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3. Hezel AF, Zhu AX: Systemic therapy for biliary tract cancers. Oncologist; 2008 Apr;13(4):415-23
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  • [Title] Systemic therapy for biliary tract cancers.
  • Biliary tract cancers (BTCs) are invasive carcinomas that arise from the epithelial lining of the gallbladder and bile ducts.
  • These include intrahepatic, perihilar, and distal biliary tree cancers as well as carcinoma arising from the gallbladder.
  • Among those patients who do undergo "curative" resection, recurrence rates are high; thus, for the majority of BTC patients, systemic chemotherapy is the mainstay of their treatment plan.
  • Patients with unresectable or metastatic BTC have a poor prognosis, with a median overall survival time of <1 year.
  • Despite a paucity of randomized phase III data, a consensus on first-line systemic therapy is emerging.
  • In this review, we discuss the clinical experience with systemic treatment of BTC, focusing on the rationale for a first-line regimen as well as future directions in the field.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Biliary Tract Neoplasms / drug therapy. Cholangiocarcinoma / drug therapy
  • [MeSH-minor] Deoxycytidine / administration & dosage. Deoxycytidine / analogs & derivatives. Fluorouracil / administration & dosage. Humans. Randomized Controlled Trials as Topic. Treatment Outcome

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  • (PMID = 18448556.001).
  • [ISSN] 1083-7159
  • [Journal-full-title] The oncologist
  • [ISO-abbreviation] Oncologist
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0W860991D6 / Deoxycytidine; B76N6SBZ8R / gemcitabine; U3P01618RT / Fluorouracil
  • [Number-of-references] 70
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4. Kobayashi K, Tsuji A, Morita S, Horimi T, Shirasaka T, Kanematsu T: A phase II study of LFP therapy (5-FU (5-fluorourasil) continuous infusion (CVI) and Low-dose consecutive (Cisplatin) CDDP) in advanced biliary tract carcinoma. BMC Cancer; 2006;6:121
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  • [Title] A phase II study of LFP therapy (5-FU (5-fluorourasil) continuous infusion (CVI) and Low-dose consecutive (Cisplatin) CDDP) in advanced biliary tract carcinoma.
  • We conducted a single arm phase II study of LFP therapy (5-FU (5-fluorourasil) continuous infusion (CVI) and Low-dose consecutive (Cisplatin) CDDP) for advanced biliary tract malignancies basically on an outpatient basis.
  • LFP THERAPY: By using a total implanted CV-catheter system, 5-FU (160 mg/m2/day) was continuously infused over 24 hours for 7 consecutive days and CDDP (6 mg/m2/day) was infused for 30 minutes twice a week as one cycle.
  • RESIST criteria (Response evaluation criteria for solid tumors) and NCI-CTC (National Cancer Institute-Common Toxicity Criteria) (ver.3.0) were used for evaluation of this therapy.
  • The median survival time (MST) and median time to treatment failure (TTF) were calculated by the Kaplan-Meier method.
  • RESULTS: Patients characteristics were: mean age 66.5(47-79): male 24 (54%): BDca (bile duct carcinoma) 27 GBca (Gallbladder carcinoma) 15: locally advanced 26, postoperative recurrence 16.
  • Neither any treatment related death nor grade 4 toxicity occurred.
  • The median number of courses of LFP Therapy which patients could receive was two (1-14).
  • There was no significant difference regarding the anti tumor effects against both malignant neoplasms.
  • CONCLUSION: LFP therapy appears to be useful modality for the clinical management of advanced biliary tract malignancy.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Bile Duct Neoplasms / drug therapy. Carcinoma / drug therapy. Gallbladder Neoplasms / drug therapy
  • [MeSH-minor] Aged. Cisplatin / administration & dosage. Dose-Response Relationship, Drug. Female. Fluorouracil / administration & dosage. Humans. Infusions, Intravenous. Male. Middle Aged. Survival Analysis. Treatment Outcome

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  • (PMID = 16677397.001).
  • [ISSN] 1471-2407
  • [Journal-full-title] BMC cancer
  • [ISO-abbreviation] BMC Cancer
  • [Language] eng
  • [Publication-type] Clinical Trial, Phase II; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] England
  • [Chemical-registry-number] Q20Q21Q62J / Cisplatin; U3P01618RT / Fluorouracil
  • [Other-IDs] NLM/ PMC1483897
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5. Yoneto T, Yoshikawa K, Fujii Y: [A patient with recurrent gallbladder cancer responding to chemotherapy with CDDP/CPT-11 and gemcitabine]. Gan To Kagaku Ryoho; 2005 Jan;32(1):99-102
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  • [Title] [A patient with recurrent gallbladder cancer responding to chemotherapy with CDDP/CPT-11 and gemcitabine].
  • A 79-year-old female patient was referred to our hospital for treatment of a recurrent gallbladder cancer.
  • The recurrence of the tumor in lymph nodes near the pancreas head was demonstrated by computer tomography.
  • We tried a course of a combination chemotherapy consisting of CPT-11 and CDDP (40 mg CPT-11/body/day on day 1 and 10 mg CDDP/body/day on day 2-5) to reduce the size of the nodes.
  • Then, we repeated a total of 8 courses of the therapy at 4-week intervals.
  • So, we substituted gemcitabine (1 g/body/day) for the combination chemotherapy with expandable metallic stent implantation to drain the bile.
  • Thereafter, the patient was given an additional 20 courses of gemcitabine therapy at 2-week intervals as an outpatient.
  • However, the patient died of liver metastasis 8 years after operation and 6 years after she started chemotherapy for the recurrence.
  • She maintained a good quality of life during that time.
  • The present case suggests that combination of chemotherapy protocols is effective for clinical management of gallbladder cancer recurrence, which is generally considered to be difficult to manage with chemotherapy.
  • [MeSH-major] Adenocarcinoma / drug therapy. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Camptothecin / analogs & derivatives. Deoxycytidine / analogs & derivatives. Gallbladder Neoplasms / drug therapy. Lymph Nodes / pathology. Neoplasm Recurrence, Local / drug therapy
  • [MeSH-minor] Aged. Cisplatin / administration & dosage. Drug Administration Schedule. Female. Humans. Lymphatic Metastasis. Survivors

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  • (PMID = 15675592.001).
  • [ISSN] 0385-0684
  • [Journal-full-title] Gan to kagaku ryoho. Cancer & chemotherapy
  • [ISO-abbreviation] Gan To Kagaku Ryoho
  • [Language] jpn
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Japan
  • [Chemical-registry-number] 0W860991D6 / Deoxycytidine; 7673326042 / irinotecan; B76N6SBZ8R / gemcitabine; Q20Q21Q62J / Cisplatin; XT3Z54Z28A / Camptothecin
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6. Fujita T, Ajiki T, Ku Y: [A case of recurrent gallbladder cancer with a remarkable tumor response to S-1]. Gan To Kagaku Ryoho; 2010 Aug;37(8):1599-601
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  • [Title] [A case of recurrent gallbladder cancer with a remarkable tumor response to S-1].
  • We herein report a case of recurrent gallbladder cancer with a remarkable tumor response to S-1 after a failure of gemcitabine (GEM) treatment.
  • Postoperative pathological diagnosis revealed gallbladder cancer with subserous layer invasion.
  • After eight months, abdominal CT showed a local tumor recurrence at the hepatic hylum, for which 4 courses of GEM were administered.
  • The therapy was considered ineffective because of the increase in tumor size, and a new lesion in the segment 6 of liver.
  • After two courses of S-1, the local recurrent tumor showed a marked decrease in size and liver metastases almost disappeared.
  • The response duration was approximately 8 months, and median survival time from the start of GEM treatment was 17. 5 months.
  • S-1, as a second-line chemotherapeutic drug, produced remarkable local tumor control and most likely survival time with good quality of life in this patient.
  • [MeSH-major] Gallbladder Neoplasms / drug therapy. Oxonic Acid / therapeutic use. Tegafur / therapeutic use
  • [MeSH-minor] Aged. Drug Combinations. Fatal Outcome. Humans. Male. Recurrence. Tomography Scanners, X-Ray Computed

