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1. Sprinzl MF, Schimanski CC, Moehler M, Schadmand-Fischer S, Galle PR, Kanzler S: Gemcitabine in combination with EGF-Receptor antibody (Cetuximab) as a treatment of cholangiocarcinoma: a case report. BMC Cancer; 2006;6:190
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Gemcitabine in combination with EGF-Receptor antibody (Cetuximab) as a treatment of cholangiocarcinoma: a case report.
  • Despite chemotherapy, which has been introduced to improve the outcome of biliary tract malignancies, the benefit in survival is still marginal.
  • CASE PRESENTATION: We report a 69-year-old patient with non-resectable CC showing hepatic metastasis and peritoneal carcinomatosis.
  • Diagnosis was based on computed tomography, mini-laparoscopy and bioptic specimens.
  • After informed consent the patient received experimental gemcitabine (1000 mg/m2) every other week and cetuximab (250 mg/m2) weekly for palliative chemotherapy.
  • During the reported follow up (since time of first presentation) 20 cycles of chemotherapy were administered.
  • Relevant chemotherapy-related toxicity was limited on gemcitabine-associated side effects.
  • Chemotherapy led to a partial response (> 30% reduction, according to RECIST) of the target lesions and disappearance of the peritoneal carcinomatosis as shown by computed tomography.
  • Partial response occurred after 17 weeks of treatment and remained stable during the entire course of chemotherapy for 9.7 months.
  • In parallel, Ca 19-9 serum levels, which were elevated 5-fold at time of diagnosis, returned to normal after 16 weeks of treatment.
  • CONCLUSION: Our experience from one patient with CC suggests, that a combination of cytotoxic chemotherapy together with cetuximab may show promising efficacy in respect to survival and quality of life.
  • Therefore cetuximab, as a component of palliative chemotherapy in biliary tract cancer, needs further evaluation in prospective randomized trials.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Bile Duct Neoplasms / drug therapy. Cholangiocarcinoma / drug therapy

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  • (PMID = 16846514.001).
  • [ISSN] 1471-2407
  • [Journal-full-title] BMC cancer
  • [ISO-abbreviation] BMC Cancer
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Antibodies, Monoclonal; 0 / Antibodies, Monoclonal, Humanized; 0W860991D6 / Deoxycytidine; B76N6SBZ8R / gemcitabine; PQX0D8J21J / Cetuximab
  • [Other-IDs] NLM/ PMC1564184
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2. Gerhardt T, Milz S, Schepke M, Feldmann G, Wolff M, Sauerbruch T, Dumoulin FL: C-reactive protein is a prognostic indicator in patients with perihilar cholangiocarcinoma. World J Gastroenterol; 2006 Sep 14;12(34):5495-500
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • AIM: To evaluate prognostic indicators for the outcome of patients with perihilar extrahepatic cholangiocarcinoma in an unselected cohort.
  • Patients with non-resectable tumors underwent either transpapillary or percutaneous transhepatic biliary drainage.
  • Additionally, 32 patients (32.7%) received photodynamic therapy (PDT) and 18 patients (18.4%) systemic chemotherapy.
  • Predefined variables at the time of diagnosis and characteristics considering the mode of treatment were entered into a Cox's proportional hazards model.
  • Included in the analysis were age, tumor stage following the modified Bismuth-Corlette classification, bilirubin, prothrombin time (PT), C-reactive protein (CRP), carbohydrate antigen 19-9 (CA19-9), history of weight loss, surgical resection, chemotherapy and PDT.
  • Applying Kaplan-Meier analysis, patients with a CRP < 12 mg/L at the time of diagnosis had a significantly longer median survival than patients with higher values (16.2 vs 7.6 mo; P = 0.009).
  • CONCLUSION: This retrospective analysis identified CRP level at the time of diagnosis as a novel indicator for the prognosis of patients with perihilar cholangiocarcinoma.
  • [MeSH-major] Bile Duct Neoplasms / blood. Bile Ducts, Intrahepatic. C-Reactive Protein / analysis. Cholangiocarcinoma / blood
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Biomarkers, Tumor / blood. Female. Hepatectomy. Humans. Male. Middle Aged. Prognosis. Proportional Hazards Models. Retrospective Studies. Survival Analysis. Treatment Outcome

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  • (PMID = 17006987.001).
  • [ISSN] 1007-9327
  • [Journal-full-title] World journal of gastroenterology
  • [ISO-abbreviation] World J. Gastroenterol.
  • [Language] eng
  • [Publication-type] Evaluation Studies; Journal Article
  • [Publication-country] China
  • [Chemical-registry-number] 0 / Biomarkers, Tumor; 9007-41-4 / C-Reactive Protein
  • [Other-IDs] NLM/ PMC4088232
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3. Miyakawa S, Ishihara S, Takada T, Miyazaki M, Tsukada K, Nagino M, Kondo S, Furuse J, Saito H, Tsuyuguchi T, Kimura F, Yoshitomi H, Nozawa S, Yoshida M, Wada K, Amano H, Miura F, Japanese Association of Biliary Surgery, Japanese Society of Hepato-Biliary-Pancreatic Surgery, Japan Society of Clinical Oncology: Flowcharts for the management of biliary tract and ampullary carcinomas. J Hepatobiliary Pancreat Surg; 2008;15(1):7-14

