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Prognostic value of lymph nodes count on survival of patients with distal cholangiocarcinomas

World Journal of Gastroenterology 2018年第9期24卷 1022-1034页

作者： Hua-Peng Lin Sheng-Wei Li Ye Liu Shi-Ji Zhou Department of Hepatobiliary Surgery The Second Affiliated Hospital of Chongqing Medical University Department of Neonatal Children’s Hospital Chongqing Medical University Department of Gastrointestinal surgery The second Affiliated Hospital of Chongqing Medical University

AIM To evaluate the prognostic value of the number of retrieved lymph nodes(LNs) and other prognostic factors for patients with distal cholangiocarcinomas, and to determine the optimal retrieved LNs cut-off *** The Surveillance, Epidemiology and End Results database was used to screen for patients with distal cholangiocarcinoma. Patients with different numbers of retrieved LNs were divided into three groups by the X-tile program. X-tile from Yale University is a useful tool for outcome-based cut-point optimization. The Kaplan-Meier method and Cox regression analysis were utilized for survival *** A total of 449 patients with distal cholangiocarcinoma met the inclusion criteria. The Kaplan-Meier survival analysis for all patients and for N1 patients revealed no significant differences among patients with different retrieved LN counts in terms of overall and cancerspecific survival. In patients with node-negative distal cholangiocarcinoma, patients with four to nine retrieved LNs had a significantly better overall(P = 0.026) and cancer-specific survival(P = 0.039) than others. In the subsequent multivariate analysis, the number of retrieved LNs was evaluated to be independently associated with survival. Additionally, patients with four to nine retrieved LNs had a significantly lower overall mortality risk [hazard ratio(HR) = 0.39; 95% confidence interval(CI): 0.20-0.74] and cancer causespecific mortality risk(HR = 0.32; 95%CI: 0.15-0.66) than other patients. Additionally, stratified survival analyses showed persistently better overall and cancerspecific survival when retrieving four to nine LNs in patients with any T stage of tumor, a tumor between 20 and 50 mm in diameter, or a poorly differentiated or undifferentiated tumor, and in patients who were ≤ 70-years-old. CONCLUSION The number of retrieved LNs was an important independent prognostic factor for patients with nodenegative distal cholangiocarcinoma. Additionally, patients with four to

关键词： Distal cholangiocarcinomas Lymph node count Survival analysis SEER

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Hepatic Hemangioendothelioma: An update

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World Journal of Gastrointestinal Oncology 2020年第3期12卷 248-266页

作者： Mayur Virarkar Mohammed Saleh Radwan Diab Melissa Taggart Peeyush Bhargava Priya Bhosale Department of Diagnostic Radiology The University of Texas MD Anderson Cancer CenterHoustonTX 77030United States Department of Pathology The University of Texas MD Anderson Cancer CenterHoustonTX 77030United States Department of Radiology The University of Medical BranchGalvestonTX 77555United States

Primary epithelioid hemangioendotheliomas of the liver(EHL)are rare tumors with a low *** molecular background of EHL is still under investigation,with WWTR1-CAMPTA1 mutation may function as a tumor ***,this tumor is misdiagnosed with angiosarcoma,cholangiocarcinomas,metastatic carcinoma,and hepatocellular carcinoma(sclerosing variant).Characteristic features on imaging modalities such as ultrasound,computed tomography,magnetic resonance imaging and positron emission tomography/computed tomography guide in diagnosis and ***“halo sign”and the“lollipop sign”on computed tomography and magnetic resonance imaging are described in the ***,there are no standardized guidelines for treating EHL with treatment options are broad including:chemotherapy,ablation,surgery and liver transplantation with inconsistent results.

关键词： Epithelioid hemangioendotheliomas Halo sign Lollipop sign Angiosarcoma cholangiocarcinomas Hepatocellular carcinoma

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Radiofrequency ablation in the management of primary hepatic and biliary tumors

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World Journal of Gastrointestinal Oncology 2022年第1期14卷 203-215页

作者： Richard Hendriquez Tara Keihanian Jatinder Goyal Rtika R Abraham Rajnish Mishra Mohit Girotra Department of Internal Medicine University of Central FloridaOrlandoFL 32816United States Department of Gastroenterology and Hepatology University of MiamiMiamiFL 33136United States Department of Gastroenterology and Hepatology Wellspan Digestive Health-York HospitalYorkPA 17403United States Department of Endocrinology Swedish Medical CenterSeattleWA 98104United States

In the United States,80%-90%of primary hepatic tumors are hepatocellular carcinomas and 10%-15%are cholangiocarcinomas(CCA),both with high mortality rate,particularly CCA,which portends a worse *** management with surgery has good outcomes in appropriately selected patients;however,novel ablative treatment options have emerged,such as radiofrequency ablation(RFA),which can improve the prognosis of both hepatic and biliary *** is aimed to generate an area of necrosis within the targeted tissue by applying thermal therapy via an electrode,with a goal to completely eradicate the tumor while preserving surrounding healthy *** of RFA in management of hepatic and biliary tumors forms the focus of our current mini-review article.

