The Clinical Management of Cholangiocarcinoma in the United States and Europe: A Comprehensive and Evidence-Based Comparison of Guidelines

Fong, Zhi Ven; Brownlee, Sarah A.; Qadan, Motaz; Tanabe, Kenneth K.

doi:10.1245/s10434-021-09671-y

Cited by 41 publications

(21 citation statements)

References 117 publications

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“…Most of the early clinical manifestations of cholangiocarcinoma are atypical, and patients seek medical treatment owing to epigastric discomfort, abdominal pain, abdominal distension, loss of appetite, and other symptoms[ 25 ]. A minority of patients with cholangiocarcinoma caused by the tumor may develop symptoms of typical obstructive jaundice with severe colic[ 26 ].…”

Section: Discussionmentioning

confidence: 99%

Da Vinci robot-assisted pancreato-duodenectomy in a patient with situs inversus totalis: A case report and review of literature

Li¹,

Lu²,

He³

et al. 2022

WJGO

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BACKGROUND Situs inversus totalis (SIT) is an extremely rare congenital malformation characterized by mirror displacement of the thoracoabdominal organs such as the heart, liver, spleen, and stomach. Herein, we describe a patient with SIT complicated with cholangiocarcinoma who underwent successful pancreaticoduodenectomy with the assistance of a da Vinci robot. CASE SUMMARY A 58-year-old female presented to the hospital with paroxysmal pain in her left upper abdomen, accompanied by jaundice and staining of the sclera as chief complaints. Imaging examination detected a mass at the distal end of the common bile duct, with inverted thoracic and abdominal organs. Endoscopic retrograde cholangiopancreatography forceps biopsy revealed the presence of a well-differentiated adenocarcinoma. The patient successfully underwent robotic-assisted pancreaticoduodenectomy; the operation lasted 300 min, the intraoperative blood loss was 500 mL, and there were no intraoperative and postoperative complications. CONCLUSION SIT is not directly related to the formation of cholangiocarcinoma. Detailed preoperative imaging examination is conducive to disease diagnosis and also convenient for determining the feasibility of tumor resection. Robot-assisted pancreaticoduodenectomy for SIT complicated with cholangiocarcinoma provides a safe, feasible, minimally invasive, and complication-free alternative with adequate preoperative planning combined with meticulous intraoperative procedures.

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Section: Discussionmentioning

confidence: 99%

Da Vinci robot-assisted pancreato-duodenectomy in a patient with situs inversus totalis: A case report and review of literature

Li¹,

Lu²,

He³

et al. 2022

WJGO

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“…Several working groups, such as the National Comprehensive Cancer Network (NCCN), the European Society for Medical Oncology (ESMO), the British Society of Gastroenterology (BSG), and the International Liver Cancer Association (ILCA) have noted the importance of the utility of different modalities, such as serum tumour markers (serum CA19-9, carcinoembryonic antigen), imaging (magnetic resonance cholangiopancreatography), and tumour biopsy for ICC diagnostic workup [ 39 ]. Interestingly, tumour biopsy for potentially resectable lesions does not have full consensus.…”

Section: Future Perspectivesmentioning

confidence: 99%

Intrahepatic cholangiocarcinoma: Tumour heterogeneity and its clinical relevance

Komuta

2022

Clin Mol Hepatol

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Treatment of intrahepatic cholangiocarcinoma (iCCA) is currently at a significant turning point due to the identification of IDH mutations and FGFR fusions that can be targeted with currently available therapies. Clinical trials of these targeted therapies have been promising, and the iCCA patients who may benefit from these targeted treatments can be identified by pathological examination prior to molecular investigations. This is because IDH mutations and FGFR fusions are mainly seen in the small duct type iCCA; a subtype of iCCA defined by the 5 th WHO classification, and which can be recognized by the pathological diagnostic process. Therefore, pathology plays an important role in precision medicine for iCCA, not only in confirming the diagnosis, but also identifying iCCA patients that may benefit from targeted treatments. However, caution is advised with the pathological diagnosis as iCCA shows tumour heterogeneity, making it difficult to distinguish small duct type iCCA from hepatocellular carcinoma (HCC), and combined HCC-CCA. This review focuses on the pathological/molecular features of both subtypes of iCCA (large and small duct type), as well as diagnostic pitfalls, their clinical relevance, and future perspectives.

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“…Additional promising tumor markers currently being evaluated for CCA include isocitrate dehydrogenase, programmed cell death protein 1, epidermal growth factor receptor, mechanistic target of rapamycin, mitogen-activated protein kinase and breast cancer pathways[ 41 , 49 ]. The identification of novel therapeutic pathways for CCA would provide a promising paradigm shift in the treatment of patients who are not candidates for resection or LT[ 50 ].…”

Section: Alternative Treatment Strategiesmentioning

confidence: 99%

Current status of liver transplantation for cholangiocarcinoma

Twohig¹,

Peeraphatdit²,

Mukherjee³

2022

WJGS

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Cholangiocarcinoma (CCA) is the second most common liver cancer with a median survival of 12-24 mo without treatment. It is further classified based on its location into intrahepatic CCA (iCCA), perihilar CCA (pCCA), and distal CCA. Surgical resection is the mainstay of treatment, but up to 70% of these tumors are inoperable at the time of diagnosis. CCA was previously an absolute contraindication for liver transplantation (LT) due to poor outcomes primary due to early recurrent disease. However, improvement in patient selection criteria and neoadjuvant treatment protocols have improved outcomes for inoperable pCCA patients with recent studies reporting LT may improve survival in iCCA. Future advances in the treatment of CCA should include refining patient selection criteria and organ allocation for all subtypes of CCA, determining effective immunotherapies and the evolving role of personalized medicine in patients ineligible for surgical resection or LT. Our article reviews the current status of LT in CCA, along with future directions in managing patients with CCA.

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The Clinical Management of Cholangiocarcinoma in the United States and Europe: A Comprehensive and Evidence-Based Comparison of Guidelines

Cited by 41 publications

References 117 publications

Da Vinci robot-assisted pancreato-duodenectomy in a patient with situs inversus totalis: A case report and review of literature

Da Vinci robot-assisted pancreato-duodenectomy in a patient with situs inversus totalis: A case report and review of literature

Intrahepatic cholangiocarcinoma: Tumour heterogeneity and its clinical relevance

Current status of liver transplantation for cholangiocarcinoma

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