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • No strategies for the diagnosis and treatment of biliary tract carcinoma have been clearly described.
  • We developed flowcharts for the diagnosis and treatment of biliary tract carcinoma on the basis of the best clinical evidence.
  • Risk factors for bile duct carcinoma are a dilated type of pancreaticobiliary maljunction (PBM) and primary sclerosing cholangitis.
  • A nondilated type of PBM is a risk factor for gallbladder carcinoma.
  • Symptoms that may indicate biliary tract carcinoma are jaundice and pain in the upper right area of the abdomen.
  • The second step of diagnosis is to find the local extension of the carcinoma by means of computed tomography (CT), magnetic resonance imaging (MRI), magnetic resonance cholangiopancreatography (MRCP), percutaneous transhepatic cholangiography (PTC), and endoscopic retrograde cholangiopancreatography (ERCP).
  • Because resection is the only way to completely cure biliary tract carcinoma, the indications for resection are determined first.
  • In patients with resectable disease, the indications for biliary drainage or portal vein embolization (PVE) are checked.
  • In those with nonresectable disease, biliary stenting, chemotherapy, radiotherapy, and/or best supportive care is selected.
  • [MeSH-major] Algorithms. Ampulla of Vater. Biliary Tract Neoplasms. Carcinoma

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  • (PMID = 18274839.001).
  • [ISSN] 0944-1166
  • [Journal-full-title] Journal of hepato-biliary-pancreatic surgery
  • [ISO-abbreviation] J Hepatobiliary Pancreat Surg
  • [Language] eng
  • [Publication-type] Journal Article; Practice Guideline; Research Support, Non-U.S. Gov't
  • [Publication-country] Japan
  • [Other-IDs] NLM/ PMC2794355
  • [Investigator] Kai M; Kimura Y; Kai S; Kimura Y; Sawada S; Shimizu H; Nakagawara H; Nakachi K; Yoshitome H; Saisyo H; Shikata S; Nimura Y
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4. Hayashi N, Hasuike Y, Fukuchi N, Kida H, Tujie M, Yoshida T, Ebisui C, Sakita I, Koshino T, Izumiyama K, Koro T, Fujimoto T: [A case of unresectable cholangiocellular carcinoma treated with surgery followed by combination chemotherapy]. Gan To Kagaku Ryoho; 2005 Oct;32(11):1852-4
Hazardous Substances Data Bank. FLUOROURACIL .

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] [A case of unresectable cholangiocellular carcinoma treated with surgery followed by combination chemotherapy].
  • The patient was a 44-year-old man, who was investigated for lateral abdominal pain and liver dysfunction, and subsequently referred to our department with a diagnosis of unresectable intrahepatic cholangiocellular carcinoma (CCC).
  • A month after the operation, a subcutaneous implant reservoir was indwelled for repeated transcatheter hepatic arterial chemo infusion therapy (5-fluorouracil 500 mg/day continuous infusion, day 1-5, and CDDP 10 mg/day, day 1) from the right femoral artery.
  • After 15 courses of home anti-cancer chemotherapy, abdominal CT revealed that the size of intrahepatic metastasis in the left lobe of the liver had not shown growth, whereas other metastitic sites popped up in the caudate lobe, which were free of chemical agent flow.
  • There was no major complication related to the chemotherapy throughout the post-treatment course.
  • Although he maintained a good level of QOL, he refused further chemotherapy due to depression.
  • In conclusion, volume reduction surgery followed by transcatheter hepatic arterial chemo infusion might be promising as an effective therapy for non resectable CCC.
  • [MeSH-major] Bile Duct Neoplasms / therapy. Bile Ducts, Intrahepatic. Cholangiocarcinoma / therapy
  • [MeSH-minor] Adult. Antimetabolites, Antineoplastic / administration & dosage. Antineoplastic Agents / administration & dosage. Antineoplastic Combined Chemotherapy Protocols / administration & dosage. Cisplatin / administration & dosage. Fluorouracil / administration & dosage. Hepatectomy. Humans. Infusions, Intra-Arterial. Liver Neoplasms / secondary. Lymph Node Excision. Male

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  • (PMID = 16315961.001).
  • [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; Q20Q21Q62J / Cisplatin; U3P01618RT / Fluorouracil
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6. Wada H, Nagano H, Dono K, Kondo M, Yamamoto T, Ota H, Nakamura M, Yoshioka S, Damdinsuren B, Yubo Y, Marubashi S, Miyamoto A, Umeshita K, Nakamori S, Sakon M, Monden M: [Successful treatment for advanced cholangiocellular carcinoma with intrahepatic metastasis and/or portal vein tumor thrombi by intraarterial chemotherapy combined with 5-fluorouracil, adriamycin and cisplatin (FAP)--two cases report]. Gan To Kagaku Ryoho; 2004 Oct;31(11):1711-3
Hazardous Substances Data Bank. FLUOROURACIL .