关键词： Radiofrequency ablation Radiofrequency ablation Hepatic tumor Biliary tumor Cholangiocarcinoma Hepatocellular carcinoma cholangiocarcinomas Hepatocellular carcinomas

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Mechanisms of biliary carcinogenesis and growth

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World Journal of Gastroenterology 2008年第19期14卷 2986-2989页

作者： Candace Wise Metaneeya Pilanthananond Benjamin F Perry Gianfranco Alpini Michael McNeal Shannon S Glaser Systems Biology and Translational Medicine Scott and White Hospital and The Texas A&M University System Health Science Center Department of Medicine Scott and White Hospital and The Texas A&M University System Health Science Center The Texas A&M University System Health Science Center

Cholangiocarcinoma is a rare cancer originating from the neoplastic transformation of the epithelial cells (i.e. cholangiocytes) that line the biliary tract. The prognosis for patients with cholangiocarcinoma is grim due to lack of viable treatment options. The increase in world-wide incidence and mortality from cholangiocarcinoma highlights the importance of understanding the intracellular mechanisms that trigger the neoplastic transformation of cholangiocytes and the growth of biliary cancers. The purpose of the following review is to address what has been learned over the past decade concerning the molecular basis of cholangiocarcinogenesis. The material presented is divided into two sections:(1) mechanisms regulating neoplastic transformation of cholangiocytes; and (2) factors regulating cholangiocarcinoma growth. An understanding of the growth regulatory mechanisms of cholangiocarcinoma will lead to the identification of therapeutic targets for this devastating cancer.

关键词： Biliary carcinogenesis cholangiocarcinomas Primary biliary cirrhosis Primary sclerosing cholangitis

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Role of magnetic resonance cholangiopancreatography in diagnosing choledochal cysts: Case series and review

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World Journal of Radiology 2013年第8期5卷 304-312页

作者： Vikas Y Sacher James S Davis Danny Sleeman Javier Casillas Department of Surgery University of Miami Department of Radiology University of Miami

AIM:To determine the merits of magnetic resonance cholangiopancreatography(MRCP) as the primary diagnostic test for choledochal cysts(CC’s).METHODS:Between 2009 and 2012,patients who underwent MRCP for perioperative diagnosis were *** information,clinical characteristics,and radiographic findings were *** results were compared with intraoperative findings.A PubMed search identified studies published between 1996-2012,employing MRCP as the primary preoperative imaging and comparing results with either endoscopic retrograde cholangiopancreatography(ERCP) or operative *** rates for CC’s and abnormal pancreaticobiliary junction(APBJ) were *** addition detection rates for clinically related biliary pathology like choledocholithiasis and cholangiocarcinomas in patients diagnosed with CC’s were also ***:Eight patients were identified with CC’*** patients out of them had typeⅣCC’s,1 had type I and 1 had a new variant of choledochal cyst with confluent dilatation of the common bile duct(CBD) and cystic *** patients had an APBJ and 3 of those had a long *** were found in 2 patients,1 had a CBD stone,and 1 pancreatic-duct stone was also *** all cases,MRCP successfully identified the type of CC’s,as well as APBJ with ductal *** analyzing the literature,we found that MRCP has 96%-100% detection rate for CC’***,we found that the range for sensitivity,specificity,and diagnostic accuracy was 53%-100%,90%-100% and 56%-100% in diagnosing ***’s detection rate was 100% for choledocholithiasis and 87% for cholangiocarcinomas with concurrent CC’***:After initial ultrasound and computed tomography scan,MRCP should be the next diagnostic test in both adult and pediatric *** should be reserved for patients where therapeutic intervention is needed.

关键词： Magnetic resonance cholangiopancreatography Choledochal cyst Abnormal pancreaticobiliary junction Diagnostic test Choledocholithiasis cholangiocarcinomas

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