scholarly journals Treatment of Intrahepatic Cholangiocarcinoma—A Multidisciplinary Approach

Cancers ◽  
2022 ◽  
Vol 14 (2) ◽  
pp. 362
Author(s):  
Felix Krenzien ◽  
Nora Nevermann ◽  
Alina Krombholz ◽  
Christian Benzing ◽  
Philipp Haber ◽  
...  
Keyword(s):  
Liver Resection ◽  
Intrahepatic Cholangiocarcinoma ◽  
Therapeutic Option ◽  
Treatment Strategies ◽  
Oncological Outcome ◽  
Advanced Tumor Stage ◽  
National Guidelines ◽  
Distal Cholangiocarcinoma ◽  
Delay In Diagnosis ◽  
Advanced Tumor

Intrahepatic cholangiocarcinoma (iCC) is distinguished as an entity from perihilar and distal cholangiocarcinoma and gallbladder carcinoma. Recently, molecular profiling and histopathological features have allowed further classification. Due to the frequent delay in diagnosis, the prognosis for iCC remains poor despite major technical advances and multimodal therapeutic approaches. Liver resection represents the therapeutic backbone and only curative treatment option, with the functional residual capacity of the liver and oncologic radicality being deciding factors for postoperative and long-term oncological outcome. Furthermore, in selected cases and depending on national guidelines, liver transplantation may be a therapeutic option. Given the often advanced tumor stage at diagnosis or the potential for postoperative recurrence, locoregional therapies have become increasingly important. These strategies range from radiofrequency ablation to transarterial chemoembolization to selective internal radiation therapy and can be used in combination with liver resection. In addition, adjuvant and neoadjuvant chemotherapies as well as targeted therapies and immunotherapies based on molecular profiles can be applied. This review discusses multimodal treatment strategies for iCC and their differential use.

Chemotherapy for surgically resected intrahepatic cholangiocarcinoma: Influence of lymph node status on treatment efficacy.

2015 ◽  
Vol 33 (3_suppl) ◽  
pp. 353-353
Author(s):  
John Thomas Miura ◽  
Fabian McCartney Johnston ◽  
Susan Tsai ◽  
Ben George ◽  
James P. Thomas ◽  
...  
Keyword(s):  
Lymph Node ◽  
Intrahepatic Cholangiocarcinoma ◽  
Proportional Hazards ◽  
Treatment Strategies ◽  
Cox Proportional Hazards ◽  
Lymph Node Status ◽  
Advanced Tumor Stage ◽  
Curative Intent ◽  
Node Status ◽  
Advanced Tumor

353 Background: High rates of recurrence following surgery (S) for intrahepatic cholangiocarcinoma (ICC) have prompted treatment strategies that incorporate chemotherapy (CT). However the benefit of CT remains poorly defined. The present study sought to determine the survival impact of CT for surgically resected ICC. Methods: Patients with non-metastatic ICC that underwent curative intent surgery (R0) were identified from the National Cancer Database (1998-2011) and stratified by receipt of CT. Log rank tests and cox proportional hazards models were used to examine overall survival (OS). Results: A total of 1,729 patients were identified (median age: 66 years, 53% female); 520 (30.1%) received CT. Patients receiving CT were younger (61 vs 66 years, p<0.01), had larger tumors (>5cm: 47 vs 40%, p<0.01), and had a higher frequency of lymph node metastasis (23 vs 12%, p<0.01). However, lymph node evaluation was not conducted in 30% (n=519) of the collective cohort. In the entire series, there was no difference in unadjusted median OS between patients receiving CT compared to S alone (30 vs 32 months, p=0.31). In multivariate models, advanced tumor stage and lymph node status (p<0.05) were associated with shorter OS. When stratified by lymph node status, CT demonstrated a significant improvement in median OS among N1 patients (HR: 0.47, 95%CI: 0.25-0.87; p=0.02). In contrast, patients with N0 disease derived no benefit from CT (HR: 0.95, 95%CI: 0.65-1.39; p=0.80). Conclusions: The use of CT was associated with a survival benefit only for ICC patients with nodal metastasis. Assessment of lymph nodes at the time of surgical resection is critical when attempting to identify a subgroup of patients best suited for CT.

Cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC) in patients with peritoneal carcinomatosis arising from gastric cancer.