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] [Successful treatment for advanced cholangiocellular carcinoma with intrahepatic metastasis and/or portal vein tumor thrombi by intraarterial chemotherapy combined with 5-fluorouracil, adriamycin and cisplatin (FAP)--two cases report].
  • The patients of unresectable cholangiocellular carcinoma (CCC) have extremely poor prognosis.
  • From June 2003, he received hepatic arterial infusion chemotherapy (FAP: 5-fluorouracil 250 mg/day continuous infusion, day 1-5, adriamycin 10 mg/day, day 1, and CDDP 10 mg/day, day 1).
  • He received FAP arterial infusion chemotherapy that was a same regimen as with the case 1 patient.
  • In both cases, there was no complication related to the chemotherapy.
  • They are alive for more than 1 year after chemotherapy had started.
  • FAP hepatic arterial infusion chemotherapy might be promising as an effective therapy for non-resectable CCC without extra hepatic metastasis.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / administration & dosage. Bile Duct Neoplasms / drug therapy. Cisplatin / administration & dosage. Doxorubicin / administration & dosage. Fluorouracil / administration & dosage
  • [MeSH-minor] Aged. Bile Ducts, Intrahepatic. Cholangiocarcinoma / drug therapy. Drug Administration Schedule. Hepatic Artery. Humans. Infusions, Intra-Arterial. Male. Neoplastic Cells, Circulating / drug effects

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  • (PMID = 15553691.001).
  • [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] 80168379AG / Doxorubicin; Q20Q21Q62J / Cisplatin; U3P01618RT / Fluorouracil; FAP protocol
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7. Ustundag Y, Bayraktar Y: Cholangiocarcinoma: a compact review of the literature. World J Gastroenterol; 2008 Nov 14;14(42):6458-66
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  • Cholangiocarcinoma (CC) is a devastating cancer arising from biliary epithelia.
  • These tumors progress insidiously, and liver failure, biliary sepsis, malnutrition and cancer cachexia are general modes of death associated with this disease.
  • To date, no established therapy for advanced disease has been established or validated.
  • However, our knowledge in tumor biology is increasing dramatically and new drugs are under investigation for treatment of this notorious tumor.
  • CC is resectable for cure in only a small percentage of patients.
  • Although CC was previously considered a contraindication to liver transplantation, new cautious protocols, including neo-adjuvant chemoradiation therapies and staging procedures before the transplantation, have made it possible to achieve long-term survival after liver transplantation in this disease.
  • New ablative therapies with photodynamic therapy, intraductal high-intensity ultrasonography and chemotherapy-impregnated plastic biliary endoprosthesis are important steps in the palliative management of extra-hepatic CCs.
  • Radiofrequency and chemo-embolization methods are also applicable for intra-hepatic CCs as palliative modes of treatment.
  • We need more prospective randomized controlled trials to evaluate the role of the new emerging therapies for CC patients.
  • [MeSH-major] Bile Duct Neoplasms. Bile Ducts, Intrahepatic. Cholangiocarcinoma
  • [MeSH-minor] Diagnosis, Differential. Humans. Neoplasm Staging. Predictive Value of Tests. Risk Factors. Treatment Outcome

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  • (PMID = 19030196.001).
  • [ISSN] 1007-9327
  • [Journal-full-title] World journal of gastroenterology
  • [ISO-abbreviation] World J. Gastroenterol.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] China
  • [Number-of-references] 94
  • [Other-IDs] NLM/ PMC2773330
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8. Freelove R, Walling AD: Pancreatic cancer: diagnosis and management. Am Fam Physician; 2006 Feb 1;73(3):485-92
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Pancreatic cancer: diagnosis and management.
  • Although only 32,000 new cases of adenocarcinoma of the pancreas occur in the United States each year, it is the fourth leading cause of cancer deaths in this country.
  • The overall five-year survival rate is 4 percent, and localized, resectable disease has only a 17 percent survival rate.
  • Risk factors include smoking, certain familial cancer syndromes, and familial chronic pancreatitis.
  • The link between risk of pancreatic cancer and other factors (e.g., diabetes, obesity) is less clear.
  • Most patients present with obstructive jaundice caused by compression of the bile duct in the head of the pancreas.
  • Epigastric or back pain, vague abdominal symptoms, and weight loss also are characteristic of pancreatic cancer.
  • Computed tomography is the most useful diagnostic and staging tool.
  • The majority of tumors are not surgically resectable because of metastasis and invasion of the major vessels posterior to the pancreas.
  • Resectable tumors are treated with the Whipple procedure or the pylorus-preserving Whipple procedure.
  • Adjuvant fluorouracil-based chemotherapy may prolong survival.
  • For nonresectable tumors, chemotherapy with gemcitabine prolongs survival.
  • Radiation combined with chemotherapy has slowed progression in locally advanced cancers.
  • [MeSH-major] Pancreatic Neoplasms / diagnosis. Pancreatic Neoplasms / therapy
  • [MeSH-minor] Biomarkers, Tumor / blood. Chemotherapy, Adjuvant. Diagnostic Imaging. Humans. Neoplasm Staging. Palliative Care. Physical Examination. Radiotherapy, Adjuvant

