Photodynamic therapy in combined treatment of cholangiocellular carcinoma (case report)

In this article a case report of an effective combined treatment of a patient with locally advanced cholangiocellular cancer who underwent neoadjuvant regional chemotherapy, extended surgery, adjuvant regional chemotherapy, as well as a set of minimally invasive endoscopic and percutaneous endobiliary techniques, which allowed the progression of the disease, including to increase the patients survival rate is presented. (5 figs, bibliography: 5 refs).

Frequency and effects of mutations in the KRAS gene on the survival of patients after surgical treatment of intrahepatic cholangiocarcinoma

Aim. To study the effect of mutations in the KRAS gene on the clinical course of intrahepatic cholangiocellular cancer (ICC) after surgical treatment in the Russian population.Materials and methods. A molecular genetic study of tumour tissue samples from 33 patients with intrahepatic cholangiocellular cancer obtained after surgical treatment was carried out using real-time polymerase chain reaction.Results. In the Russian population, the frequency of mutations in the KRAS gene in ICC was 27%, mainly in 12 (78%), 13 (33%), 61 (55%), 117 (44%) and 146 (44%) codons of 2, 3, 4 exons. In terms of KRAS gene mutations, intrahepatic cholangiocellular cancer is characterised by a pronounced heterogeneity. As a rule, the KRAS gene demonstrates multiple mutations at several loci and co-mutations in other genes, in particular, in IDH1/IDH2, PIK3CA, NRAS and BRAF genes. KRAS gene mutations in ICC were found to be significantly more common in women. The overall survival rate was significantly higher in patients with a KRAS mutation as compared to those with the wild type of the gene. Regarding the relapse-free survival rate in the groups of patients with the mutant and wild type of the KRAS gene, no significant differences were found.Conclusion. In the Russian population, no negative association between mutations in the KRAS gene and clinical outcomes was observed.

Two-stage liver resection for intrahepatic cholangiocarcinoma

The small remnant liver volume remains an urgent problem in liver resection surgery. The use of the method of twostage liver resection – the Associated Liver Partition and Portal vein ligation for Staged hepatectomy in most cases allows to solve this problem. However, this method is associated with a number of complications and limitations. The presented clinical observation shows the effectiveness of an alternative version of this technology – radiofrequency ablation of the liver parenchyma in the plane of the proposed resection with ligation of the right branch of the portal vein to increase the volume of the estimated liver remnant in intrahepatic cholangiocellular cancer.