2011 ◽  
Vol 29 (4_suppl) ◽  
pp. 132-132
Author(s):  
P. Piso ◽  
G. Glockzin ◽  
H. J. Schlitt
Keyword(s):  
Gastric Cancer ◽  
Peritoneal Carcinomatosis ◽  
Therapeutic Option ◽  
Operating Time ◽  
Morbidity Rate ◽  
Advanced Tumor Stage ◽  
Advanced Tumor ◽  
Crs And Hipec ◽  
The Mean

132 Background: Peritoneal carcinomatosis is a common sign of advanced tumor stage or disease recurrence in patients with gastric cancer. The prognosis of these patients is poor. There is some evidence that CRS and HIPEC may improve the oncological outcome of a highly selected part of patients with peritoneal carcinomatosis arising from gastric cancer. Nevertheless, the use of CRS and HIPEC as an additional therapeutic option is still controversial. Methods: Between 01/2005 and 09/2009 16 out of 256 patients underwent CRS and HIPEC for peritoneal carcinomatosis arising from gastric cancer at the University of Regensburg Medical Center. The mean age of patients at the time of surgery was 52 years (range 32-69). Four patients were female (25%). The mean follow-up time was 16.3 months. Results: Thirteen patients (81.25%) underwent complete macroscopic cytoreduction (CC-0/1). HIPEC was performed in all patients. The median hospital stay was 19.5 days (range 8-44) and the median stay on ICU 1 day (range 0-14), respectively. The median operating time was 342 minutes (range 49- 510). The perioperative grade 3/4 morbidity rate was 37.5%. Postoperative complications were pneumonia (2), pancreatitis (2), pneumothorax (2), intraabdominal abscess (2), renal insufficiency (1), urine bladder dysfunction (1) and wound infection (1). There was no operative mortality in our series. The 1-year survival rate was 68.7%. The mean survival of the ten patients that died during follow-up was 14.1 months (range 3.4-44.8). Conclusions: In highly selected patients with gastric cancer and peritoneal carcinomatosis CRS and HIPEC may lead to prolonged survival rates. However, the therapy should be integrated in an interdisciplinary multimodality treatment concept. Further prospective randomized trials are required to determine the role of CRS and HIPEC in the treatment of patients with gastric cancer. No significant financial relationships to disclose.

scholarly journals CCTs as new biomarkers for the prognosis of head and neck squamous cancer

Open Medicine ◽  
2020 ◽  
Vol 15 (1) ◽  
pp. 672-688
Author(s):  
Yanbo Dong ◽  
Siyu Lu ◽  
Zhenxiao Wang ◽  
Liangfa Liu
Keyword(s):  
Head And Neck ◽  
Survival Data ◽  
Enrichment Analysis ◽  
Functional Enrichment Analysis ◽  
Functional Enrichment ◽  
Advanced Tumor Stage ◽  
Expression Levels ◽  
T Complex ◽  
Advanced Tumor ◽  
Squamous Cancer

AbstractThe chaperonin-containing T-complex protein 1 (CCT) subunits participate in diverse diseases. However, little is known about their expression and prognostic values in human head and neck squamous cancer (HNSC). This article aims to evaluate the effects of CCT subunits regarding their prognostic values for HNSC. We mined the transcriptional and survival data of CCTs in HNSC patients from online databases. A protein–protein interaction network was constructed and a functional enrichment analysis of target genes was performed. We observed that the mRNA expression levels of CCT1/2/3/4/5/6/7/8 were higher in HNSC tissues than in normal tissues. Survival analysis revealed that the high mRNA transcriptional levels of CCT3/4/5/6/7/8 were associated with a low overall survival. The expression levels of CCT4/7 were correlated with advanced tumor stage. And the overexpression of CCT4 was associated with higher N stage of patients. Validation of CCTs’ differential expression and prognostic values was achieved by the Human Protein Atlas and GEO datasets. Mechanistic exploration of CCT subunits by the functional enrichment analysis suggests that these genes may influence the HNSC prognosis by regulating PI3K-Akt and other pathways. This study implies that CCT3/4/6/7/8 are promising biomarkers for the prognosis of HNSC.

scholarly journals Genetic Variants of lncRNA GAS5 Are Associated with the Clinicopathologic Development of Oral Cancer

2021 ◽  
Vol 11 (5) ◽  
pp. 348
Author(s):  
Ming-Hong Hsieh ◽  
Hsueh-Ju Lu ◽  
Chiao-Wen Lin ◽  
Chia-Yi Lee ◽  
Shang-Jung Yang ◽  
...  
Keyword(s):  
Cell Differentiation ◽  
Oral Cancer ◽  
Cancer Patients ◽  
Alcohol Drinking ◽  
Tumor Size ◽  
Genetic Variants ◽  
Tumor Stage ◽  
Advanced Tumor Stage ◽  
Advanced Tumor ◽  
Oral Cancer Patients

