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Evaluation and Recommendation of the 8th Edition of American Joint Committee on Cancer (AJCC) Staging System for Intrahepatic Cholangiocarcinoma (ICC) in 820 Patients from the Surveillance, Epidemiology, and End Results (SEER) Database. J Gastrointest Surg 2021; 25:145-154. [PMID: 32193847 DOI: 10.1007/s11605-020-04557-y] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Accepted: 02/19/2020] [Indexed: 02/07/2023]
Abstract
BACKGROUND The AJCC made four changes to T category in the 8th AJCC stage for ICC, but this is a topic of debate. METHODS Data from 820 patients with ICC were extracted from the SEER database. Survival analysis of the 8th AJCC stage was examined. RESULTS To verify the four T staging changes by survival analysis: prognosis of patients with tumor size > 5 cm was poorer than that with tumor size ≤ 5 cm (P < 0.05); in N0M0 cohort, there was no significant difference in survival between solitary tumor with vascular invasion and multiple tumors (P = 0.092), tumor perforating the visceral peritoneum with and without involving local extrahepatic structures by direct invasion (P = 0.470), and tumor with and without periductal invasion (PI) (P = 0.220). The prognosis of patients with ≥ 4 positive lymph nodes was relatively poor compared with 1-3 positive lymph nodes (P = 0.037) and similar to patients with stage IV (8th AJCC, P = 0.585). CONCLUSION This study found that there was no significant difference in survival between tumor perforating the visceral peritoneum with and without involving local extrahepatic structures by direct invasion, whereas other T staging changes were effective. The inclusion of the number of positive lymph nodes in the 8th AJCC stage may improve prognostic discrimination in ICC patients.
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Soosaraei M, Daryani A, Sarvi S, Rahimi MT, Fakhar M, Ziaei Hezarjaribi H, Sharif M. Activity of Iranian Medicinal Herbs against Human Intestinal Parasites (HIP): A Systematic Review. MEDICAL LABORATORY JOURNAL 2020. [DOI: 10.29252/mlj.14.5.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
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Juntermanns B, Kaiser GM, Orth L, Reis H, Jaradat D, Sydor S, Buechter M, Kasper S, Mathé Z, Sotiropoulos GC, Baba HA, Canbay A, Paul A, Fingas CD. Comparison of the sixth and the seventh editions of the UICC classification for intrahepatic cholangiocarcinoma. Eur J Med Res 2018; 23:29. [PMID: 29859128 PMCID: PMC5984789 DOI: 10.1186/s40001-018-0329-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2016] [Accepted: 05/26/2018] [Indexed: 12/13/2022] Open
Abstract
Background The current seventh edition of the TNM classification for intrahepatic cholangiocarcinoma (ICC) includes tumor number, vascular invasion, lymph node involvement but no longer the tumor size as compared to the sixth edition. The impact of the seventh edition on stage-based prognostic prediction for patients with ICC was evaluated. Methods Between 03/2001 and 02/2013, 98 patients with the diagnosis of an ICC were surgically treated at our center. Median survival times were calculated for these patients after separate classification by both sixth and seventh editions. Results Median overall survival was increased in patients classified to the lower tumor stages I and II using the seventh as compared to the sixth edition: stage I (54.9 vs. 47.3 months), stage II (19.9 vs. 18.9 months), stage III (17.2 vs. 19.9 months), and stage IV (23.2 vs. 15.3 months), respectively. The seventh edition definition of the T category resulted in an increased median survival regarding the T1 (50.4 vs. 47.3 months) as well as the T2 category (19.9 vs. 15.6 months) and revealed a reduced median survival of patients within the T3 (21.6 vs. 24.8 months) as well as the T4 category (19.9 vs. 27.0 months). Conclusions The UICC seventh edition TNM classification for ICC improves separation of patients with intermediate stage tumors as compared to the sixth edition. The prognostic value of the UICC staging system has been improved by the seventh edition. Trial registration The data for this study have been retrospectively registered and the study has been approved by the ethic committee of the medical faculty of the University Hospital of Essen, Germany (license number 15-6353-BO).
