Hepatobiliary Cancers

Benson, Al B.; Abrams, Thomas A.; Ben‐Josef, Edgar; Bloomston, P. Mark; Botha, Jean F.; Clary, Bryan M.; Covey, Anne M.; Curley, Steven A.; D’Angelica, Michael I.; Davila, Rene; Ensminger, William D.; Gibbs, John F.; Laheru, Daniel A.; Malafa, Mokenge P.; Marrero, Jorge A.; Meranze, Steven G.; Mulvihill, Sean J.; Park, James O.; Posey, James; Sachdev, Jasgit C.; Salem, Riad; Sigurdson, Elin R.; Sofocleous, Constantinos T.; Vauthey, Jean Nicolas; Venook, Alan P.; Goff, Laura Williams; Yen, Yun; Zhu, Andrew X.

doi:10.6004/jnccn.2009.0027

Cited by 698 publications

(153 citation statements)

References 479 publications

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“…More recently, beneficial responses and excellent outcomes after external beam radiation therapy (EBRT) in HCC patients have been reported, and EBRT is now officially recommended as one of the therapeutic options for inoperable liver cancer by the National Comprehensive Cancer Network guidelines [19]. In addition, promising results after EBRT have been noted, particularly in PVTT management.…”

Section: Introductionmentioning

confidence: 96%

Radiotherapeutic Options for Hepatocellular Carcinoma with Portal Vein Tumor Thrombosis

Lee

Seong²

2014

Liver Cancer

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Portal vein tumor thrombosis (PVTT) is a common paraneoplastic condition in advanced primary hepatocellular carcinoma or hepatobiliary tract malignancies. Tumors with PVTT are frequently associated with adverse and aggressive features such as intrahepatic tumor dissemination, early treatment failure, or deterioration of hepatic function. Therefore, the treatment outcomes for PVTT in historical series are often dismal and discouraging. More recently, beneficial effects and excellent outcomes of external beam radiation therapy (EBRT) for treating this disease have been reported, and the use of EBRT is becoming more common because of the non-invasive nature of RT and rapid advances in RT technology. We hope to be able to cure this devastating condition in the near future with more advanced and efficacious disease management strategies. The current status and clinical trial results for EBRT as a promising treatment option for managing PVTT will be discussed here.

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Section: Introductionmentioning

confidence: 96%

Radiotherapeutic Options for Hepatocellular Carcinoma with Portal Vein Tumor Thrombosis

Lee

Seong²

2014

Liver Cancer

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“…Early post-cholecystectomy cross-sectional imaging with computed tomography (CT) or magnetic resonance imaging is generally the standard restaging policy often considered in conjunction with laparoscopy given the high rate of occult disseminated disease. 9,10 However, the index cholecystectomy more often than not complicates the management of these patients and nearly half of them do not undergo radical resection owing to disseminated disease. 11,13 First, the depth of invasion through the dissection plane during cholecystectomy and the commonly misleading inflammation may result in incomplete resection or a breach of the tumour plane with occult or overt seeding during the initial operation.…”

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confidence: 99%

Implications of the Index Cholecystectomy and Timing of Referral for Radical Resection of Advanced Incidental Gallbladder Cancer

Tsirlis

Ausania

White

et al. 2015

annals

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INTRODUCTION Advanced (pT2/T3) incidental gallbladder cancer is often deemed unresectable after restaging. This study assesses the impact of the primary operation, tumour characteristics and timing of management on re-resection. METHODS The records of 60 consecutive referrals for incidental gallbladder cancer in a single tertiary centre from 2003 to 2011 were reviewed retrospectively. Decision on re-resection of incidental gallbladder cancer was based on delayed interval restaging at three months following cholecystectomy. Demographics, index cholecystectomy data, primary pathology, CA19-9 tumour marker levels at referral and time from cholecystectomy to referral as well as from referral to restaging were analysed. RESULTS Thirty-seven patients with pT2 and twelve patients with pT3 incidental gallbladder cancer were candidates for radical re-resection. Following interval restaging, 24 patients (49%) underwent radical resection and 25 (51%) were deemed inoperable. The inoperable group had significantly more patients with positive resection margins at cholecystectomy (p=0.002), significantly higher median CA19-9 levels at referral (p=0.018) and were referred significantly earlier (p=0.004) than the patients who had resectable tumours. On multivariate analysis, urgent referral (p=0.036) and incomplete cholecystectomy (p=0.048) were associated significantly with inoperable disease following restaging. CONCLUSIONS In patients with incidental, potentially resectable, pT2/T3 gallbladder cancer, inappropriate index cholecystectomy may have a significant impact on tumour dissemination. Early referral of breached tumours is not associated with resectability.

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“…Because most patients are diagnosed with advanced disease, only 30% of patients receive potentially curative therapies, such as surgical resection [4,5], transplantation [6,7] or percutaneous ablation [8,9,10]. The majority of patients with unresectable HCC usually undergo palliative treatment, such as transarterial chemoembolization (TACE) [11], hepatic arterial infusion chemotherapy [12] and systemic chemotherapy, including molecular-targeting agents [12,13,14,15,16,17]. …”

Section: Introductionmentioning

confidence: 99%

Duration of Stable Disease Is Associated with Overall Survival in Patients with Advanced Hepatocellular Carcinoma Treated with Sorafenib

Arizumi

Ueshima

Chishina

et al. 2014

Dig Dis

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Background: Sorafenib is a molecular-targeting agent showing improved overall survival (OS) for advanced hepatocellular carcinoma (HCC). Although tumor dormancy, characterized by stable tumor status or stable disease (SD) without tumor regression, is a unique feature of sorafenib treatment, the contribution of SD to OS remains debatable. This study aimed to clarify the correlation between SD periods and OS in patients with HCC treated with sorafenib. Methods: From May 2009 to January 2013, 269 patients with advanced-stage HCC were treated with sorafenib at the Kinki University Hospital. The antitumor response of sorafenib was evaluated in 158 patients using the modified Response Evaluation Criteria in Solid Tumors, and patients with SD were divided into two subgroups according to the median duration of SD: short SD (<3 months) and long SD (≥3 months). The relationship between the duration of SD and OS was analyzed among patients with complete (CR) and partial response (PR), and long and short SD using the Kaplan-Meier method. Results: The median OS was 5.7 months in the short SD, 20.8 months in the long SD and 17.9 months in the CR + PR group. Although the duration of OS was significantly longer in the long SD group than the short SD group, no difference in OS was detected between the patients with CR + PR and patients with long SD. The impact of long SD on OS could be as strong as that of CR + PR. Conclusion: Achievement of long SD is one of the important goals for improving survival in patients with HCC treated with sorafenib.

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Hepatobiliary Cancers

Cited by 698 publications

References 479 publications

Radiotherapeutic Options for Hepatocellular Carcinoma with Portal Vein Tumor Thrombosis

Radiotherapeutic Options for Hepatocellular Carcinoma with Portal Vein Tumor Thrombosis

Implications of the Index Cholecystectomy and Timing of Referral for Radical Resection of Advanced Incidental Gallbladder Cancer

Duration of Stable Disease Is Associated with Overall Survival in Patients with Advanced Hepatocellular Carcinoma Treated with Sorafenib

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