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  • (PMID = 16477897.001).
  • [ISSN] 0002-838X
  • [Journal-full-title] American family physician
  • [ISO-abbreviation] Am Fam Physician
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Biomarkers, Tumor
  • [Number-of-references] 51
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9. Matsuo R, Kondo T, Ohshiro Y, Moon Y, Yamamoto Y, Takeshima T, Todoroki T, Ohkohchi N: [A case of stage IVA intrahepatic biliary tract cancer successfully treated with gemcitabine]. Gan To Kagaku Ryoho; 2006 Oct;33(10):1501-4
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  • [Title] [A case of stage IVA intrahepatic biliary tract cancer successfully treated with gemcitabine].
  • We reported a case of non-resectable intrahepatic biliary tract cancer, treated with Gemcitabine and oral anticancer drugs.
  • CT scan revealed intrahepatic biliary tract cancer in the left lobe, which had metastasized to both lobes.
  • Based on the diagnosis of non-resectable intrahepatic biliary tract cancer, systemic chemotherapy using gemcitabine (GEM) was employed.
  • One course of the treatment consisted of 4 weeks.
  • GEM 1,000 mg was administered once a week for 3 weeks followed by a week of no treatment.
  • At the same time, the oral anti-cancer drug (5'-DFUR 600 mg/day) was administered every day.
  • After 4 courses of chemotherapy, both the primary tumor and the hepatic metastasis were diminished, and the serum level of CA19-9 was reduced to the normal value.
  • The chemotherapy was continued by outpatient-clinic treatment, preserving the quality of life for 13 months.
  • The present case shows that gemcitabine/5'-DFUR combination is well supported in advanced unresectable biliary tract cancer.
  • [MeSH-major] Antimetabolites, Antineoplastic / administration & dosage. Bile Duct Neoplasms / drug therapy. Bile Ducts, Intrahepatic. Deoxycytidine / analogs & derivatives. Liver Neoplasms / secondary
  • [MeSH-minor] Administration, Oral. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. CA-19-9 Antigen / blood. Carcinoembryonic Antigen / blood. Drug Administration Routes. Floxuridine / administration & dosage. Humans. Male. Middle Aged. Neoplasm Staging. Tomography, X-Ray Computed

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  • (PMID = 17033247.001).
  • [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 / CA-19-9 Antigen; 0 / Carcinoembryonic Antigen; 039LU44I5M / Floxuridine; 0W860991D6 / Deoxycytidine; B76N6SBZ8R / gemcitabine; V1JK16Y2JP / doxifluridine
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10. Birk D, Beger HG: Neoadjuvant, adjuvant, and palliative treatment of pancreatic cancer. Curr Gastroenterol Rep; 2001 Apr;3(2):129-35
MedlinePlus Health Information. consumer health - Pancreatic Cancer.

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Neoadjuvant, adjuvant, and palliative treatment of pancreatic cancer.
  • Pancreatic cancer remains a highly malignant disease.
  • Curative treatment is only possible for patients diagnosed at a very early stage.
  • Therefore, the vast majority of pancreatic cancer patients receive palliative treatment.
  • Surgical palliation is offered to patients who are found not to have a resectable tumor.
  • The treatment of obstructive jaundice is managed by stenting of the common bile duct or by a surgical bypass.
  • The best possible surgical procedure should be based on the factors that influence hospital mortality, length of survival, and quality of life.
  • In patients with a life expectancy of longer than 3 months, surgical bypass is recommended, with hepaticojejunostomy the treatment of choice.
  • In the same surgical procedure, the relief of duodenal obstruction with a gastroenteric bypass should be achieved.
  • Chemotherapy, radiotherapy, or a combination of both is employed as a neoadjuvant measure, as an adjuvant treatment, or, in most patients, as palliation.
  • As palliative chemotherapy alone, 5-fluorouracil (5-FU) plus folinic acid is still the treatment of choice; however, newer drugs, such as gemcitabine, seem to have similar or marginally better results.
  • [MeSH-major] Neoadjuvant Therapy. Palliative Care. Pancreatic Neoplasms / therapy
  • [MeSH-minor] Chemotherapy, Adjuvant. Europe / epidemiology. Humans. Quality of Life. Radiotherapy, Adjuvant. Risk Factors. United States / epidemiology

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  • (PMID = 11276380.001).
  • [ISSN] 1522-8037
  • [Journal-full-title] Current gastroenterology reports
  • [ISO-abbreviation] Curr Gastroenterol Rep
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Number-of-references] 58
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11. Kiesslich T, Berlanda J, Plaetzer K, Krammer B, Berr F: Comparative characterization of the efficiency and cellular pharmacokinetics of Foscan- and Foslip-based photodynamic treatment in human biliary tract cancer cell lines. Photochem Photobiol Sci; 2007 Jun;6(6):619-27
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  • [Title] Comparative characterization of the efficiency and cellular pharmacokinetics of Foscan- and Foslip-based photodynamic treatment in human biliary tract cancer cell lines.
  • Due to the poor prognosis and limited management options for perihilar cholangiocarcinoma (CC) the development of alternatives for treatment is an important topic.
  • Photodynamic therapy (PDT) with porfimer as palliative or neoadjuvant endoscopic treatment of non-resectable perihilar CC has improved quality of life and survival time, but cannot eradicate the primary tumors because of inadequate tumoricidal depth (4 mm only around the tumor stenoses).
  • The use of meta-tetrahydroxyphenyl chlorin (mTHPC) and photoactivation at higher wavelengths (650-660 nm) provides high tumoricidal depth (10 mm) for PDT of pancreatic cancer and should yield similar tumoricidal depth in CC.
  • This study investigates the photodynamic characteristics of mTHPC in solvent-based formulation (Foscan) and in liposomal (water soluble) formulation (Foslip) in an in vitro model system consisting of two biliary cancer cell lines (GBC, gall bladder cancer and BDC, bile duct cancer cells).
  • Dark toxicity, photodynamic efficiency, time-dependent uptake and retention and intracellular localization of Foscan and Foslip were studied.
  • The results prove mTHPC as a potent photosensitizing agent with high phototoxic potential in biliary cancer cells as a concentration of 600 ng ml(-1) and irradiation with 1.5 J cm(-2) (660 +/- 10 nm) is sufficient for about 90% cell killing.
  • This study demonstrates the potential of mTHPC for treatment of bile duct malignancies and provides evidence that Foslip is an equivalent water-soluble formulation of mTHPC that should ease intravenous application and thus clinical use of mTHPC.
  • [MeSH-major] Biliary Tract Neoplasms / drug therapy. Mesoporphyrins / metabolism. Photochemotherapy. Radiation-Sensitizing Agents / metabolism