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Affiliation(s)
- Benjamin Juntermanns
- Department of General, Visceral and Transplantation Surgery, University Hospital Essen, University Duisburg-Essen, Hufelandstrasse 55, 45147, Essen, Germany
| | - Gernot Maximilian Kaiser
- Department of General, Visceral and Transplantation Surgery, University Hospital Essen, University Duisburg-Essen, Hufelandstrasse 55, 45147, Essen, Germany. .,Department of General and Visceral Surgery, St. Bernhard-Hospital, Bürgermeister-Schmelzing-Str. 90, 47475, Kamp-Lintfort, Germany.
| | - Lena Orth
- Department of General, Visceral and Transplantation Surgery, University Hospital Essen, University Duisburg-Essen, Hufelandstrasse 55, 45147, Essen, Germany
| | - Henning Reis
- Institute of Pathology, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Derar Jaradat
- Department of General, Visceral and Transplantation Surgery, University Hospital Essen, University Duisburg-Essen, Hufelandstrasse 55, 45147, Essen, Germany
| | - Svenja Sydor
- Department of Gastroenterology and Hepatology, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Matthias Buechter
- Department of Gastroenterology and Hepatology, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Stefan Kasper
- Department of Medical Oncology, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Zoltan Mathé
- Department of Transplantation and Surgery, Semmelweis University, Budapest, Hungary
| | - Georgios Charalambos Sotiropoulos
- Department of General, Visceral and Transplantation Surgery, University Hospital Essen, University Duisburg-Essen, Hufelandstrasse 55, 45147, Essen, Germany
| | - Hideo Andreas Baba
- Institute of Pathology, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Ali Canbay
- Department of Gastroenterology and Hepatology, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Andreas Paul
- Department of General, Visceral and Transplantation Surgery, University Hospital Essen, University Duisburg-Essen, Hufelandstrasse 55, 45147, Essen, Germany
| | - Christian Dominik Fingas
- Department of General, Visceral and Transplantation Surgery, University Hospital Essen, University Duisburg-Essen, Hufelandstrasse 55, 45147, Essen, Germany
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Kang SH, Hwang S, Lee YJ, Kim KH, Ahn CS, Moon DB, Ha TY, Song GW, Jung DH, Lee SG. Prognostic comparison of the 7th and 8th editions of the American Joint Committee on Cancer staging system for intrahepatic cholangiocarcinoma. JOURNAL OF HEPATO-BILIARY-PANCREATIC SCIENCES 2018; 25:240-248. [DOI: 10.1002/jhbp.543] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Affiliation(s)
- Sang-Hyun Kang
- Department of Surgery; Asan Medical Center; University of Ulsan College of Medicine; 88 Olympic-ro 43-gil, Songpa-gu Seoul 138-736 Korea
| | - Shin Hwang
- Department of Surgery; Asan Medical Center; University of Ulsan College of Medicine; 88 Olympic-ro 43-gil, Songpa-gu Seoul 138-736 Korea
| | - Young-Joo Lee
- Department of Surgery; Asan Medical Center; University of Ulsan College of Medicine; 88 Olympic-ro 43-gil, Songpa-gu Seoul 138-736 Korea
| | - Ki-Hun Kim
- Department of Surgery; Asan Medical Center; University of Ulsan College of Medicine; 88 Olympic-ro 43-gil, Songpa-gu Seoul 138-736 Korea
| | - Chul-Soo Ahn
- Department of Surgery; Asan Medical Center; University of Ulsan College of Medicine; 88 Olympic-ro 43-gil, Songpa-gu Seoul 138-736 Korea
| | - Deok-Bog Moon
- Department of Surgery; Asan Medical Center; University of Ulsan College of Medicine; 88 Olympic-ro 43-gil, Songpa-gu Seoul 138-736 Korea
| | - Tae-Yong Ha
- Department of Surgery; Asan Medical Center; University of Ulsan College of Medicine; 88 Olympic-ro 43-gil, Songpa-gu Seoul 138-736 Korea
| | - Gi-Won Song
- Department of Surgery; Asan Medical Center; University of Ulsan College of Medicine; 88 Olympic-ro 43-gil, Songpa-gu Seoul 138-736 Korea
| | - Dong-Hwan Jung
- Department of Surgery; Asan Medical Center; University of Ulsan College of Medicine; 88 Olympic-ro 43-gil, Songpa-gu Seoul 138-736 Korea
| | - Sung-Gyu Lee
- Department of Surgery; Asan Medical Center; University of Ulsan College of Medicine; 88 Olympic-ro 43-gil, Songpa-gu Seoul 138-736 Korea
