Outcomes of neoadjuvant therapy for cholangiocarcinoma: A review of existing evidence assessing treatment response and R0 resection rate

Le, Viet Ha; O’Connor, Victoria; Li, Daneng; Melstrom, Laleh G.; Fong, Yuman; DiFronzo, A.L.

doi:10.1002/jso.26230

Cited by 22 publications

(27 citation statements)

References 51 publications

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“…According to The American Joint Committee on Cancer (AJCC) and The Union for International Cancer Control (UICC) definition, dCCA arises from the extrahepatic biliary tree from the confluence of the common hepatic bile duct with the cystic duct to form the common bile duct and all the way through the pancreatic portion to the ampulla of Vater ( 17 ). It has been reported to occur relatively more frequently in Western countries and North America, accounting for approximately 30% of all CCA ( 18 – 20 ). The incidence is low in Southeast Asia, accounting for approximately 10% of all CCA in Thailand ( 15 , 16 ).…”

Section: Introductionmentioning

confidence: 99%

“…Surgery is usually the first choice for palliative treatment, while chemotherapy and radiotherapy are secondary options ( 22 ). The 5-year survival time and rate are approximately 20 months and 25%, respectively ( 16 , 18 – 20 , 23 ). In addition, alternative therapy such as immunotherapy with immune checkpoint inhibitors (ICI), has been suggested by Rizzo A. and the team for advanced CCA treatment.…”

Section: Introductionmentioning

confidence: 99%

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Prognostic Significance of Growth Pattern in Predicting Outcome of Opisthorchis viverrini-Associated Distal Cholangiocarcinoma in Thailand

Kunprom

Aphivatanasiri

Sa-Ngiamwibool

et al. 2022

Front. Public Health

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Distal cholangiocarcinoma (dCCA) is a rare type of CCA in Asia, even in Opisthorchis viverrini-prevalent Northeastern Thailand. The clinical ambiguity and imprecision of diagnosis surrounding this malignancy result in high mortality due often to advanced/metastatic disease on presentation. We aim to identify a prognostic factor that can improve the performance stratification and influence the outcome of dCCA patients after curative resection. A total of 79 patients who underwent curative-intended surgery for dCCA was enrolled. Possible risk factors for survival were analyzed with log-rank test, and independent factors with Cox regression model. dCCA patients were staged and classified according to the 8th edition the American Joint Committee on Cancer (AJCC) Staging Manual. Results were then compared with the revised classification employing the prognostic factor identified from multivariate analysis. Multivariate analysis revealed that growth pattern (p < 0.01) and distant metastasis (p = 0.012) were independent factors. Growth patterns comprise intraductal (ID), periductal infiltrating (PI), mass-forming (MF), and mixed types. When dCCA patients were grouped into those having good and poor outcomes (with and without ID components, respectively). The survival outcomes significantly differed among patients with and without ID components, which was better than with the 8th AJCC staging system in our cohort. Furthermore, Chi-square test showed that patterns without ID components (PI, MF, PI + MF) correlated with lymph node and distant metastasis. Therefore, classification of dCCA patients after curative-intended surgical resection based on growth pattern provides additional beneficial information for the prediction of survival in dCCA patients.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Prognostic Significance of Growth Pattern in Predicting Outcome of Opisthorchis viverrini-Associated Distal Cholangiocarcinoma in Thailand

Kunprom

Aphivatanasiri

Sa-Ngiamwibool

et al. 2022

Front. Public Health

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“…To date, the utility of NAC for biliary tract cancer has not been established. 27 In recent years, the utility of gemcitabine plus S-1 combination therapy as NAC in pancreatic cancer has been reported. 28 There are also ongoing clinical trials, 29 and NAC may be studied for biliary tract cancer in the future.…”

Section: Discussionmentioning

confidence: 99%

Utility of the inside stent as a preoperative biliary drainage method for patients with malignant perihilar biliary stricture

Nakamura

Ishii

Serikawa

et al. 2021

J Hepato Biliary Pancreat

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Malignant diseases that cause perihilar biliary strictures include perihilar cholangiocarcinoma, gallbladder cancer, primary malignant liver cancer (hepatocellular carcinoma and intrahepatic cholangiocarcinoma), pancreatic cancer, and hilar lymph node metastasis. Of these diseases, surgical resection is the only curative treatment for perihilar cholangiocarcinoma, gallbladder cancer, and primary malignant liver cancer. Although lobectomy and biliary reconstruction are the basic surgical procedures, accurate diagnosis of cancer progression by various diagnostic imaging techniques and appropriate preoperative biliary drainage (PBD) are required for surgical planning.Most patients with malignant perihilar biliary stricture are accompanied by jaundice and liver dysfunction. It has been

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“…Neoadjuvant therapy data are mainly limited to small size cohort studies with different treatment modalities-including radiotherapy, chemotherapy, chemoradiation, and local liver-directed therapies-and heterogeneous approaches, with a R0 resection rate ranging from 30 to 80% [48].…”

Section: Neoadjuvant and Adjuvant Therapymentioning

confidence: 99%

Vascular Resection for Intrahepatic Cholangiocarcinoma: Current Considerations

Alikhanov

Dudareva

Trigo

et al. 2021

JCM

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Intrahepatic cholangiocarcinoma (iCCA) accounts for approximately 10% of all primary liver cancers. Surgery is the only potentially curative treatment, even in cases of macrovascular invasion. Since resection offers the only curative chance, even extended liver resection combined with complex vascular or biliary reconstruction of the surrounding organs seems justified to achieve complete tumour removal. In selected cases, the major vascular resection is the only change to try getting the cure. The best results are achieved by the referral centre with a wide experience in complex liver surgery, such as ALPPS procedure, IVC resection, and ante-situ and ex-situ resections. However, despite aggressive surgery, tumour recurrence occurs frequently and long-term oncological results are very poor. This suggests that significant progress in prognosis cannot be expected by surgery alone. Instead, multimodal treatment including neoadjuvant chemotherapy, radiotherapy, and subsequent adjuvant treatment for iCCA seem to be necessary to improve results.

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Outcomes of neoadjuvant therapy for cholangiocarcinoma: A review of existing evidence assessing treatment response and R0 resection rate

Cited by 22 publications

References 51 publications

Prognostic Significance of Growth Pattern in Predicting Outcome of Opisthorchis viverrini-Associated Distal Cholangiocarcinoma in Thailand

Prognostic Significance of Growth Pattern in Predicting Outcome of Opisthorchis viverrini-Associated Distal Cholangiocarcinoma in Thailand

Utility of the inside stent as a preoperative biliary drainage method for patients with malignant perihilar biliary stricture

Vascular Resection for Intrahepatic Cholangiocarcinoma: Current Considerations

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