The long noncoding RNA, Growth arrest-specific 5 (GAS5) plays a crucial role in the development of oral cancer. However, potential genetic variants in GAS5 that affect the susceptibility and progression of oral cancer have rarely been explored. In this study, two loci of GAS5 single nucleotide polymorphisms (SNPs) (rs145204276 and rs55829688) were genotyped by using the TaqMan allelic discrimination in 1125 oral cancer patients and 1195 non-oral-cancer individuals. After statistical analyses, the distribution of both the GAS5 SNP rs145204276 and GAS5 SNP rs55829688 frequencies were similar between the study and control groups. However, the patients with GAS5 SNP rs145204276 variants (Ins/Del or Del/Del) showed a higher tendency of moderate to poor cell differentiation of oral cancer (OR: 1.454, 95% CI: 1.041–2.031, p = 0.028). Moreover, the GAS5 SNP rs145204276 variants (Ins/Del or Del/Del) in the non-alcohol-drinking population were associated with significantly advanced tumor stage (OR: 1.500, 95% CI: 1.081–2.081, p = 0.015) and larger tumor size (OR: 1.494, 95% CI: 1.076–2.074, p = 0.016). Furthermore, individuals with the GAS5 SNP rs145204276 variant were associated with a higher expression of GAS5 in the GTEx database (p = 0.002), and the higher GAS5 level was associated with poor cell differentiation, advanced tumor stage and larger tumor size in head and neck squamous cell carcinoma from the TCGA database (all p < 0.05). In conclusion, the GAS5 SNP rs145204276 variant is related to poor-differentiation cell status in oral cancer. Besides, the presence of the GAS5 SNP rs145204276 variant is associated with a worse tumor stage and tumor size in oral cancer patients without alcohol drinking.

scholarly journals Recurrence after Curative Resection for Intrahepatic Cholangiocarcinoma: How to Predict the Chance of Repeat Hepatectomy?

2021 ◽  
Vol 10 (13) ◽  
pp. 2820
Author(s):  
Serena Langella ◽  
Nadia Russolillo ◽  
Paolo Ossola ◽  
Andrea-Pierre Luzzi ◽  
Michele Casella ◽  
...  
Keyword(s):  
Liver Resection ◽  
Intrahepatic Cholangiocarcinoma ◽  
Major Hepatectomy ◽  
Multivariable Analysis ◽  
Study Data ◽  
Good Survival ◽  
Lower Probability ◽  
Factors Affecting ◽  
Time To Recurrence ◽  
Second Resection

(1) Background: Tumor recurrence after liver resection (LR) for intrahepatic cholangiocarcinoma (ICC) is common. Repeat liver resection (RLR) for recurrent ICC results in good survival outcomes in selected patients. The aim of this study was to investigate factors affecting the chance of resectability of recurrent ICC. (2) Methods: LR for ICC performed between January 2001 and December 2020 were retrospectively reviewed. Patients who had undergone first LR were considered for the study. Data on recurrences were analyzed. A logistic regression model was used for multivariable analysis of factors related to RLR rate. (3) Results: In total, 140 patients underwent LR for ICC. Major/extended hepatectomies were required in 105 (75%) cases. The 90-day mortality was 5.7%, Clavien–Dindo grade 3, 4 complications were 9.3%, N+ disease was observed in 32.5%, and the median OS was 38.3 months. Recurrence occurred in 91 patients (65%). The site of relapse was the liver in 53 patients (58.2%). RLR was performed in 21 (39.6%) patients. Factors that negatively affected RLR were time to recurrence ≤12 months (OR 7.4, 95% CI 1.68–33.16, p = 0.008) and major hepatectomy (OR 16.7, 95% CI 3.8–73.78, p < 0.001) at first treatment. Survival after recurrence was better in patients who underwent RLR as compared with not resected patients (31 vs. 13.2 months, p = 0.02). (4) Conclusions: Patients with ICC treated at first resection with major hepatectomy and those who recurred in ≤12 months had significantly lower probability to receive a second resection for recurrence.

scholarly journals EPDR1 is related to stages and metastasize in bladder cancer and can be used as a prognostic biomarker

BMC Urology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yue Yang ◽  
Hanchao Zhang ◽  
Zhengdao Liu ◽  
Faliang Zhao ◽  
Guobiao Liang
Keyword(s):  
Bladder Cancer ◽  
T Cells ◽  
Prognostic Biomarker ◽  
Transmembrane Protein ◽  
Tumor Stage ◽  
Receptor Interaction ◽  
Advanced Tumor Stage ◽  
Normal Bladder ◽  
Advanced Tumor ◽  
Significant Difference