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  • (PMID = 17549263.001).
  • [ISSN] 1474-905X
  • [Journal-full-title] Photochemical & photobiological sciences : Official journal of the European Photochemistry Association and the European Society for Photobiology
  • [ISO-abbreviation] Photochem. Photobiol. Sci.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] England
  • [Chemical-registry-number] 0 / Mesoporphyrins; 0 / Radiation-Sensitizing Agents; FU21S769PF / temoporfin
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12. Ishizaki T, Abe T, Koyanagi Y, Katsumata K, Wada T, Tsuchida A, Aoki T: [A case of liver failure associated with liver damage due to mFOLFOX 6 after resection for multiple liver metastases from colorectal cancer]. Gan To Kagaku Ryoho; 2007 Jun;34(6):945-8
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] [A case of liver failure associated with liver damage due to mFOLFOX 6 after resection for multiple liver metastases from colorectal cancer].
  • A case of colorectal cancer in a 60-year-old man became resectable after downstaging was achieved with mFOLFOX 6 for multiple liver metastases from colorectal cancer.
  • After chemotherapy, the liver metastases showed partial response, and the lung metastasis stable disease.
  • However,on postoperative day 28, the patient was hospitalized again with liver dysfunction, which evolved into liver failure, in spite of conservative treatment.
  • The needle biopsy specimens of the liver taken on readmission showed bile duct occlusion, portal hypertension, and perisinusoidal fibrosis, and histopathology of the surgical non-tumoral liver specimen showed the same findings.
  • [MeSH-major] Antineoplastic Combined Chemotherapy Protocols / adverse effects. Colorectal Neoplasms / pathology. Hepatectomy. Liver Failure / chemically induced. Liver Neoplasms / drug therapy. Liver Neoplasms / secondary
  • [MeSH-minor] Chemotherapy, Adjuvant. Combined Modality Therapy. Fluorouracil / adverse effects. Humans. Leucovorin / adverse effects. Lung Neoplasms / drug therapy. Lung Neoplasms / secondary. Male. Middle Aged. Organoplatinum Compounds / adverse effects

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  • (PMID = 17565263.001).
  • [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 / Organoplatinum Compounds; Q573I9DVLP / Leucovorin; U3P01618RT / Fluorouracil; Folfox protocol
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13. Nanashima A, Yamaguchi H, Shibasaki S, Ide N, Sawai T, Tsuji T, Hidaka S, Sumida Y, Nakagoe T, Nagayasu T: Adjuvant photodynamic therapy for bile duct carcinoma after surgery: a preliminary study. J Gastroenterol; 2004 Nov;39(11):1095-101
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Adjuvant photodynamic therapy for bile duct carcinoma after surgery: a preliminary study.
  • BACKGROUND: Photodynamic therapy (PDT) is a new palliative option in patients with non-resectable bile duct carcinoma (BDC).
  • Here, we assessed the efficacy of adjuvant photodynamic therapy in eight patients with BDC who underwent surgical resection.
  • METHODS: Five patients had extrahepatic BDC, two had intrahepatic cholangiocarcinoma, and one had ampullary carcinoma.
  • Cancer cells were microscopically detected in the stump of the hepatic duct in six patients, and biliary stenosis caused by remnant tumor was observed in one patient.
  • One patient had tumor recurrence with occlusion of the bile duct.
  • After PDT, four patients developed mild dermatitis, but no severe morbidity or mortality was noted.
  • In two patients with occlusion caused by tumor growth, resolution of bile duct stenosis was noted on day 7.
  • [MeSH-major] Bile Duct Neoplasms / drug therapy. Bile Duct Neoplasms / surgery. Bile Ducts, Extrahepatic. Bile Ducts, Intrahepatic. Cholangiocarcinoma / drug therapy. Cholangiocarcinoma / surgery. Dihematoporphyrin Ether / therapeutic use. Photochemotherapy
  • [MeSH-minor] Female. Humans. Male. Middle Aged. Neoplasm Recurrence, Local / drug therapy. Neoplasm, Residual. Time Factors