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  • (PMID = 20716896.001).
  • [ISSN] 0385-0684
  • [Journal-full-title] Gan to kagaku ryoho. Cancer & chemotherapy
  • [ISO-abbreviation] Gan To Kagaku Ryoho
  • [Language] jpn
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Japan
  • [Chemical-registry-number] 0 / Drug Combinations; 150863-82-4 / S 1 (combination); 1548R74NSZ / Tegafur; 5VT6420TIG / Oxonic Acid
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9. Matsuyama S, Takei M, Kido S, Magata S, Motoyama K, Kitahara K, Miyazaki K: [A case of para-aortic lymph node recurrence of gallbladder cancer completely responding to single drug (UFT) chemotherapy]. Gan To Kagaku Ryoho; 2003 Apr;30(4):547-9
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  • [Title] [A case of para-aortic lymph node recurrence of gallbladder cancer completely responding to single drug (UFT) chemotherapy].
  • A 67-year-old man with gallbladder cancer was treated by cholecystectomy and extrahepatic bile duct resection with regional lymph node dissection.
  • At 10 months after surgery, CT demonstrated para-aortic lymph node recurrence.
  • Single drug chemotherapy of UFT at 400 mg was started.
  • After one month, the lymph node recurrence could not be detected by CT.
  • UFT may be the primary candidate for chemotherapy for lymph node recurrence of gallbladder cancer.
  • [MeSH-major] Adenocarcinoma / drug therapy. Adenocarcinoma / surgery. Antineoplastic Agents / administration & dosage. Gallbladder Neoplasms / drug therapy. Gallbladder Neoplasms / surgery. Lymph Node Excision. Lymph Nodes / pathology. Tegafur / administration & dosage. Uracil / administration & dosage
  • [MeSH-minor] Aged. Bile Ducts, Extrahepatic / surgery. Cholecystectomy. Drug Administration Schedule. Drug Combinations. Humans. Lymphatic Metastasis. Male

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  • (PMID = 12722690.001).
  • [ISSN] 0385-0684
  • [Journal-full-title] Gan to kagaku ryoho. Cancer & chemotherapy
  • [ISO-abbreviation] Gan To Kagaku Ryoho
  • [Language] jpn
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Japan
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Drug Combinations; 0 / UFT(R) drug; 1548R74NSZ / Tegafur; 56HH86ZVCT / Uracil
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10. Morimoto H, Ajiki T, Takase S, Fujita T, Matsumoto T, Mita Y, Matsumoto I, Fujino Y, Suzuki Y, Kuroda Y, Ku Y: Resection of gallbladder cancer with hepatic metastasis after chemotherapy with gemcitabine. J Hepatobiliary Pancreat Surg; 2008;15(6):655-8
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  • [Title] Resection of gallbladder cancer with hepatic metastasis after chemotherapy with gemcitabine.
  • A 69-year-old man diagnosed as having gallbladder cancer with liver invasion and metastasis to Couinaud's hepatic segment 8 (S8) was referred to our hospital.
  • Pathological examination demonstrated viable cancer cells with necrosis and fibrosis in the gallbladder, and fibrosis without viable cancer cells in the induration in liver S8.
  • Gemcitabine was re-administered as postoperative adjuvant chemotherapy.
  • Twenty months after the surgery, there was no sign of recurrence.
  • In selected patients, gemcitabine treatment may be effective against gallbladder cancer with metastasis.
  • [MeSH-major] Antimetabolites, Antineoplastic / therapeutic use. Deoxycytidine / analogs & derivatives. Gallbladder Neoplasms / drug therapy. Gallbladder Neoplasms / surgery. Liver Neoplasms / drug therapy. Liver Neoplasms / surgery
  • [MeSH-minor] Aged. Biomarkers, Tumor / blood. Carcinoembryonic Antigen / blood. Chemotherapy, Adjuvant. Humans. Male. Tomography, X-Ray Computed

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  • (PMID = 18987939.001).
  • [ISSN] 0944-1166
  • [Journal-full-title] Journal of hepato-biliary-pancreatic surgery
  • [ISO-abbreviation] J Hepatobiliary Pancreat Surg
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Japan
  • [Chemical-registry-number] 0 / Antimetabolites, Antineoplastic; 0 / Biomarkers, Tumor; 0 / Carcinoembryonic Antigen; 0W860991D6 / Deoxycytidine; B76N6SBZ8R / gemcitabine
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11. Katoh K, Sone M, Nakasato T, Ehara S, Takahashi M, Nitta H, Wakabayashi G: [Arterial infusion chemotherapy for advanced gallbladder cancer and liver metastasis]. Gan To Kagaku Ryoho; 2008 Oct;35(10):1691-5
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  • [Title] [Arterial infusion chemotherapy for advanced gallbladder cancer and liver metastasis].
  • Ten patients with advanced gallbladder cancer were treated by arterial infusion chemotherapy.
  • The response rate was 50% and the median survival time was 192 days.
  • In one patient with good PR, a primary tumor was resected, and he survived for 2 years 7 months without recurrence.
  • Systemic chemotherapy using gemcitabine is well accepted, however arterial infusion chemotherapy will be one of the options when systemic chemotherapy is fails.
  • [MeSH-major] Antineoplastic Agents / therapeutic use. Gallbladder Neoplasms / drug therapy. Gallbladder Neoplasms / pathology. Infusions, Intra-Arterial. Liver Neoplasms / drug therapy. Liver Neoplasms / secondary
  • [MeSH-minor] Aged. Aged, 80 and over. Angiography. Female. Humans. Male. Middle Aged. Neoplasm Staging. Survival Rate. Tomography, X-Ray Computed