AbstractBackgroundBladder cancer (BLCA) is a malignant urothelial carcinoma and has a high mortality rate. EPDR1 (ependymin related 1) is a type II transmembrane protein and related to calcium-dependent cell adhesion.MethodsWe explored the potential oncogenic roles of EPDR1 in BLCA basing on the multiple public datasets.ResultsWe found that EPDR1 expression had a significant difference in BLCA and adjacent normal bladder tissues, and the level of EPDR1was up-regulated with advanced tumor stage and metastasis in BLCA. Meanwhile, the high expression group of EPDR1 had a shorter OS compared to the low or medium expression-group. Furthermore, EPDR1 expression was associated with tumor-infiltrating immune cells (TIICs), including NK cells, CD8 + T cells, CD4 + T cells, Macrophages cells, and so on. Moreover, EPDR1 also involved in several signaling pathways as well as PI3K/AKT pathway, Cytokine receptor interaction, and apoptosis.ConclusionEPDR1 can be used as a novel prognostic biomarker as well as an effective target for diagnosis and treatment in BLCA.

scholarly journals E-Cadherin expression in human tumors: a tissue microarray study on 10,851 tumors

2021 ◽  
Vol 9 (1) ◽  
Author(s):  
Eike Burandt ◽  
Felix Lübbersmeyer ◽  
Natalia Gorbokon ◽  
Franziska Büscheck ◽  
Andreas M. Luebke ◽  
...  
Keyword(s):  
Tissue Microarray ◽  
Poor Prognosis ◽  
Triple Negative ◽  
Lobular Carcinoma ◽  
Tumor Stage ◽  
Advanced Tumor Stage ◽  
Carcinoma Of The Breast ◽  
Advanced Tumor ◽  
Tumor Entities ◽  
E Cadherin

Abstract Background The E-Cadherin gene (CDH1, Cadherin 1), located at 16q22.1 encodes for a calcium-dependent membranous glycoprotein with an important role in cellular adhesion and polarity maintenance. Methods To systematically determine E-Cadherin protein expression in normal and cancerous tissues, 14,637 tumor samples from 112 different tumor types and subtypes as well as 608 samples of 76 different normal tissue types were analyzed by immunohistochemistry in a tissue microarray format. Results E-Cadherin was strongly expressed in normal epithelial cells of most organs. From 77 tumor entities derived from cell types normally positive for E-Cadherin, 35 (45.5%) retained at least a weak E-Cadherin immunostaining in ≥99% of cases and 61 (79.2%) in ≥90% of cases. Tumors with the highest rates of E-Cadherin loss included Merkel cell carcinoma, anaplastic thyroid carcinoma, lobular carcinoma of the breast, and sarcomatoid and small cell neuroendocrine carcinomas of the urinary bladder. Reduced E-Cadherin expression was linked to higher grade (p = 0.0009), triple negative receptor status (p = 0.0336), and poor prognosis (p = 0.0466) in invasive breast carcinoma of no special type, triple negative receptor status in lobular carcinoma of the breast (p = 0.0454), advanced pT stage (p = 0.0047) and lymph node metastasis in colorectal cancer (p < 0.0001), and was more common in recurrent than in primary prostate cancer (p < 0.0001). Of 29 tumor entities derived from E-Cadherin negative normal tissues, a weak to strong E-Cadherin staining could be detected in at least 10% of cases in 15 different tumor entities (51.7%). Tumors with the highest frequency of E-Cadherin upregulation included various subtypes of testicular germ cell tumors and renal cell carcinomas (RCC). E-Cadherin upregulation was more commonly seen in malignant than in benign soft tissue tumors (p = 0.0104) and was associated with advanced tumor stage (p = 0.0276) and higher grade (p = 0.0035) in clear cell RCC, and linked to advanced tumor stage (p = 0.0424) and poor prognosis in papillary RCC (p ≤ 0.05). Conclusion E-Cadherin is consistently expressed in various epithelial cancers. Down-regulation or loss of E-Cadherin expression in cancers arising from E-Cadherin positive tissues as well as E-Cadherin neo-expression in cancers arising from E-Cadherin negative tissues is linked to cancer progression and may reflect tumor dedifferentiation.

scholarly journals The Presence of Small Nerve Fibers in the Tumor Microenvironment as Predictive Biomarker of Oncological Outcome Following Partial Hepatectomy for Intrahepatic Cholangiocarcinoma

