Zentrales Gallengangskarzinom (Klatskin-Tumor)

Stavrou, Gregor A.; Donati, Marcello; Faiss, Siegbert; Jenner, R.; Niehaus, Klaus; Oldhafer, Karl J.

doi:10.1007/s00104-012-2390-y

Cited by 8 publications

(6 citation statements)

References 37 publications

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“…It originates from the bifurcation of the extrahepatic bile duct and was first described in 1965 by Gerald Klatskin who reported 15 cases and defined some features in these cholangiocarcinomas [2–4]. Most KCCs are adenocarcinomas with poor differentiation degree, spreading along the duct and nerve sheath [5]. There are some risk factors, including primary sclerosing cholangitis (PSC), liver fluke infection (C. sinensis and Opisthorchis viverrini), and intrahepatic bile duct stones, but most KCCs are sporadic with no obvious predisposing factors [6].…”

Section: Introductionmentioning

confidence: 99%

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Klatskin Tumor: A Population-Based Study of Incidence and Survival

Zhang

Liu

2019

Med Sci Monit

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Background Klatskin tumor (KCC) is a rare type of tumor, with an annual incidence rate of no more than 1: 100 000. Because of its rarity, KCC is difficult to investigate. The present study provides new insights into KCC by a using public database. Material/Methods We used the Surveillance, Epidemiology, and End Results (SEER) database to conduct the analysis. Klatskin tumor patients were identified and compared with patients that had other kinds of cholangiocarcinomas (OCC). We identified differences between the 2 groups of patients and assessed tumor characteristics. We used Cox regression analysis to identify the prognostic indicators for KCC. The propensity score 1-to-1 matching method was used to compare the survival difference between KCC and OCC. Result We extracted data on 26 137 patients diagnosed with cholangiocarcinomas between 1973 and 2014 from the SEER database: 1341 cases were diagnosed with KCC and 24 796 cases were diagnosed with OCC. The number of diagnoses has gradually increased in both groups. There were significant differences in pathology grades, T stage, N stage, M stage, and SEER historic stage between the KCC and OCC groups. Survival analysis showed that the OCC group had better survival compared to the KCC group, both in matched and unmatched cohorts. The Cox regression results showed that older age, higher M stages, and higher pathology grades were associated with worse prognosis for KCC patients. Conclusions KCC patients have worse survival compared to OCC patients. Older age, higher M stages, and higher pathology grades were associated with worse survival in KCC patients.

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Section: Introductionmentioning

confidence: 99%

“…Current surgical strategies usually include choledochectomy, extended hepatectomy, and portal resection. Due to the local anatomy, the proximal and lateral safety margin R0 resection is a surgery that demands excellent technique [5]. Molina et al reported that lymph node involvement and metastasis were important prognostic factors.…”

Section: Introductionmentioning

confidence: 99%

Klatskin Tumor: A Population-Based Study of Incidence and Survival

Zhang

Liu

2019

Med Sci Monit

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“…Although surgical resection with negative margins is the only hope for a cure, only a small subset of patients is amenable to surgery at the time of diagnosis [21,22]. Complete surgical resection is the most critical prognostic factor for survival; however, total or neartotal resection is challenging because of the close anatomical relationship of the bile duct bifurcation with the portal vein bifurcation and hepatic arteries [5,22]. In the current study, most of the KT patients who were offered treatment received radiation alone as a primary treatment, followed by surgery, and the survival was poor (1.08±1.26 years).…”

Section: Discussionmentioning

confidence: 99%

“…KT also accounts for approximately 2% of all cancer diagnoses, with an overall incidence of 2-4 cases/100,000 population/year patients and is seen slightly more frequently in males (male:female ratio of 1.3:1) [4]. Almost two-thirds of KT cases occur in patients over the age of 65 years, with a near 10% increase in patients over 80 years of age [5].…”

Section: Introductionmentioning

confidence: 99%

Klatskin Tumor in the Light of ICD-O-3: A Population-Based Clinical Outcome Study Involving 1,144 Patients from the Surveillance, Epidemiology, and End Result (SEER) Database (2001-2012)