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  • (PMID = 18931570.001).
  • [ISSN] 0385-0684
  • [Journal-full-title] Gan to kagaku ryoho. Cancer & chemotherapy
  • [ISO-abbreviation] Gan To Kagaku Ryoho
  • [Language] jpn
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] Japan
  • [Chemical-registry-number] 0 / Antineoplastic Agents
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12. Takeda Y, Hasuike Y, Kashiwazaki M, Tsujinaka T: [Adjuvant arterial infusion chemotherapy for patients with biliary cancer]. Gan To Kagaku Ryoho; 2004 Oct;31(11):1835-7
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  • [Title] [Adjuvant arterial infusion chemotherapy for patients with biliary cancer].
  • Although surgery is the only potentially curative treatment for biliary cancer, patients frequently develop liver metastasis, local recurrence, and peritoneal metastasis after complete resection.
  • Liver metastasis is a common mode of progression for biliary cancer, and the prognosis is extremely poor when it occurs.
  • Between January 2000 and December 2003, 18 out of 37 patients received adjuvant arterial infusion chemotherapy after curative resection of biliary cancer.
  • Nine of these 18 patients had bile duct cancer, seven had gallbladder cancer, and two had cancer of the papilla of Vater.
  • Two cycles of this chemotherapy were delivered through an angiography catheter without using a reservoir port.
  • This treatment caused no severe systemic or abdominal complications.
  • The 1-year survival rate was 76.2% in the adjuvant chemotherapy group versus 52.7% in the non-adjuvant chemotherapy group, while the 3-year survival rates were 47.6% and 39.5%, respectively (Wilcoxon test, p=0.048).
  • Median overall survival was superior in the adjuvant chemotherapy group and the difference was significant.
  • High-dose arterial infusion of 5-FU seems to be a safe, tolerable, and effective regimen for preventing the postoperative recurrence of biliary cancer.
  • [MeSH-major] Biliary Tract Neoplasms / therapy. Fluorouracil / administration & dosage
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Ampulla of Vater. Bile Duct Neoplasms / surgery. Bile Duct Neoplasms / therapy. Chemotherapy, Adjuvant. Common Bile Duct Neoplasms / surgery. Common Bile Duct Neoplasms / therapy. Drug Administration Schedule. Female. Gallbladder Neoplasms / surgery. Gallbladder Neoplasms / therapy. Humans. Infusions, Intra-Arterial / methods. Male. Middle Aged

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  • (PMID = 15553731.001).
  • [ISSN] 0385-0684
  • [Journal-full-title] Gan to kagaku ryoho. Cancer & chemotherapy
  • [ISO-abbreviation] Gan To Kagaku Ryoho
  • [Language] jpn
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] Japan
  • [Chemical-registry-number] U3P01618RT / Fluorouracil
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13. Nakadaira K, Kurosaki I, Ueki H: [Recurrent gallbladder carcinoma treated with combination chemotherapy with gemcitabine, CPT-11 and S-1--a successful case with metastatic tumors replaced by marked calcification]. Gan To Kagaku Ryoho; 2008 May;35(5):837-9
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  • [Title] [Recurrent gallbladder carcinoma treated with combination chemotherapy with gemcitabine, CPT-11 and S-1--a successful case with metastatic tumors replaced by marked calcification].
  • We described a case with recurrent gallbladder carcinoma, successfully treated by combination chemotherapy using gemcitabine, CPT-11, and S-1 that was administered as second-line chemotherapy after failure of gemcitabine monotherapy.
  • She had received the combination chemotherapy for 15 months and is now alive.
  • [MeSH-major] Adenocarcinoma / drug therapy. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Gallbladder Neoplasms / drug therapy
  • [MeSH-minor] Aged. Antimetabolites, Antineoplastic / administration & dosage. Antineoplastic Agents, Phytogenic / administration & dosage. Calcinosis. Camptothecin / administration & dosage. Camptothecin / analogs & derivatives. Deoxycytidine / administration & dosage. Deoxycytidine / analogs & derivatives. Drug Combinations. Female. Humans. Liver Neoplasms / pathology. Liver Neoplasms / secondary. Neoplasm Recurrence, Local. Oxonic Acid / administration & dosage. Tegafur / administration & dosage

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  • (PMID = 18487925.001).
  • [ISSN] 0385-0684
  • [Journal-full-title] Gan to kagaku ryoho. Cancer & chemotherapy
  • [ISO-abbreviation] Gan To Kagaku Ryoho
  • [Language] jpn
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Japan
  • [Chemical-registry-number] 0 / Antimetabolites, Antineoplastic; 0 / Antineoplastic Agents, Phytogenic; 0 / Drug Combinations; 0W860991D6 / Deoxycytidine; 150863-82-4 / S 1 (combination); 1548R74NSZ / Tegafur; 5VT6420TIG / Oxonic Acid; 7673326042 / irinotecan; B76N6SBZ8R / gemcitabine; XT3Z54Z28A / Camptothecin
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14. Sakai A, Tsuji Y, Kikuchi O, Jinno A, Tanabe W, Terashima Y, Maeda Y, Doi A, Hata T, Yamamoto N, Aoyama I, Arai O, Kiyosuke Y, Katayama S, Hirao K, Miyoshi M, Mouri H, Matsueda K, Yamamoto H: [Marked effect of combination chemotherapy with tegafur-gimeracil-oteracil potassium and gemcitabine on a suspected case of pancreas cancer or gallbladder cancer metastasis to bone: further diagnosis of disseminated carcinomatosa of bone marrow recurrence after the 23 years of gastric cancer operation by autopsy findings]. Gan To Kagaku Ryoho; 2008 Mar;35(3):529-32
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  • [Title] [Marked effect of combination chemotherapy with tegafur-gimeracil-oteracil potassium and gemcitabine on a suspected case of pancreas cancer or gallbladder cancer metastasis to bone: further diagnosis of disseminated carcinomatosa of bone marrow recurrence after the 23 years of gastric cancer operation by autopsy findings].
  • A 70-year-old woman who underwent proximal gastrectomy for gastric cancer (poorly-differentiated adenocarcinoma) of Stage IIIB at age 46 visited our hospital April 2004 because of exacerbated pain by movement in the buttocks since November 2003.
  • She showed multiple bone metastasis by CT (computerized tomography).
  • Pancreas cancer or gallbladder cancer was suspected by CT, and a high tumor marker score (CA19-9 18,625 U/mL, DUPAN-II 15,000 U/ mL elevations were acknowledged).
  • Although her symptoms were severe with performance status (PS) 4, she was administered combination chemotherapy with gemcitabine and cisplatin.
  • After 2 cycle therapy, her PS was improved to 2, but the tumor markers had elevated.
  • So we changed the chemotherapy menu to S-1 and gemcitabine.
  • There was a remarkable response to this chemotherapy, and the result of CT and bone scintigraphy suggested that her bone metastasis was improved.
  • Because of hematologic relapse due to DIC at 1 year after the first treatment, she was readmitted to our hospital and later died.
  • The autopsical result revealed recurrence of gastric cancer 23 years post-operatively.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Bone Marrow Neoplasms / diagnosis. Bone Neoplasms / drug therapy. Gallbladder Neoplasms / drug therapy. Pancreatic Neoplasms / drug therapy. Stomach Neoplasms / surgery
  • [MeSH-minor] Aged. Autopsy. Female. Gastrectomy. Humans. Neoplasm Staging. Oxonic Acid / therapeutic use. Pyridines / therapeutic use. Radionuclide Imaging. Tegafur / therapeutic use. Time Factors. Treatment Failure