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  • (PMID = 15580404.001).
  • [ISSN] 0944-1174
  • [Journal-full-title] Journal of gastroenterology
  • [ISO-abbreviation] J. Gastroenterol.
  • [Language] eng
  • [Publication-type] Journal Article
  • [Publication-country] Japan
  • [Chemical-registry-number] 97067-70-4 / Dihematoporphyrin Ether
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14. Snady H: Interventional endoscopy, neoadjuvant therapy and the gastroenterologist. Hematol Oncol Clin North Am; 2002 Feb;16(1):53-79
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Interventional endoscopy, neoadjuvant therapy and the gastroenterologist.
  • With current treatment, survival of greater than 1 year should be anticipated for many patients with pancreatic cancer.
  • Obstructive jaundice is managed successfully with endoscopic placement of a plastic stent early in the evaluation of a patient with suspected regional pancreatic cancer, and a metal wall stent is reserved for patients with known 1997 AJCC stage IVB carcinoma or nonoperative patients.
  • Relief of biliary obstruction allows improvement in liver function and more time to evaluate tumor stage accurately to determine initial treatment (see Fig. 1).
  • A cost-effective algorithm to determine accurate stage and treatment can start with the size of the mass on initial imaging studies.
  • EUS-guided FNA represents a significant improvement over CT scan-guided FNA to make a tissue diagnosis.
  • Small pancreatic masses that would be resected regardless of whether an FNA is positive or negative require only an EUS evaluation to establish an early resectable stage.
  • Tumors reliably staged as unresectable by nonoperative imaging methods including EUS are treated with chemotherapy with or without concurrent radiotherapy because median survival of these patients is 2 years in some series.
  • For chronic pain or gastric outlet obstruction not responding or treatable by chemoradiotherapy, endoscopically guided celiac plexus nerve block and stenting improve the quality of life for patients with pancreatic cancer.
  • A team approach is required to achieve the objectives of improved quality of life, prolonged survival, and possible cure for pancreatic cancer.
  • [MeSH-major] Adenocarcinoma / therapy. Endoscopy. Endoscopy, Gastrointestinal. Endosonography. Neoadjuvant Therapy. Pancreatic Neoplasms / therapy
  • [MeSH-minor] Ampulla of Vater / surgery. Antineoplastic Agents / therapeutic use. Autonomic Nerve Block / methods. Carcinoma, Neuroendocrine / diagnosis. Carcinoma, Neuroendocrine / therapy. Chemotherapy, Adjuvant. Cholangiopancreatography, Endoscopic Retrograde. Cholestasis / etiology. Cholestasis / therapy. Combined Modality Therapy. Common Bile Duct Neoplasms / surgery. Diagnostic Imaging / methods. Gastric Outlet Obstruction / surgery. Humans. Lymphoma, Non-Hodgkin / diagnosis. Lymphoma, Non-Hodgkin / therapy. Neoplasm Staging / methods. Pain Management. Palliative Care. Pancreatic Cyst / therapy. Prognosis. Radiotherapy, Adjuvant. Stents

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  • (PMID = 12063829.001).
  • [ISSN] 0889-8588
  • [Journal-full-title] Hematology/oncology clinics of North America
  • [ISO-abbreviation] Hematol. Oncol. Clin. North Am.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antineoplastic Agents
  • [Number-of-references] 115
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15. Li FH, Chen XQ, Luo HY, Li YH, Wang F, Qiu MZ, Teng KY, Li ZH, Xu RH: [Prognosis of 84 intrahepatic cholangiocarcinoma patients]. Ai Zheng; 2009 May;28(5):528-32
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • Current treatment for ICC is unsatisfied.
  • This study was to investigate the prognosis of patients with resectable or unresectable ICC.
  • METHODS: Clinical data of 84 patients with pathologically confirmed ICC treated at Cancer Center, Sun Yat-sen University from January 1997 to December 2007 were reviewed.
  • RESULTS: Of the 84 patients, 56 (66.7%) had resectable ICC, and 28 (33.3%) had unresectable ICC.
  • Among the 56 patients with resectable ICC, 27 (48.2%) underwent radical resection, and 29 (51.8%) underwent palliative resection.
  • For the patients with resectable ICC, univariate analysis revealed that operation pattern, histological type, tumor size and number, lymph node metastasis, intrahepatic metastasis, portal vein thrombus, postoperative serum level of albumin, preoperative serum levels of CEA, CA199, TBIL, ALT and AST were related to the prognosis; multivariate analysis found that operation pattern, histological type, tumor number, preoperative serum levels of CEA, CA199 and TBIL were independent prognostic factors.
  • For the patients with unresectable ICC, univariate analysis found that histological type and preoperative serum level of CA199 were related to the prognosis; whereas multivariate analysis found that histological type was the only independent prognostic factor.
  • Chemotherapy showed no survival benefit in both resectable and unresectable ICC groups (P=0.30, P=0.78).
  • CONCLUSIONS: Radical resection is the main effective treatment for ICC patients to achieve long-term survival.
  • Preoperative serum levels of CEA, CA199 and TBIL are significant prognostic factor for patients with resectable ICC.
  • [MeSH-major] Bile Ducts, Intrahepatic. Hepatectomy / methods
  • [MeSH-minor] Adult. Aged. Bile Duct Neoplasms / blood. Bile Duct Neoplasms / pathology. Bile Duct Neoplasms / surgery. Bilirubin / blood. CA-19-9 Antigen / blood. Carcinoembryonic Antigen / blood. Chemotherapy, Adjuvant. Cholangiocarcinoma / blood. Cholangiocarcinoma / pathology. Cholangiocarcinoma / surgery. Female. Follow-Up Studies. Humans. Liver Neoplasms / blood. Liver Neoplasms / pathology. Liver Neoplasms / surgery. Lymphatic Metastasis. Male. Middle Aged. Neoplasm Staging. Neoplastic Cells, Circulating. Palliative Care. Proportional Hazards Models. Radiotherapy, Adjuvant. Remission Induction. Retrospective Studies. Survival Rate. Young Adult

