Preemptive Surgery for Premalignant Foregut Lesions

Sharma, Rohit; London, Mark; Magenta, Laura L.; Posner, Mitchell C.; Roggin, Kevin K.

doi:10.1007/s11605-009-0935-2

Cited by 7 publications

(4 citation statements)

References 158 publications

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“…Up to 36% of patients with low‐grade dysplasia (LGD) and HGD are found to have CCA in liver explants 43. Therefore, there are advocates for preemptive liver transplantation in those patients with HGD found on biliary biopsy 43, 44. HGD, which can be considered carcinoma in situ , often represents a field defect throughout the biliary tree, making segmental resection an unattractive option.…”

Section: Cca In Patients With Pscmentioning

confidence: 99%

Cancer surveillance in patients with primary sclerosing cholangitis

2011

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Primary sclerosing cholangitis (PSC) is a chronic fibroinflammatory syndrome involving the biliary tract, often accompanied by inflammatory bowel disease. This syndrome is a prototype disease linking chronic inflammation to carcinogenesis. Indeed, PSC is associated with an increased risk of cholangiocarcinoma, gallbladder cancer, hepatocellular carcinoma, and colorectal cancer. Herein, we review the risk for these malignancies in PSC and discuss rational cancer surveillance strategies for these patients. Where evidence is limited, we suggest a pragmatic approach. In this regard we recommend interval screening for cholangiocarcinoma with non-invasive imaging modalities and serum carbohydrate antigen 19-9 determinations annually. These imaging studies also serve to screen for gallbladder cancer and hepatocellular carcinoma. Screening for colorectal cancer is more firmly established in PSC patients with inflammatory bowel disease and includes colonoscopy at the time of PSC diagnosis and, thereafter, at 1-2 year intervals. We also highlight areas where more information is required such as management of biliary tract dysplasia and cancer chemoprevention in PSC.

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Section: Cca In Patients With Pscmentioning

confidence: 99%

Cancer surveillance in patients with primary sclerosing cholangitis

2011

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“…It may be straightforward that early treatment of premalignant lesions can lead to improved survival by reducing local tumor spread 14, 70. However, considering that some dysplastic nodules do not show any interval change over several years or even disappear during follow‐up,6, 49 and that the mortality and morbidity associated with RFA of liver tumors may not be negligible,15, 16 early treatment of HGDN intrinsically can raise a concern about overtreatment 70. The current simulation study shows that the additional 5‐year overall survival benefit in Group I compared with Group II was only 0.20% when the overall malignant transformation rate was set at 50%.…”

Section: Discussionmentioning

confidence: 99%

Radiofrequency ablation of high-grade dysplastic nodules

Cho¹,

Chung²,

Kim³

et al. 2011

Hepatology

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“…La ablación del epitelio quístico pancreático mediante la inyección de agentes citotóxicos guiado por EUS, como el etanol (21) o paclitaxel (22), muestra resultados tempranos promisorios, aunque se requieren datos de seguimiento a largo plazo para evaluar la eficacia y determinar las indicaciones precisas para el uso de esta terapia (2).…”

Section: Figura 4 Microscopia (Coloración De Hematoxilina Y Eosina 200x)unclassified

Neoplasias mucinosas del páncreas: caso clínico y revisión de la literatura

Sáenz¹,

Molano

González

et al. 2018

Rev. Colomb. Gastroenterol.

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Las neoplasias quísticas mucinosas del páncreas son lesiones relativamente frecuentes, afectan principalmente a mujeres perimenopausicas, la mayoría son únicos, localizados en el cuerpo y la cola del páncreas, no tiene comunicación con el sistema ductal pancreático. Menos del 20% están asociadas a malignidad. La evaluación debe incluir, la presentación clínica, las imágenes, la utilización de la ultrasonografía endoscópica y toma de biopsias por punción, la citología y el análisis químico del liquido para medición de niveles ACE. La resección quirúrgica completa es el único tratamiento que mejora la sobrevida a largo plazo en pacientes con lesiones quísticas mucinosas malignas. Se realiza una revisión de la literatura a propósito de un caso diagnosticado por el grupo de gastroenterología clínico quirúrgica, Clínica la Presentación, Manizales, Colombia.

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Preemptive Surgery for Premalignant Foregut Lesions

Abstract: Preemptive operations require optimal judgment and surgical precision to maximize function and enhance survival. Ultimately, balancing the risk of surgical intervention with less invasive interventions or observation must be individualized on a case-by-case basis.

Cited by 7 publications

References 158 publications

Cancer surveillance in patients with primary sclerosing cholangitis

Cancer surveillance in patients with primary sclerosing cholangitis

Radiofrequency ablation of high-grade dysplastic nodules

Neoplasias mucinosas del páncreas: caso clínico y revisión de la literatura

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