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  • (PMID = 18347411.001).
  • [ISSN] 0385-0684
  • [Journal-full-title] Gan to kagaku ryoho. Cancer & chemotherapy
  • [ISO-abbreviation] Gan To Kagaku Ryoho
  • [Language] jpn
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Japan
  • [Chemical-registry-number] 0 / Pyridines; 1548R74NSZ / Tegafur; 5VT6420TIG / Oxonic Acid; UA8SE1325T / gimeracil
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15. Oku T, Yoshizaki N, Waga E, Sumiyoshi T, Ohira N, Nishihori Y, Ohi M, Kondo H, Motohara T, Yoshida Y: [A case of liver metastasis from gallbladder cancer with marked response to arterial infusion chemotherapy]. Gan To Kagaku Ryoho; 2003 Oct;30(10):1515-8
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  • [Title] [A case of liver metastasis from gallbladder cancer with marked response to arterial infusion chemotherapy].
  • A mass lesion in the gallbladder was found by ultrasonography.
  • She was referred to our hospital for further examination and was diagnosed with gallbladder cancer.
  • After arterial infusion chemotherapy by 5-FU and CDDP, or 5-FU alone, liver metastasis markedly responded and became undetectable, and therapy was therefore discontinued.
  • The patient has been disease-free without any sign of recurrence for 7 months after CR was achieved.
  • It is suggested that arterial infusion chemotherapy is useful and safe for the treatment of liver metastasis from gallbladder cancer.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Gallbladder Neoplasms / drug therapy. Infusion Pumps, Implantable. Liver Neoplasms / drug therapy. Liver Neoplasms / secondary
  • [MeSH-minor] Aged. Cholecystectomy. Cisplatin / administration & dosage. Combined Modality Therapy. Drug Administration Schedule. Female. Fluorouracil / administration & dosage. Hepatic Artery. Humans. Infusions, Intra-Arterial. Remission Induction

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  • (PMID = 14584288.001).
  • [ISSN] 0385-0684
  • [Journal-full-title] Gan to kagaku ryoho. Cancer & chemotherapy
  • [ISO-abbreviation] Gan To Kagaku Ryoho
  • [Language] jpn
  • [Publication-type] Case Reports; English Abstract; Journal Article; Review
  • [Publication-country] Japan
  • [Chemical-registry-number] Q20Q21Q62J / Cisplatin; U3P01618RT / Fluorouracil; CF regimen
  • [Number-of-references] 14
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16. Ishii N, Suzuki S, Fujitani S, Tsukamoto M, Arai M, Iizuka Y, Fukuda K, Horiki N, Fujita Y: [A case of recurrent gall bladder cancer responding to chemotherapy with gemcitabine after endoscopic metallic biliary stent implantation]. Gan To Kagaku Ryoho; 2008 Aug;35(8):1403-5
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  • [Title] [A case of recurrent gall bladder cancer responding to chemotherapy with gemcitabine after endoscopic metallic biliary stent implantation].
  • He had undergone cholecystectomy for gall bladder cancer.
  • Computed tomography showed the biliary duct was obstructed by recurrent gall bladder cancer at the hepatic hilum.
  • After endoscopic metallic biliary stent implantation, gemcitabine(700 mg/m(2) day)was administered once a week for two weeks followed by a week of no treatment.
  • After three courses of the chemotherapy, computed tomography showed that the tumor at the hepatic hilum was no longer visible and that the serum CA19-9 level was reduced to normal.
  • Grade 2 appetite loss and grade 3 neutropenia were observed as adverse reactions to the treatment.
  • Gemcitabine therapy after endoscopic intervention was safe and effective in this case of recurrent gall bladder cancer with obstructive jaundice.
  • [MeSH-major] Deoxycytidine / analogs & derivatives. Gallbladder Neoplasms / drug therapy. Gallbladder Neoplasms / surgery. Liver Neoplasms / drug therapy. Metals. Stents
  • [MeSH-minor] Aged. Endoscopes. Humans. Male. Recurrence. Tomography, X-Ray Computed

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  • (PMID = 18701859.001).
  • [ISSN] 0385-0684
  • [Journal-full-title] Gan to kagaku ryoho. Cancer & chemotherapy
  • [ISO-abbreviation] Gan To Kagaku Ryoho
  • [Language] jpn
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Japan
  • [Chemical-registry-number] 0 / Metals; 0W860991D6 / Deoxycytidine; B76N6SBZ8R / gemcitabine
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17. Mori Y, Katsumata K, Tokita H, Kato F, Yamamoto J, Tsuchida A, Aoki T: [A case of recurrence after resection of stage IV advanced bile duct cancer responding well to S-1/cisplatin combination chemotherapy]. Gan To Kagaku Ryoho; 2007 Sep;34(9):1485-7
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  • [Title] [A case of recurrence after resection of stage IV advanced bile duct cancer responding well to S-1/cisplatin combination chemotherapy].
  • The patient was a 70-year-old man who in November 2000 had undergone pancreatoduodenectomy for a diagnosis of lower bile duct cancer by his previous physician.
  • Left cervical and intra-abdominal lymph node enlargement were detected at 3 years 4 months postoperatively, and a biopsy resulted in a histopathological diagnosis of metastasis by bile duct cancer.
  • S-1/CDDP therapy seemed to be capable of serving as a useful treatment for gallbladder and bile duct cancer in the future.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Bile Duct Neoplasms / drug therapy. Neoplasm Recurrence, Local / drug therapy
  • [MeSH-minor] Aged. Antimetabolites, Antineoplastic / administration & dosage. Antineoplastic Agents / administration & dosage. Cisplatin / administration & dosage. Drug Combinations. Humans. Lymphatic Metastasis / pathology. Male. Oxonic Acid / administration & dosage. Pancreaticoduodenectomy. Tegafur / administration & dosage

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  • (PMID = 17876152.001).
  • [ISSN] 0385-0684
  • [Journal-full-title] Gan to kagaku ryoho. Cancer & chemotherapy
  • [ISO-abbreviation] Gan To Kagaku Ryoho
  • [Language] jpn
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Japan
  • [Chemical-registry-number] 0 / Antimetabolites, Antineoplastic; 0 / Antineoplastic Agents; 0 / Drug Combinations; 150863-82-4 / S 1 (combination); 1548R74NSZ / Tegafur; 5VT6420TIG / Oxonic Acid; Q20Q21Q62J / Cisplatin
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18. Yoshida R, Matsuda T, Watanabe T, Iwadou H, Hunabiki K, Kamikawa Y: [A case of gallbladder cancer which completely responded to gemcitabine]. Gan To Kagaku Ryoho; 2010 Sep;37(9):1771-3
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  • [Title] [A case of gallbladder cancer which completely responded to gemcitabine].
  • A 7 9-year-old man with advanced gallbladder cancer (stage IVa) underwent chemotherapy with single-agent gemcitabine (1,400mg/body: day 1, 8, 15, every 4 weeks) as first-line chemotherapy.
  • As soon as the chemotherapy started, the carbohydrate antigen 19-9 (CA19-9) level was notably reduced, and after 4 courses, CT scan revealed that the tumor was markedly reduced in size.
  • Intraoperative findings revealed that the gallbladder atrophied and, with no obvious invasion to adjacent organs, a small hard mass like only fibrosis was confirmed.
  • In the histological findings, cancer tissue was replaced by fibrosis, and malignant cells could not be detected.
  • Now the patient has remained well without recurrence after 6-month follow-up.
  • Many clinical trials show that gemcitabine, which is used as a single agent or combined with other agents (for example, cisplatin), demonstrated high efficacy with manageable toxicity in patients with advanced or metastatic biliary tract cancer.
  • For this disease, including gallbladder cancer, gemcitabine is the mainstay of chemotherapy, and it is thought that this agent could have high efficacy in many cases.
  • [MeSH-major] Deoxycytidine / analogs & derivatives. Gallbladder Neoplasms / drug therapy
  • [MeSH-minor] Aged. Combined Modality Therapy. Humans. Male. Neoplasm Staging. Remission Induction. Tomography, X-Ray Computed