Khan

Ullah

Matolo

et al. 2021

Cureus

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IntroductionKlatskin tumors (KTs) occur at the confluence of the right and left extrahepatic ducts and are classified based on their anatomical and histological codes in the International Classification of Diseases for Oncology (ICD-O). The second edition of the ICD-O (ICD-O-2) allocated a distinctive histological code to KT, which also included intrahepatic cholangiocarcinoma (CC). This unclear coding may result in ambiguous reporting of the demographic and clinical features of KT. The current study aimed to investigate the demographic, clinical, and pathological factors affecting the prognosis and survival of KT in the light of the updated third edition of ICD-O, Ninth Revision (ICD-O-3). MethodsData of 1,144 patients with KT from the Surveillance, Epidemiology, and End Result (SEER) database (2001)(2002)(2003)(2004)(2005)(2006)(2007)(2008)(2009)(2010)(2011)(2012) were extracted. Patients with KT were analyzed for age, sex, race, stage, treatment, and long-term survival. The data were analyzed using chi-square tests, t-tests, and univariate and multivariate analyses. The Kaplan-Meier analysis was used to compare long-term survival between KT and subgroups of all biliary CCs. ResultsOf all biliary CCs, KT comprised 9.35%, with a mean age of diagnosis of 73±13 years, and was more common in men (54.8%) and Caucasian patients (69.5%). Histologically, moderately differentiated tumors were the most common (38.9%) followed by poorly differentiated (35.7%), well-differentiated (23.3%), and undifferentiated tumors (2.2%) (p<0.001). Most tumors in the KT group were 2-4 cm in size (41.5%), while fewer were >4 cm (29.7%) and <2 cm (28.8%) (p<0.001). ICD-O-3 defined most KTs in extrahepatic location (53.5%), while the remainder were in other biliary locations (46.5%) (p<0.001). Most KT patients received no treatment (73%), and for those who were treated, the most frequent modality was radiation (52.7%), followed by surgery (28.1%), and both surgery and radiation (19.2%) (p<0.001). Mean survival time for KT patients treated with surgery was inferior to all CCs of the biliary tree (1.72±2.61 vs. 1.87±2.18 years) (p=0.047). Multivariate analysis identified regional metastasis (OR=2.8; 95% CI=2.6-3.0), distant metastasis (OR=2.1; 95% CI=1.9-2.4), lymph node positivity (OR=1.6; 95% CI=1.4-1.8), Caucasian race (OR=2.0; 95% CI=1.8-2.2), and male sex (OR=1.2; 95% CI=1.1-1.3) were independently associated with increased mortality for KT (p<0.001). ConclusionThe ICD-O-3 has permitted a greater understanding of KT. KT is a rare and lethal biliary malignancy that presents most often in Caucasian men in their seventh decade of life with moderately differentiated histology. Surgical resection does not provide any survival advantage compared to similarly treated biliary CCs. In addition, the combination of surgery and radiation appeared to provide no added survival benefits compared to other treatment modalities for KT.

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“…Ведущим симптомом, вынуждающим пациентов обратиться к врачу, является желтуха. Гистологически опухоли внепеченочных желчных протоков (ОВЖП) представляют собой аденокарциному различной степени дифференцировки, диффузно растущие вдоль протока, а также периневральной оболочки [2].…”

Section: Introductionunclassified

Photodynamic therapy in the palliative treatment of a stage IV Klatskin tumor

Stranadko

Лобаков

Morokhotov

et al. 2022

jour

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РезюмеОбоснование: Опухоль Клацкина -холангиокарцинома долевых и общего печеночного протоков (рак ворот печени), локализующаяся проксимальнее места слияния общего печеночного и пузырного протоков (до начала сегментарных печеночных протоков второго порядка). В настоящее время в комплексной терапии пациентов с неоперабельными стадиями внепеченочной холангиокарциномы рекомендовано использование фотодинамической терапии (ФДТ), что достоверно увеличивает продолжительность жизни в сравнении с изолированной паллиативной терапией.Описание клинического случая: Представленный клинический случай демонстрирует успешное применение ФТД у пациентки с холангиокарциномой бифуркации общего печеночного протока T4N1M1, Bismuth-IV в сочетании с наружным дренированием желчных протоков с целью разрешения механической желтухи.Заключение: Показан значительный эффект ФТД у пациентки с неоперабельной опухолью Клацкина. Применение ФТД увеличивает продолжительность жизни в сравнении со средней выживаемостью на фоне проведения паллиативной терапии.Ключевые слова: Клинический случай, фотодинамическая терапия, внепеченочная холангиокарцинома Конфликт интересов. Авторы заявляют об отсутствии конфликта интересов.Странадко Евгений Филиппович, д. м. н., профессор, руководитель отделения лазерной онкологии и фотодинамической терапии Лобаков Александр Иванович, д. м. н., профессор кафедры хирургии факультета усовершенствования врачей Морохотов Владимир Александрович, доцент кафедры хирургии факультета усовершенствования врачей, врач-хирург Рябов Михаил Владимирович, к. м. н., старший научный сотрудник отделения лазерной онкологии и фотодинамической терапии Карпов Николай Владимирович, младший научный сотрудник, врач-хирург Морозов Сергей Валентинович, д. м. н., профессор кафедры хирургии факультета усовершенствования врачей, врачхирург, онколог Шубин Валерий Константинович, научный сотрудник, врач-хирург Богомазов Юрий Константинович, к. м. н., врач-колопроктолог

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Zentrales Gallengangskarzinom (Klatskin-Tumor)

Cited by 8 publications

References 37 publications

Klatskin Tumor: A Population-Based Study of Incidence and Survival

Klatskin Tumor: A Population-Based Study of Incidence and Survival

Klatskin Tumor in the Light of ICD-O-3: A Population-Based Clinical Outcome Study Involving 1,144 Patients from the Surveillance, Epidemiology, and End Result (SEER) Database (2001-2012)

Photodynamic therapy in the palliative treatment of a stage IV Klatskin tumor

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