinoma is still not clear especially with the low response rates [5] , disappointing efficacy results and lack of a superior standard chemotherapeutic regimen [7,38] . Conflicting data exist regarding the role of chemotherapy in cholangiocarcinoma.…”

Section: Farhat Mh Et Al Prognosis In Cholangiocarcinomamentioning

confidence: 99%

Prognostic factors in patients with advanced cholangiocarcinoma: Role of surgery, chemotherapy and body mass index

Farhat¹,

Shamseddine²,

Tawil³

et al. 2008

WJG

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AIM:To study the factors that may affect survival of cholangiocarcinoma in Lebanon. METHODS: A retrospective review of the medical records of 55 patients diagnosed with cholangiocarcinoma at the American University of Beirut between 1990 and 2005 was conducted. Univariate and multivariate analyses were performed to determine the impact of surgery, chemotherapy, body mass index, bilirubin level and other factors on survival. RESULTS: The median survival of all patients was 8.57 mo (0.03-105.2). Univariate analysis showed that low bilirubin level (< 10 mg/dL), radical surgery and chemotherapy administration were significantly associated with better survival (P = 0.012, 0.038 and 0.038, respectively). In subgroup analysis on patients who had no surgery, chemotherapy administration prolonged median survival significantly (17.0 mo vs 3.5 mo, P = 0.001). Multivariate analysis identified only low bilirubin level < 10 mg/dL and chemotherapy administration as independent predictors associated with better survival (P < 0.05). CONCLUSION: Our data show that palliative and postoperative chemotherapy as well as a bilirubin level < 10 mg/dL are independent predictors of a significant increase in survival in patients with cholangiocarcinoma.

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“…Moreover, the majority of patients have frequent recurrences after the surgery, and pursue the chemotherapy or radiotherapy treatment when recurrences happened after the surgery (2,15). Several previous studies have demonstrated high risks of disease progression, using surgically-resected GBC cases, and histological grade, depth of wall infiltration, and lymph node status have been determined to be clinicopathological prognostic factors (6,22).…”

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Histological phenotype is correlated with the wall-invasion pattern of gallbladder adenocarcinoma

et al. 2014

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Gallbladder carcinoma (GBC) is one of the most aggressive malignancies, and frequently shows vascular invasion and lymph node metastasis. Our previous study has classified the wall-invasion pattern of GBC into two groups, i.e., infiltrative growth type (IG type) and destructive growth type (DG type). The DG type was significantly associated with poor clinical outcome. In this study, we analyzed the relationship between the wall-invasion pattern and the histological phenotype of GBC, using 61 surgically-resected primary gallbladder adenocarcinomas. Histologically, the 61 cases were classified into the biliary (44 cases, 72.1%), gastric foveolar (13 cases, 21.3%), and intestinal (4 cases, 6.6%) types. Biliary type frequently exhibited MUC1, but less frequently showed MUC2, MUC5AC, and MUC6. The biliary type and MUC1 expression were significantly correlated with DG type wall-invasion pattern (P = 0.020 and P < 0.001, respectively). In conclusion, histological phenotype and mucin expression were thought to be indicators of aggressiveness of GBC.Gallbladder carcinoma (GBC) is the most common malignancy of the biliary tract and the fifth most common malignancy of the digestive system. GBC is a relatively uncommon neoplasm in the majority of countries, and its incidence rate shows marked geographic and ethnic variation. Japan and several Latin American countries, such as Chile, Mexico and Bolivia, have the highest incidences of GBC in the world (11,27). In Japan, GBC is responsible for 1.25% and 3.49% of cancer death in male and female, respectively. The number of surgically resected cases of GBC has recently increased because of advances in imaging diagnosis and operative procedures. However, GBC is a highly lethal disease since it is usually diagnosed at advance stage (5).The 5-year survival rate of patients with GBC is 10-30% despite of surgical resection. Moreover, the majority of patients have frequent recurrences after the surgery, and pursue the chemotherapy or radiotherapy treatment when recurrences happened after the surgery (2, 15). Several previous studies have demonstrated high risks of disease progression, using surgically-resected GBC cases, and histological grade, depth of wall infiltration, and lymph node status have been determined to be clinicopathological prognostic factors (6,22). In addition, we have classified the wall-invasion pattern of GBC into two groups, i.e., infiltrative growth type (IG type) and destructive growth type (DG type) (18)(19)(20). The DG type was significantly associated with lymph node metastasis and poor prognosis. In this study, we analyzed the relationship between the wall-invasion pattern and the histological phenotype of GBC, using 61 surgically-resected primary gallbladder adenocarcinomas.

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Biliary tract neoplasms: update 2003

Cited by 29 publications

References 71 publications

Skp2 is an independent prognosticator of gallbladder carcinoma among p27Kip1-interacting cell cycle regulators: an immunohistochemical study of 62 cases by tissue microarray

Skp2 is an independent prognosticator of gallbladder carcinoma among p27Kip1-interacting cell cycle regulators: an immunohistochemical study of 62 cases by tissue microarray

Prognostic factors in patients with advanced cholangiocarcinoma: Role of surgery, chemotherapy and body mass index

Histological phenotype is correlated with the wall-invasion pattern of gallbladder adenocarcinoma

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