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  • (PMID = 20841944.001).
  • [ISSN] 0385-0684
  • [Journal-full-title] Gan to kagaku ryoho. Cancer & chemotherapy
  • [ISO-abbreviation] Gan To Kagaku Ryoho
  • [Language] jpn
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Japan
  • [Chemical-registry-number] 0W860991D6 / Deoxycytidine; B76N6SBZ8R / gemcitabine
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19. Park JS, Yoon DS, Kim KS, Choi JS, Lee WJ, Chi HS, Kim BR: Actual recurrence patterns and risk factors influencing recurrence after curative resection with stage II gallbladder carcinoma. J Gastrointest Surg; 2007 May;11(5):631-7
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  • [Title] Actual recurrence patterns and risk factors influencing recurrence after curative resection with stage II gallbladder carcinoma.
  • Recent studies showed that aggressive radical resection for advanced gallbladder carcinoma can give an acceptable prognosis.
  • However, recurrence frequently remains the main problem after curative resection of advanced gallbladder carcinoma.
  • The aim of this study was to identify the patterns and risk factors of recurrence after curative resection for stage II gallbladder carcinoma.
  • Between January 1991 and December 2003, 100 patients received radical curative resection for gallbladder carcinoma at Yonsei University Medical Center.
  • Of these, 77 were defined with stage II gallbladder carcinoma according to the Union Internationale Contre Le Cancer classification (sixth edition).
  • Of the 77 patients, 67 were reviewed for the predictors of tumor recurrence.
  • Among the 67 patients, 38 (56.7%) suffered a recurrence.
  • The mean length to the recurrence was 21.1 +/- 26.7 months, with the most common site being the intraabdominal organs: liver and aortocaval lymph nodes.
  • Infiltrating and poorly differentiated types were identified as independent prognostic factors of recurrence after curative resection for stage II gallbladder carcinoma and it suggests that large multicenter randomized control trials are necessary to clarify the role of adjuvant chemotherapy in these patients.
  • [MeSH-major] Carcinoma / surgery. Gallbladder Neoplasms / surgery. Neoplasm Recurrence, Local / pathology
  • [MeSH-minor] Cholecystectomy / classification. Cholecystectomy, Laparoscopic. Colectomy. Common Bile Duct / surgery. Female. Follow-Up Studies. Hepatectomy. Humans. Liver Neoplasms / secondary. Lymph Node Excision. Lymphatic Metastasis / pathology. Male. Middle Aged. Neoplasm Seeding. Neoplasm Staging. Pancreaticoduodenectomy. Retrospective Studies. Risk Factors. Survival Rate. Time Factors

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  • (PMID = 17468922.001).
  • [ISSN] 1091-255X
  • [Journal-full-title] Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract
  • [ISO-abbreviation] J. Gastrointest. Surg.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
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20. de Aretxabala X, Losada H, Mora J, Roa I, Burgos L, Yáñez E, Quijada I, Roa JC: [Neoadjuvant chemoradiotherapy in gallbladder cancer]. Rev Med Chil; 2004 Jan;132(1):51-7
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  • [Title] [Neoadjuvant chemoradiotherapy in gallbladder cancer].
  • [Transliterated title] Quimiorradioterapia de neoadyuvancia en cáncer de vesícula biliar.
  • BACKGROUND: Gallbladder cancer is generally associated with a poor prognosis, being local recurrence the main pattern of failure.
  • AIM: To evaluate neoadjuvant chemoradiation as a means to improve the prognosis in gallbladder cancer.
  • PATIENTS AND METHODS: Twenty three gallbladder cancer patients were prospectively treated between June 1993 and September 1999 in the Temuco Regional Hospital.
  • Eighteen (82%) patients had subserosal infiltration, while three (13%) had serosal and two (9%) adipose tissue infiltration.
  • Chemotherapy was done with 5-fluorouracil in continuous infusion during 5 days at day 1 and 28 of treatment.
  • RESULTS: Twenty patients had hematological problems secondary to the therapy.
  • Leucopenia and thrombocytopenia were the most common toxic effects and eight had leucopenia under 2.0 x 10(3) during the treatment course.
  • Chemoradiation delayed surgical treatment in eight patients.
  • After the chemoradiation protocol, seven patients were excluded from surgical treatment and 14 patients underwent resection.
  • CONCLUSIONS: In this series of patients chemoradiation had no positive effect and a potentially detrimental effect in patients with gallbladder cancer.
  • [MeSH-major] Gallbladder Neoplasms / drug therapy. Gallbladder Neoplasms / radiotherapy
  • [MeSH-minor] Adult. Aged. Antimetabolites, Antineoplastic / therapeutic use. Chemotherapy, Adjuvant. Combined Modality Therapy. Female. Fluorouracil / therapeutic use. Humans. Middle Aged. Prognosis. Prospective Studies. Radiotherapy, Adjuvant. Survival Analysis. Treatment Outcome

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  • (PMID = 15379053.001).
  • [ISSN] 0034-9887
  • [Journal-full-title] Revista médica de Chile
  • [ISO-abbreviation] Rev Med Chil
  • [Language] spa
  • [Publication-type] English Abstract; Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] Chile
  • [Chemical-registry-number] 0 / Antimetabolites, Antineoplastic; U3P01618RT / Fluorouracil
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21. Sasson AR, Hoffman JP, Ross E, Meropol NJ, Szarka CE, Freedman G, Pinover W, Pingpank JF, Eisenberg BL: Trimodality therapy for advanced gallbladder cancer. Am Surg; 2001 Mar;67(3):277-83; discussion 284
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  • [Title] Trimodality therapy for advanced gallbladder cancer.
  • We conducted a retrospective review of all patients who underwent surgical extirpation for stage III, stage IV, or recurrent carcinoma of the gallbladder.
  • Between 1991 and 1999 ten patients underwent surgical resection for advanced gallbladder cancer.
  • All patients received adjuvant therapy either pre- or postoperatively.
  • Radiotherapy was used in all patients and chemotherapy in 90 per cent of patients.
  • Two patients subsequently underwent resection for locally recurrent disease.
  • An additional patient with stage II disease initially was also treated surgically for a local recurrence.
  • Surgical management involved cholecystectomy and resection of various amounts of liver surrounding the gallbladder bed and regional lymphadenectomy.
  • Resection of recurrent disease included excision of all gross tumor.
  • Median disease-free interval after each resection of recurrent disease was 13.8 months (range 4-28 months).
  • We conclude that trimodality therapy in selected patients with stage III, IV, or recurrent carcinoma of the gallbladder is possible and may result in prolonged survival.
  • [MeSH-major] Adenocarcinoma / therapy. Antineoplastic Agents / therapeutic use. Cholecystectomy. Gallbladder Neoplasms / therapy. Neoplasm Recurrence, Local / therapy
  • [MeSH-minor] Acute Disease. Aged. Chemotherapy, Adjuvant. Cholecystitis / etiology. Chronic Disease. Female. Humans. Jaundice / etiology. Male. Middle Aged. Neoplasm Staging. Prognosis. Proportional Hazards Models. Radiotherapy, Adjuvant. Retrospective Studies. Survival Analysis. Treatment Outcome