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  • (PMID = 19624884.001).
  • [Journal-full-title] Ai zheng = Aizheng = Chinese journal of cancer
  • [ISO-abbreviation] Ai Zheng
  • [Language] chi
  • [Publication-type] English Abstract; Journal Article
  • [Publication-country] China
  • [Chemical-registry-number] 0 / CA-19-9 Antigen; 0 / Carcinoembryonic Antigen; RFM9X3LJ49 / Bilirubin
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16. Klebl F, Endlicher E, Kullmann F: [Palliative therapy in cholangio- and gallbladder carcinoma]. Z Gastroenterol; 2006 Jul;44(7):587-98
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] [Palliative therapy in cholangio- and gallbladder carcinoma].
  • [Transliterated title] Palliative Therapie von Gallengangs- und Gallenblasenkarzinomen.
  • Non-resectable cholangiocarcinoma and gallbladder carcinoma have a poor prognosis.
  • In addition to the general aspects of "best supportive care", biliary drainage is an important part of the palliative treatment of patients with malignant biliary stenosis.
  • Photodynamic therapy has led to an improved median survival in hilar cholangiocarcinoma in two controlled studies.
  • Whether or not systemic chemotherapy should be applied is still under debate.
  • A single study including advanced biliary and pancreatic cancer patients has demonstrated a survival benefit for the combined group.
  • In recent years, new chemotherapy protocols have been applied, some with promising results.
  • Intra-arterial chemotherapy and chemotherapeutically coated stents have not been evaluated well enough to be recommended outside clinical studies.
  • Ablative therapies have been used in a limited number of patients only.
  • Further studies are necessary to clarify whether these treatment modalities are effective.
  • [MeSH-major] Bile Duct Neoplasms / therapy. Cholangiocarcinoma / therapy. Gallbladder Neoplasms / therapy. Palliative Care / methods
  • [MeSH-minor] Animals. Humans. Practice Guidelines as Topic. Practice Patterns, Physicians'. Treatment Outcome

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  • (PMID = 16823700.001).
  • [ISSN] 0044-2771
  • [Journal-full-title] Zeitschrift für Gastroenterologie
  • [ISO-abbreviation] Z Gastroenterol
  • [Language] ger
  • [Publication-type] English Abstract; Journal Article; Review
  • [Publication-country] Germany
  • [Number-of-references] 138
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17. Pisters PW, Hudec WA, Lee JE, Raijman I, Lahoti S, Janjan NA, Rich TA, Crane CH, Lenzi R, Wolff RA, Abbruzzese JL, Evans DB: Preoperative chemoradiation for patients with pancreatic cancer: toxicity of endobiliary stents. J Clin Oncol; 2000 Feb;18(4):860-7
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Preoperative chemoradiation for patients with pancreatic cancer: toxicity of endobiliary stents.
  • PURPOSE: A recent multicenter study of preoperative chemoradiation and pancreaticoduodenectomy for localized pancreatic adenocarcinoma suggested that biliary stent-related complications are frequent and severe and may prevent the delivery of all components of multimodality therapy in many patients.
  • The present study was designed to evaluate the rates of hepatic toxicity and biliary stent-related complications and to evaluate the impact of this morbidity on the delivery of preoperative chemoradiation for pancreatic cancer at a tertiary care cancer center.
  • PATIENTS AND METHODS: Preoperative chemoradiation was used in 154 patients with resectable pancreatic adenocarcinoma (142 patients, 92%) or other periampullary tumors (12 patients, 8%).
  • Patients were treated with preoperative fluorouracil (115 patients), paclitaxel (37 patients), or gemcitabine (two patients) plus concurrent rapid-fractionation (30 Gy; 123 patients) or standard-fractionation (50.4 Gy; 31 patients) radiation therapy.
  • CONCLUSION: Preoperative chemoradiation for pancreatic cancer is associated with low rates of hepatic toxicity and biliary stent-related complications.
  • The need for biliary decompression is not a clinically significant concern in the delivery of preoperative therapy to patients with localized pancreatic cancer.
  • [MeSH-major] Adenocarcinoma / surgery. Antineoplastic Combined Chemotherapy Protocols / therapeutic use. Bile Ducts / pathology. Neoadjuvant Therapy. Pancreatic Neoplasms / surgery. Pancreaticoduodenectomy. Stents / adverse effects
  • [MeSH-minor] Adult. Aged. Aged, 80 and over. Ampulla of Vater. Antimetabolites, Antineoplastic / administration & dosage. Antineoplastic Agents, Phytogenic / administration & dosage. Common Bile Duct Neoplasms / drug therapy. Common Bile Duct Neoplasms / radiotherapy. Common Bile Duct Neoplasms / surgery. Deoxycytidine / administration & dosage. Deoxycytidine / analogs & derivatives. Female. Fluorouracil / administration & dosage. Follow-Up Studies. Hospitalization. Humans. Incidence. Liver / drug effects. Liver / radiation effects. Male. Middle Aged. Paclitaxel / administration & dosage. Radiotherapy Dosage. Retrospective Studies