Cancers ◽  
2021 ◽  
Vol 13 (15) ◽  
pp. 3661
Author(s):  
Jan Bednarsch ◽  
Xiuxiang Tan ◽  
Zoltan Czigany ◽  
Dong Liu ◽  
Sven Arke Lang ◽  
...  
Keyword(s):  
Tumor Microenvironment ◽  
Intrahepatic Cholangiocarcinoma ◽  
Cox Regression ◽  
Oncological Outcome ◽  
Nerve Fibers ◽  
Nodal Metastases ◽  
Cancer Specific Survival ◽  
Curative Intent ◽  
Term Outcome ◽  
Long Term Outcome

The oncological role of the density of nerve fibers (NFs) in the tumor microenvironment (TME) in intrahepatic cholangiocarcinoma (iCCA) remains to be determined. Therefore, data of 95 iCCA patients who underwent hepatectomy between 2010 and 2019 was analyzed regarding NFs and long-term outcome. Extensive group comparisons were carried out and the association of cancer-specific survival (CSS) and recurrence-free survival (RFS) with NFs were assessed using Cox regression models. Patients with iCCA and NFs showed a median CSS of 51 months (5-year-CSS = 47%) compared to 27 months (5-year-CSS = 21%) in patients without NFs (p = 0.043 log rank). Further, NFs (hazard ratio (HR) = 0.39, p = 0.002) and N-category (HR = 2.36, p = 0.010) were identified as independent predictors of CSS. Patients with NFs and without nodal metastases displayed a mean CSS of 89 months (5-year-CSS = 62%), while patients without NFs or with nodal metastases but not both showed a median CCS of 27 months (5-year-CSS = 25%) and patients with both positive lymph nodes and without NFs showed a median CCS of 10 months (5-year-CSS = 0%, p = 0.001 log rank). NFs in the TME are, therefore, a novel and important prognostic biomarker in iCCA patients. NFs alone and in combination with nodal status is suitable to identify iCCA patients at risk of poor oncological outcomes following curative-intent surgery.

scholarly journals Teratomatous Elements in Orchiectomy Specimens Are Associated with a Reduced Relapse-Free Survival in Metastasized Testicular Germ Cell Tumors

2021 ◽  
pp. 1-7
Author(s):  
Pia Paffenholz ◽  
Tim Nestler ◽  
Yasmine Maatoug ◽  
Melanie von Brandenstein ◽  
Barbara Köditz ◽  
...  
Keyword(s):  
Germ Cell ◽  
Germ Cell Tumors ◽  
Retroperitoneal Lymph Node Dissection ◽  
Advanced Tumor Stage ◽  
Testicular Germ Cell Tumors ◽  
Relapse Free Survival ◽  
Testicular Germ Cell ◽  
Free Survival ◽  
Advanced Tumor ◽  
The Impact

<b><i>Introduction:</i></b> The impact of teratomatous elements in orchiectomy specimens of metastasized testicular germ cell tumors (TGCT) regarding oncological outcome is still unclear. <b><i>Methods:</i></b> We performed a retrospective analysis including 146 patients with metastasized TGCT analysing patient characteristics. <b><i>Results:</i></b> Twenty-six (18%) of all patients showed teratomatous elements in the orchiectomy specimens. TGCT with teratomatous elements showed a significantly higher frequency of clinical-stage 2C-3 disease (73 vs. 49%, <i>p</i> = 0.031), visceral metastases (58 vs. 32%, <i>p</i> = 0.015), and poor prognosis (<i>p</i> = 0.011) than TGCT without teratomatous elements. Teratoma-containing TGCT revealed a significantly higher rate of post-chemotherapy retroperitoneal lymph node dissection (PC-RPLND, 54 vs. 32%, <i>p</i> = 0.041), with teratomatous elements being more often present in the PC-RPLND specimens (43 vs. 11%, <i>p</i> = 0.020) than nonteratoma-containing primaries. In the Kaplan-Meier estimates, the presence of teratomatous elements in orchiectomy specimens was associated with a significantly reduced relapse-free survival (RFS) (<i>p</i> = 0.049) during a median follow-up of 36 months (10–115.5). <b><i>Conclusions:</i></b> The presence of teratomatous elements in orchiectomy specimens is associated with an advanced tumor stage, worse treatment response as well as a reduced RFS in metastasized TGCT. Consequently, the presence of teratomatous elements might act as a reliable stratification tool for treatment decision in TGCT patients.

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