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  • (PMID = 11270889.001).
  • [ISSN] 0003-1348
  • [Journal-full-title] The American surgeon
  • [ISO-abbreviation] Am Surg
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents
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22. de Aretxabala X, Roa I, Berrios M, Hepp J, Gallardo J, Cordova A, Roa JC, Leon J, Maluenda F: Chemoradiotherapy in gallbladder cancer. J Surg Oncol; 2006 Jun 15;93(8):699-704
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  • [Title] Chemoradiotherapy in gallbladder cancer.
  • Gallbladder cancer (GC) is considered a rare disease associated with a poor prognosis.
  • Unfortunately, the low number of cases makes the performance of trials addressing the role of adjuvant, neoadjuvant, and/or palliative therapy difficult.
  • For a long time, the majority of trials were 5-fluorouracil (5 FU)-based, and results were uniformly poor.
  • Since the introduction of Gemcitabine, response rates of approximately 30% have been observed through the use of this drug and new approaches have been tested.
  • In this sense, drugs such as Cisplatin and Capecitabine have been employed concurrently with gemcitabine and/or radiation.
  • Since a recurrence pattern is both distant and local, chernoradiation seems a logical option to deal with the disease.
  • However, at the present time, the lack of valid and scientific evidence means that most of the recommendations originate from trials dealing with other tumors, such as pancreas cancer and biliary tract cancer (BTC).
  • The aforementioned treatment alternatives warrant further evaluation focusing on GC.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Gallbladder Neoplasms / drug therapy. Gallbladder Neoplasms / radiotherapy
  • [MeSH-minor] Antimetabolites, Antineoplastic / administration & dosage. Biliary Tract Neoplasms / drug therapy. Biliary Tract Neoplasms / radiotherapy. Capecitabine. Cisplatin / administration & dosage. Combined Modality Therapy. Deoxycytidine / administration & dosage. Deoxycytidine / analogs & derivatives. Female. Fluorouracil / administration & dosage. Humans. Male. Neoadjuvant Therapy. Palliative Care. Survival Analysis

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  • [Copyright] Copyright 2006 Wiley-Liss, Inc.
  • (PMID = 16724351.001).
  • [ISSN] 0022-4790
  • [Journal-full-title] Journal of surgical oncology
  • [ISO-abbreviation] J Surg Oncol
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antimetabolites, Antineoplastic; 0W860991D6 / Deoxycytidine; 6804DJ8Z9U / Capecitabine; B76N6SBZ8R / gemcitabine; Q20Q21Q62J / Cisplatin; U3P01618RT / Fluorouracil
  • [Number-of-references] 39
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23. Nakamoto Y, Ogata M, Yamamoto M: [A long-term survivor treated with S-1 and gemcitabine for recurrence following an operation for advanced gall bladder cancer]. Gan To Kagaku Ryoho; 2010 Oct;37(10):1979-81
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  • [Title] [A long-term survivor treated with S-1 and gemcitabine for recurrence following an operation for advanced gall bladder cancer].
  • The patient was a 75-year-old woman who had undergone an operation for T4, N0: stage IV a gall bladder cancer in May of 2003.
  • UFT was given as adjuvant chemotherapy.
  • Then S-1 and gemcitabine (GEM) were given because of the recurrence of peritoneal dissemination in June 2006.
  • To our knowledge, no case of a long survivor with S-1 and GEM for recurrence after a gall bladder cancer operation has been reported in the literature.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Deoxycytidine / analogs & derivatives. Gallbladder Neoplasms / drug therapy. Oxonic Acid / therapeutic use. Tegafur / therapeutic use
  • [MeSH-minor] Aged. Drug Combinations. Fatal Outcome. Female. Humans. Neoplasm Staging. Recurrence. Time Factors. Tomography, X-Ray Computed

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  • (PMID = 20948268.001).
  • [ISSN] 0385-0684
  • [Journal-full-title] Gan to kagaku ryoho. Cancer & chemotherapy
  • [ISO-abbreviation] Gan To Kagaku Ryoho
  • [Language] jpn
  • [Publication-type] Case Reports; English Abstract; Journal Article
  • [Publication-country] Japan
  • [Chemical-registry-number] 0 / Drug Combinations; 0W860991D6 / Deoxycytidine; 150863-82-4 / S 1 (combination); 1548R74NSZ / Tegafur; 5VT6420TIG / Oxonic Acid; B76N6SBZ8R / gemcitabine
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24. Fiebiger WC, Scheithauer W, Traub T, Kurtaran A, Gedlicka C, Kornek GV, Virgolini I, Raderer M: Absence of therapeutic efficacy of the somatostatin analogue lanreotide in advanced primary hepatic cholangiocellular cancer and adenocarcinoma of the gallbladder despite in vivo somatostatin-receptor expression. Scand J Gastroenterol; 2002 Feb;37(2):222-5
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  • [Title] Absence of therapeutic efficacy of the somatostatin analogue lanreotide in advanced primary hepatic cholangiocellular cancer and adenocarcinoma of the gallbladder despite in vivo somatostatin-receptor expression.
  • Because of the absence of standard chemotherapy for advanced biliary carcinoma and reports of expression of receptors for somatostatin (SST), we performed a phase II study to evaluate the clinical potential of the long-acting SST analogue lanreotide (LAN) for treatment of this disease.
  • METHODS: Twenty consecutive patients with histologically verified primary hepatic cholangiocellular cancer or primary adenocarcinoma of the gallbladder were enrolled in the study.
  • Before initiation of therapy, SST-receptor scintigraphy using 111In-DOTA-LAN was carried out in eight patients to check for in vivo expression of SST receptors.
  • Restaging by means of computed tomography was performed every 8 weeks, and response was assessed according to World Health Organisation standard criteria.
  • Side effects were generally mild, only two patients complained of mild nausea and one patient had meteorism attributed to therapy.
  • Therapeutic results, however, were disappointing, with only one patient demonstrating complete remission (CR), which lasted for 18 months before diagnosis of recurrence.
  • Four patients had stable disease (SD) lasting between 3.5 and 9+ months accompanied by weight gain and improvement in performance status in 2 cases, while the remaining 15 patients progressed during therapy.
  • The median time to progression was 2.5 months (range 1-18), and the median survival was 4.5 months (range 1.5-18+ months).
  • No clear-cut correlation between scan result and therapeutic outcome could be demonstrated, as not only the patient with CR and two with SD, but also five patients with progressive disease had a positive scan result.
  • CONCLUSION: Our data show that adenocarcinomas of the gallbladder and hepatic cholangiocellular carcinomas express SST receptors in vivo as judged by 111In-DOTA-LAN scintigraphy.
  • Despite this fact, LAN did not display therapeutic activity in this study.
  • [MeSH-major] Antineoplastic Agents / therapeutic use. Bile Duct Neoplasms / drug therapy. Bile Ducts, Intrahepatic. Cholangiocarcinoma / drug therapy. Peptides, Cyclic / therapeutic use. Receptors, Somatostatin / metabolism. Somatostatin / therapeutic use
  • [MeSH-minor] Aged. Female. Gallbladder Neoplasms / drug therapy. Gallbladder Neoplasms / radionuclide imaging. Heterocyclic Compounds. Humans. Male. Prospective Studies. Radiopharmaceuticals

