Treatment and Prognosis for Patients With Intrahepatic Cholangiocarcinoma

Mavros, Michael N.; Economopoulos, Konstantinos P.; Alexiou, Vangelis G.; Pawlik, Timothy M.

doi:10.1001/jamasurg.2013.5137

Cited by 620 publications

(538 citation statements)

References 63 publications

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“…With respect to human mass‐forming ICC, larger tumor size has been reported by some3, 22, 23 but not by others 24, 25 to independently predict poor recurrence‐free survival following curative‐intent tumor resection. Our data shown in Fig.…”

Section: Discussionmentioning

confidence: 93%

Overexpression of periostin and distinct mesothelin forms predict malignant progression in a rat cholangiocarcinoma model

Manzanares

Campbell

Maldonado

et al. 2017

Hepatology Communications

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Periostin and mesothelin have each been suggested to be predictors of poor survival for patients with intrahepatic cholangiocarcinoma, although the clinical prognostic value of both of these biomarkers remains uncertain. The aim of the current study was to investigate these biomarkers for their potential to act as tumor progression factors when assessed in orthotopic tumor and three‐dimensional culture models of rat cholangiocarcinoma progression. Using our orthotopic model, we demonstrated a strong positive correlation between tumor and serum periostin and mesothelin and increasing liver tumor mass and associated peritoneal metastases that also reflected differences in cholangiocarcinoma cell aggressiveness and malignant grade. Periostin immunostaining was most prominent in the desmoplastic stroma of larger sized more aggressive liver tumors and peritoneal metastases. In comparison, mesothelin was more highly expressed in the cholangiocarcinoma cells; the slower growing more highly differentiated liver tumors exhibited a luminal cancer cell surface immunostaining for this biomarker, and the rapidly growing less differentiated liver and metastatic tumor masses largely showed cytoplasmic mesothelin immunoreactivity. Two molecular weight forms of mesothelin were identified, one at ∼40 kDa and the other, a more heavily glycosylated form, at ∼50 kDa. Increased expression of the 40‐kDa mesothelin over that of the 50 kDa form predicted increased malignant progression in both the orthotopic liver tumors and in cholangiocarcinoma cells of different malignant potential in three‐dimensional culture. Moreover, coculturing of cancer‐associated myofibroblasts with cholangiocarcinoma cells promoted overexpression of the 40‐kDa mesothelin, which correlated with enhanced malignant progression in vitro. Conclusion: Periostin and mesothelin are useful predictors of tumor progression in our rat desmoplastic cholangiocarcinoma models. This supports their relevance to human intrahepatic cholangiocarcinoma. (Hepatology Communications 2018;2:155–172)

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Section: Discussionmentioning

confidence: 93%

Overexpression of periostin and distinct mesothelin forms predict malignant progression in a rat cholangiocarcinoma model

Manzanares

Campbell

Maldonado

et al. 2017

Hepatology Communications

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“…There are no survivors at 3 years in patients without surgical resection. Surgical resection has been shown to achieve a 3‐year survival of 40‐50% 7, 8. Tan et al,9 using SEER Medicare data, identified 3756 patients with ICC, and only 12% underwent cancer‐directed surgery.…”

Section: Intrahepatic Cholangiocarcinomamentioning

confidence: 99%

“…However, surgical results of hepatectomy for liver metastasis have not been fully justified. Kurosaki et al38 reported 13 patients with bile duct cancer7 and ampullary cancer6 who underwent hepatectomy for hepatic recurrence after initial pancreaticoduodenectomy. In their series, four of the 13 cases survived more than 5 years.…”

Section: Extrahepatic Bile Duct Cancermentioning

confidence: 99%

Clinical implication of surgical resection for recurrent biliary tract cancer: Does it work or not?

Miyazaki

Shimizu

Yoshitomi

et al. 2017

Annals of Gastroent Surgery

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Although recent advances in imaging diagnosis, surgical techniques, and perioperative management can result in increased resectability and improved surgical outcomes, most resected patients still develop cancer recurrence. If patients develop cancer recurrence, their prognosis is very ominous. However, there have been some recent reports to show promising outcomes by aggressive surgical strategy in selected patients who developed cancer recurrence. Because there are various surgical procedures being selected at initial surgery in patients with biliary tract cancers, recurrent patterns after resection are very variable in each patient. However, surgical procedures might usually be very complicated and difficult if re‐surgical resection is considered in patients with recurrent biliary tract cancer, Therefore, surgical re‐resection could bring about high surgical morbidity and mortality rates in most previously reported series. Although re‐surgical resection might offer a chance of favorable outcome in selected patients with biliary tract cancers, these aggressive surgical approaches should be carried out in strictly selected patients by expert surgeons at high‐volume centers.

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“…Its incidence and mortality are increasing worldwide [2] and complete surgical resection remains the only potential curative treatment with a 5-year survival rate of 30%-40% [3]. Since these tumors are clinically silent, patients are usually diagnosed with bulky lesions, infiltrating vascular structures or intra-or extrahepatic metastases.…”

Section: Introductionmentioning

confidence: 99%

Multimodal Therapy including Yttrium-90 Radioembolization as a Bridging Therapy to Liver Transplantation for a Huge and Locally Advanced Intrahepatic Cholangiocarcinoma

Rayar

Sandri

Houssel‐Debry

et al. 2016

JGLD

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Treatment of intrahepatic cholangiocarcinoma remains a major challenge. For an unresectable lesion without extrahepatic spread, liver transplantation could be a potential solution but it is still associated with poor oncologic results owing to the absence of effective neoadjuvant treatment. We report the case of a young man with locally advanced intrahepatic cholangiocarcinoma presenting with multiple intrahepatic metastases and vascular structure involvement. The lesion was significantly downstaged by a multimodal therapy including intra-arterial Yttrium-90 radioembolization, systemic chemotherapy and external radiotherapy, allowing liver transplantation. Three years after the procedure, oncologic outcome is excellent with no sign of recurrence.Multimodal therapy including Yttrium-90 radioembolization could be relevant as neoadjuvant treatment before liver transplantation for unresectable intrahepatic cholangiocarcinoma. Abbrevations: CA 19-9: carbohydrate antigen 19-9; FDG-PET: fluorodeoxyglucose positron emission tomography; HCC: hepatocellular carcinoma; ICC: intrahepatic cholangiocarcinoma; LT: liver transplantation; MRI: magnetic resonance imaging; PHC: perihilar cholangiocarcinoma; Ytt-90: Yttrium-90.

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Treatment and Prognosis for Patients With Intrahepatic Cholangiocarcinoma

Abstract: The prognosis of ICC is dictated mainly by tumor factors. Future research could focus on the usefulness of adjuvant treatment as well as other multidisciplinary treatment modalities.

Cited by 620 publications

References 63 publications

Overexpression of periostin and distinct mesothelin forms predict malignant progression in a rat cholangiocarcinoma model

Overexpression of periostin and distinct mesothelin forms predict malignant progression in a rat cholangiocarcinoma model

Clinical implication of surgical resection for recurrent biliary tract cancer: Does it work or not?

Multimodal Therapy including Yttrium-90 Radioembolization as a Bridging Therapy to Liver Transplantation for a Huge and Locally Advanced Intrahepatic Cholangiocarcinoma

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