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  • (PMID = 10673529.001).
  • [ISSN] 0732-183X
  • [Journal-full-title] Journal of clinical oncology : official journal of the American Society of Clinical Oncology
  • [ISO-abbreviation] J. Clin. Oncol.
  • [Language] eng
  • [Publication-type] Journal Article; Research Support, Non-U.S. Gov't
  • [Publication-country] United States
  • [Chemical-registry-number] 0 / Antimetabolites, Antineoplastic; 0 / Antineoplastic Agents, Phytogenic; 0W860991D6 / Deoxycytidine; B76N6SBZ8R / gemcitabine; P88XT4IS4D / Paclitaxel; U3P01618RT / Fluorouracil
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18. Rauws EA: Photodynamic therapy and Klatskin tumour: an overview. Scand J Gastroenterol Suppl; 2006;(243):135-8
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  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Photodynamic therapy and Klatskin tumour: an overview.
  • The prognosis of patients with an unresectable bile duct cancer is poor.
  • In 60-70% of patients, cholangiocarcinoma is located in the hepatic duct bifurcation and known as Klatskin tumour.
  • Chemotherapy and/or radiotherapy have not been evaluated in randomized, controlled trials.
  • Photodynamic therapy (PDT) is a new and promising locoregional treatment, the aim of which is to destroy tumour cells selectively.
  • Recently, the first prospective, randomized controlled study with PDT in a selected group of non-resectable cholangiocarcinoma patients was stopped prematurely.
  • However, further studies are awaited in unselected patients with unresectable cholangiocarcinoma before PDT can be considered as the standard adjuvant therapy.
  • [MeSH-major] Bile Duct Neoplasms / drug therapy. Hepatic Duct, Common / pathology. Klatskin Tumor / drug therapy. Photochemotherapy
  • [MeSH-minor] Cholangiocarcinoma / drug therapy. Clinical Trials as Topic. Humans

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  • (PMID = 16782632.001).
  • [ISSN] 0085-5928
  • [Journal-full-title] Scandinavian journal of gastroenterology. Supplement
  • [ISO-abbreviation] Scand. J. Gastroenterol. Suppl.
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Norway
  • [Number-of-references] 28
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19. Isayama H: Current topics in pancreato-biliary endotherapy: what can we do? J Hepatobiliary Pancreat Surg; 2009;16(5):589-91
MedlinePlus Health Information. consumer health - Pancreatic Diseases.

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • This article introduced new procedures and devices, and revealed improvement of treatment outcomes.
  • MATERIALS AND METHODS: Biliary covered metallic stent (CMS) has developed, and the indication of CMS placement is changing because of its removability.
  • CMS is effective not only for unresectable biliary malignancies but also for resectable tumors, benign biliary strictures, and benign pancreatic strictures.
  • Drug-eluting CMS can be used as anti-tumor agents.
  • Interventional endoscopic ultrasonography (EUS) has shifted the treatment paradigm because it is possible to approach lesions through the digestive tract wall.
  • The diagnosis and treatment of pancreatic cancer using interventional EUS technique are effective, feasible, and promising.
  • Recently, trans-gastric necrosectomy for an infected pseudocyst was reported as an alternative treatment to surgery.
  • Endoscopic papillary large balloon dilation (EPLBD), new procedure to the papilla, can treat large bile duct stones effectively without lithotripsy.
  • These procedures are of very great interest because they alter the treatment algorithms for many pancreato-biliary diseases.
  • [MeSH-major] Biliary Tract Diseases / therapy. Biliary Tract Diseases / ultrasonography. Endoscopy, Digestive System / methods. Pancreatic Diseases / therapy. Pancreatic Diseases / ultrasonography
  • [MeSH-minor] Catheterization / methods. Cholangiopancreatography, Endoscopic Retrograde / methods. Cholangiopancreatography, Endoscopic Retrograde / trends. Endosonography / methods. Endosonography / trends. Female. Forecasting. Humans. Male. Risk Assessment. Stents. Treatment Outcome. Ultrasonography, Interventional

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  • (PMID = 19543686.001).
  • [ISSN] 1436-0691
  • [Journal-full-title] Journal of hepato-biliary-pancreatic surgery
  • [ISO-abbreviation] J Hepatobiliary Pancreat Surg
  • [Language] eng
  • [Publication-type] Journal Article; Review
  • [Publication-country] Japan
  • [Number-of-references] 27
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20. Komori T, Sasaki Y, Yamada T, Ohigashi H, Ishikawa O, Inoue E, Ishiguro S, Seki T, Imaoka S: Unusual atrophic change after repeated arterial therapy for hepatocellular carcinoma: report of a case. Surg Today; 2004;34(1):76-9
MedlinePlus Health Information. consumer health - Liver Cancer.

  • [Source] The source of this record is MEDLINE®, a database of the U.S. National Library of Medicine.
  • [Title] Unusual atrophic change after repeated arterial therapy for hepatocellular carcinoma: report of a case.
  • We report the case of a 45-year-old man with advanced hepatocellular carcinoma (HCC) who was able to undergo radical surgery after repeated transarterial therapy.
  • Transarterial chemoembolization was repeated three times, and thereafter, transarterial infusion chemotherapy using Lipiodol was performed on the right hepatic artery.
  • Because notable atrophy of the right lobe and compensated hypertrophy of the left lobe were detected after this therapy, an extended right lobectomy could be performed.
  • The remarkable atrophic change of the right lobe was thought to be due to an obstruction of the right portal veins by the spread of inflammation around the bile duct necrosis, in addition to the narrowing of the hepatic artery.
  • A thorough understanding of this phenomenon and the development of methods to clinically apply it in the treatment of cancer patients may thus lead to an increase in the percentage of resectable cases of advanced HCC.
  • [MeSH-major] Carcinoma, Hepatocellular / drug therapy. Chemoembolization, Therapeutic. Iodized Oil / therapeutic use. Liver Neoplasms / drug therapy

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  • (PMID = 14714235.001).
  • [ISSN] 0941-1291
  • [Journal-full-title] Surgery today
  • [ISO-abbreviation] Surg. Today
  • [Language] eng
  • [Publication-type] Case Reports; Journal Article
  • [Publication-country] Japan
  • [Chemical-registry-number] 8001-40-9 / Iodized Oil
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