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  • (PMID = 11843061.001).
  • [ISSN] 0036-5521
  • [Journal-full-title] Scandinavian journal of gastroenterology
  • [ISO-abbreviation] Scand. J. Gastroenterol.
  • [Language] eng
  • [Publication-type] Clinical Trial; Clinical Trial, Phase II; Journal Article
  • [Publication-country] Norway
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0 / Heterocyclic Compounds; 0 / Peptides, Cyclic; 0 / Radiopharmaceuticals; 0 / Receptors, Somatostatin; 0 / indium 111-DOTA-lanreotide; 118992-92-0 / lanreotide; 51110-01-1 / Somatostatin
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25. Paolucci V, Neckell M, Götze T, Workgroup Surgical Endoscopy, German Society of Surgery: [Unsuspected gallbladder carcinoma--the CAE-S/CAMIC registry]. Zentralbl Chir; 2003 Apr;128(4):309-12
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  • [Title] [Unsuspected gallbladder carcinoma--the CAE-S/CAMIC registry].
  • [Transliterated title] Das "okkulte" Gallenblasenkarzinom--CAE-S/CAMIC-Zentralregister.
  • INTRODUCTION: Results of earlier surveys raised the prospect that laparoscopic surgical procedures may specifically increase the risk of port wound metastasis and generally of tumour cell seeding if at the time of operation an unsuspected gallbladder cancer existed.
  • Other observations lead to presume that laparoscopic technique could deteriorate the prognosis of gallbladder cancer.
  • MATERIAL AND METHOD: The Workgroup Surgical Endoscopy (CAE) of the German Society of Surgery has started 1997 a registry of all cases of cholecystectomy--laparoscopic as well open--with a postoperative incidental finding of a gallbladder carcinoma.
  • The aim of our registry is to compare the prospectively collected follow up data on the outcome of these patients and to answer the question whether laparoscopic cholecystectomy affects the course and the prognosis of patients with unsuspected gallbladder cancer.
  • RESULTS: Until now 142 cases of incidental gallbladder cancer following laparoscopic and 79 cases following open cholecystectomy as well as 24 cases after intraoperative conversion to the open procedure have been recorded.
  • Following laparoscopic primary procedure we registered 10 port site metastases (7 %), following open primary procedure 4 (5.1 %) wound recurrences.
  • The total recurrence rate at the moment is about 27 % after laparoscopic treatment and 31 % for conventionally operated patients.
  • 70 of the 245 patients underwent a second radical procedure after diagnosis of gallbladder carcinoma.
  • A postoperative combined radio- and chemotherapy was undertaken in 4 cases, a chemotherapy alone in 14 cases.
  • DISCUSSION: At the present, after a median follow up of 27 months, the incidence of abdominal wall recurrences is very similar following laparoscopic and conventional procedure (7 % vs. 5.1 %).
  • The access technique, open or laparoscopic, doesn't seem to influence the prognosis of unsuspected gallbladder carcinoma.
  • [MeSH-major] Adenocarcinoma / diagnosis. Carcinoma, Squamous Cell / diagnosis. Cholecystectomy, Laparoscopic / statistics & numerical data. Cholecystitis / surgery. Cholelithiasis / surgery. Gallbladder Neoplasms / diagnosis. Incidental Findings. Neoplasm Seeding. Registries / statistics & numerical data
  • [MeSH-minor] Aged. Combined Modality Therapy / statistics & numerical data. Female. Follow-Up Studies. Humans. Male. Middle Aged. Neoplasm Recurrence, Local / diagnosis. Neoplasm Recurrence, Local / mortality. Neoplasm Recurrence, Local / pathology. Neoplasm Recurrence, Local / surgery. Neoplasm Staging. Reoperation / statistics & numerical data. Retrospective Studies. Survival Rate

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  • (PMID = 12700988.001).
  • [ISSN] 0044-409X
  • [Journal-full-title] Zentralblatt für Chirurgie
  • [ISO-abbreviation] Zentralbl Chir
  • [Language] ger
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] Germany
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26. Hong YS, Lee J, Lee SC, Hwang IG, Choi SH, Heo JS, Park JO, Park YS, Lim HY, Kang WK: Phase II study of capecitabine and cisplatin in previously untreated advanced biliary tract cancer. Cancer Chemother Pharmacol; 2007 Aug;60(3):321-8
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  • [Title] Phase II study of capecitabine and cisplatin in previously untreated advanced biliary tract cancer.
  • BACKGROUND: Biliary tract cancer is one of the most aggressive and chemotherapy-refractory tumors.
  • Although only curative treatment modality is surgery, most patients are not suitable for surgery due to advanced stage of the disease at diagnosis.
  • Thus most patients with biliary tract cancer are possible candidates for palliative chemotherapy.
  • We performed a phase II study of combination chemotherapy with capecitabine and cisplatin in these patients to evaluate efficacy and toxicity of the regimen.
  • METHODS: Patients with previously untreated metastatic, recurrent, or inoperable biliary tract cancer were enrolled.
  • Response was assessed for every two cycles of chemotherapy and treatment was stopped when tumor had progressed or stable with no further response.
  • Fifteen patients (46.9%) had gallbladder cancer, 13 (40.6%) had intrahepatic cholangiocarcinoma, and 4 (12.5%) had extrahepatic biliary cancer.
  • The median time to progression was 3.5 months (95% CI, 1.3-5.8), and the median overall survival was 12.4 months (95% CI, 6.3-18.5) after the median follow-up duration of 9.5 months (4.8-26.1 months).
  • A total of 108 cycles of chemotherapy was delivered.
  • There was no treatment-related death.
  • CONCLUSION: The combination chemotherapy of capecitabine and cisplatin demonstrated a promising antitumor activity with mild toxicity profile in patients with advanced biliary tract cancer.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Biliary Tract Neoplasms / drug therapy
  • [MeSH-minor] Adult. Aged. Capecitabine. Cisplatin / administration & dosage. Deoxycytidine / administration & dosage. Deoxycytidine / analogs & derivatives. Disease Progression. Drug Administration Schedule. Female. Fluorouracil / administration & dosage. Fluorouracil / analogs & derivatives. Humans. Male. Middle Aged. Neoplasm Metastasis. Recurrence. Survival Analysis

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  • (PMID = 17143602.001).
  • [ISSN] 0344-5704
  • [Journal-full-title] Cancer chemotherapy and pharmacology
  • [ISO-abbreviation] Cancer Chemother. Pharmacol.
  • [Language] eng
  • [Publication-type] Clinical Trial, Phase III; Journal Article
  • [Publication-country] Germany
  • [Chemical-registry-number] 0W860991D6 / Deoxycytidine; 6804DJ8Z9U / Capecitabine; Q20Q21Q62J / Cisplatin; U3P01618RT / Fluorouracil
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27. Furuse J: Postoperative adjuvant treatments for biliary tract cancer. J Hepatobiliary Pancreat Surg; 2008;15(5):463-7
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  • [Title] Postoperative adjuvant treatments for biliary tract cancer.
  • Surgery currently remains the only potentially curative treatment for biliary tract cancer, and most patients develop recurrence.
  • Thus, effective adjuvant therapy is required to increase the curability of surgery and to prolong the survival in these patients.
  • However, to date, no standard postoperative adjuvant therapy regimen has been established for patients with biliary tract cancer.
  • Based on favorable results reported from phase II trials, gemcitabine and S-1 are currently available as promising agents for the treatment of unresectable biliary tract cancer in Japan.
  • Both agents are also expected to be effective in the postoperative adjuvant therapy setting for biliary tract cancer, and well-designed randomized controlled trials (phase III trials) to determine the efficacy of these agents in the postoperative adjuvant setting should be pursued vigorously.
  • In phase III trials, appropriate stratification of patients is important, and the primary disease (gallbladder cancer versus nongallbladder cancers), curability (R0 or R1), and presence/absence of lymph node metastasis should be taken into account.
  • [MeSH-major] Antineoplastic Agents / administration & dosage. Biliary Tract Neoplasms / drug therapy. Deoxycytidine / analogs & derivatives. Pancreatic Neoplasms / drug therapy
  • [MeSH-minor] Chemotherapy, Adjuvant. Humans. Randomized Controlled Trials as Topic

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  • (PMID = 18836797.001).
  • [ISSN] 0944-1166
  • [Journal-full-title] Journal of hepato-biliary-pancreatic surgery
  • [ISO-abbreviation] J Hepatobiliary Pancreat Surg
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Japan
  • [Chemical-registry-number] 0 / Antineoplastic Agents; 0W860991D6 / Deoxycytidine; B76N6SBZ8R / gemcitabine
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28. Jarnagin WR, Shoup M: Surgical management of cholangiocarcinoma. Semin Liver Dis; 2004 May;24(2):189-99
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  • Biliary tract cancer affects approximately 7500 Americans each year.
  • Tumors arising from the gallbladder are the most common; those of bile duct origin, or cholangiocarcinoma, are less frequently encountered, constituting approximately 2% of all reported cancers.
  • Complete resection remains the most effective and only potentially curative therapy for cholangiocarcinoma.
  • Distal cholangiocarcinomas, on the other hand, are treated like all periampullary malignancies and typically require pancreaticoduodenectomy.
  • Most patients with cholangiocarcinoma present with advanced disease that is not amenable to surgical treatment, and even with a complete resection, recurrence rates are high.
  • Adjuvant therapy (chemotherapy and radiation therapy) has not been shown clearly to reduce recurrence risk.
  • [MeSH-minor] Adenocarcinoma / diagnosis. Adenocarcinoma / surgery. Bile Ducts, Extrahepatic / surgery. Bile Ducts, Intrahepatic / surgery. Hepatectomy. Humans. Neoplasm Staging. Palliative Care

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  • (PMID = 15192791.001).
  • [ISSN] 0272-8087
  • [Journal-full-title] Seminars in liver disease
  • [ISO-abbreviation] Semin. Liver Dis.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 68
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29. Harder J, Blum HE: [Cholangiocarcinoma]. Praxis (Bern 1994); 2002 Aug 21;91(34):1352-6
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  • They are a heterogeneous group of neoplasias that include the most common perihilar or Klatskin tumor (60%), the intrahepatic (peripheral) CCC, the extrahepatic bile duct cancer, the gallbladder cancer and the cancer of the ampulla of Vater.
  • At the time of diagnosis only 20% of patients can be treated by surgery, that offers the only chance for cure.
  • Due to high recurrence rates liver transplantation is not indicated.
  • Neither chemotherapy nor radiation therapy improves survival.
  • In patients not eligible for curative surgery prevention or treatment of cholestatis is the main objective.
  • Palliative chemotherapy results in response rates up to 20%.
  • By combining different treatment modalities significant survival can be achieved in some patients.
  • Evidence Based Medicine studies are needed before treatment strategies can be recommended for clinical practice.
  • [MeSH-minor] Gallbladder Neoplasms / diagnosis. Gallbladder Neoplasms / pathology. Hepatic Duct, Common / pathology. Humans. Klatskin Tumor / diagnosis. Klatskin Tumor / pathology. Neoplasm Staging. Prognosis

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  • (PMID = 12233266.001).
  • [ISSN] 1661-8157
  • [Journal-full-title] Praxis
  • [ISO-abbreviation] Praxis (Bern 1994)
  • [Language] ger
  • [Publication-type] English Abstract; Journal Article; Review
  • [Publication-country] Switzerland
  • [Number-of-references] 24
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30. Leonard GD, O'Reilly EM: Biliary tract cancers: current concepts and controversies. Expert Opin Pharmacother; 2005 Feb;6(2):211-23
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  • Biliary tract cancer, which consists of gall bladder cancer and cholangio-carcinoma, presents many challenges to practising physicians.
  • It is a relatively rare cancer that often causes a diagnostic dilemma, as its presentation may be similar to that of non-malignant conditions.
  • In many cases, histological or cytological confirmation of a cancer diagnosis is not possible preoperatively.
  • The management of this disease is also complex due to a morbid patient population and limited data on the optimal therapeutic approach.
  • Surgery remains the mainstay of treatment, although the extent of resection required is still debated.
  • The role of adjuvant therapy is also controversial, but a combined modality approach appears to be beneficial in patients with a high risk of recurrence, such as those with node positive tumors or positive resection margins.
  • When surgery is not possible, the prognosis of patients with biliary tract cancer is very poor.
  • In unresectable patients, the combination of chemotherapy and radiotherapy can result in a prolonged survival for some patients.
  • Gemcitabine-based combination chemotherapy may also provide successful palliation and has achieved response rates of approximately 30% and a median survival of > 15 months in one study.
  • Ultimately, treatment decisions should be individualised and participation in clinical trials is encouraged.
  • Further progress in the management of biliary tract cancer is anticipated using biological therapies and continued research is essential to discover the optimal treatment for this challenging disease.
  • [MeSH-major] Antineoplastic Agents / therapeutic use. Bile Duct Neoplasms / therapy. Gallbladder Neoplasms / therapy
  • [MeSH-minor] Biliary Tract Neoplasms / diagnosis. Biliary Tract Neoplasms / etiology. Biliary Tract Neoplasms / therapy. Clinical Trials as Topic / statistics & numerical data. Humans. Neoplasm Staging / statistics & numerical data

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  • (PMID = 15757418.001).
  • [ISSN] 1744-7666
  • [Journal-full-title] Expert opinion on pharmacotherapy
  • [ISO-abbreviation] Expert Opin Pharmacother
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Antineoplastic Agents
  • [Number-of-references] 128
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31. Pinto A, Tuttolomondo A, Fernandez P, Siragusa S, Di Raimondo D, Malato A, Di Sciacca R, La Placa S, Miceli S, Licata G: Recurrent venous thromboembolism complicated by heparin-induced thrombocytopenia as a first manifestation of an occult cancer: a case report. Int J Immunopathol Pharmacol; 2008 Jan-Mar;21(1):247-50
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  • [Title] Recurrent venous thromboembolism complicated by heparin-induced thrombocytopenia as a first manifestation of an occult cancer: a case report.
  • Its management is difficult and it can be more complicated in patients with cancer because of the hemorrhagic risk carried out by direct inhibitor of thrombin, the currently approved drug for HIT.
  • At present, it is not clear whether cancer patients also have an increased risk of HIT.
  • We describe the case of a patient with occult cancer at the moment of the index venous thrombosis, who developed Deep Vein Thrombosis (DVT) and concomitant HIT with thrombotic complications (recurrent contra-lateral venous thrombosis).
  • This case highlights the potential relationship between DVT, as first episode of an occult cancer, and the risk of developing HIT.
  • The use of alternative antithrombotic therapy seems to be efficacious even in this high-risk cancer patient.
  • [MeSH-major] Gallbladder Neoplasms / complications. Heparin / adverse effects. Thrombocytopenia / complications. Venous Thromboembolism / etiology
  • [MeSH-minor] Aged. Female. Humans. Recurrence

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  • (PMID = 18336754.001).
  • [ISSN] 0394-6320
  • [Journal-full-title] International journal of immunopathology and pharmacology
  • [ISO-abbreviation] Int J Immunopathol Pharmacol
  • [Language] eng
  • [Publication-type] Case Reports; Letter
  • [Publication-country] England
  • [Chemical-registry-number] 9005-49-6 / Heparin
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