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Abstract
UNLABELLED Introduction and aims. Cholangiocarcinomas are a heterogeneous group of tumors that can be classified into three clinically distinct types of cancers, intrahepatic, perihilar and distal cholangiocarcinoma. The inconsistent use of nomenclature for these cancers has obscured a true knowledge of the epidemiology, natural history and response to therapy of these cancers. Our aims were to define demographic characteristics, management and outcomes of these three distinct cancer types. MATERIALS AND METHODS A retrospective study of patients enrolled in an institutional cancer registry from 1992 to 2010. Median survival was compared between different treatment modalities over three time periods for the three types of cholangiocarcinoma at different stages of the disease using Kaplan Meyer analysis. RESULTS 242 patients were identified. All cases were reviewed and classified into intrahepatic (90 patients), distal (48 patients) or perihilar (104 patients) cholangiocarcinomas. These cancers differed in median age of onset, gender distribution, median survival and stage. 13.8% of patients presented with stage I, 5.8% with stage II, 9.6% with stage III, 28% with stage IV, with 41.8% having unknown stage. The overall median survival was 15.8 months, and was 23, 25, 14, and 4.5 months for stages I, II, III, and IV respectively. Surgery improved survival in both early and advanced stages. Multimodality therapies further improved outcomes, particularly for perihilar cholangiocarcinoma. CONCLUSION Perihilar, distal and intrahepatic cholangiocarcinoma vary in their presentation, natural history and therapeutic approach to management. A consistently applied classification is essential for meaningful interpretation of studies of these cancers.
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Affiliation(s)
- David Waseem
- Department of Transplantation, Mayo Clinic Florida, USA
| | - Patel Tushar
- Department of Transplantation, Mayo Clinic Florida, USA
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Yao KJ, Jabbour S, Parekh N, Lin Y, Moss RA. Increasing mortality in the United States from cholangiocarcinoma: an analysis of the National Center for Health Statistics Database. BMC Gastroenterol 2016; 16:117. [PMID: 27655244 PMCID: PMC5031355 DOI: 10.1186/s12876-016-0527-z] [Citation(s) in RCA: 68] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Accepted: 08/22/2016] [Indexed: 02/06/2023] Open
Abstract
Background While mortality in the United States has decreased for most cancers, mortality from combined hepatocellular liver cancer and intrahepatic cholangiocarcinoma (ICC) has increased and ranked 1st in annual percent increase among cancer sites. Because reported statistics combine ICC with other liver cancers, mortality rates of cholangiocarcinoma (CCA) remain unknown. This study is to determine CCA mortality trends and variation based on national data. Methods This nation-wide study was based on the underlying cause of death data collected by the National Center for Health Statistics (NCHS) between 1999 and 2014. The Center for Disease Control (CDC) Wide-ranging Online Data for Epidemiologic Research (WONDER) system was used to obtain data. ICC and extra-hepatic CCA (ECC) were defined by ICD-10 diagnosis codes. Age-adjusted mortality rate was standardized to the US population in 2000. Results There were more than 7000 CCA deaths each year in the US after 2013. CCA mortality for those aged 25+ increased 36 % between 1999 and 2014, from 2.2 per 100,000 (95 % confidence interval [CI] 2.1–2.3) to 3.0 per 100,000 (95 % CI, 2.9–3.1). Mortality rates were lower among females compared with males (risk ratio [RR] 0.78, 95 % CI 0.77–0.79). Asians had the highest mortality. Between 2004 and 2014, the increase in CCA mortality was highest among African Americans (45 %) followed by Asians (22 %), and whites (20 %). Conclusion Based on the most recent national data, CCA mortality rates have increased substantially in the past decade. Among different race/ethnic groups, African Americans have the highest increase in CCA mortality. Electronic supplementary material The online version of this article (doi:10.1186/s12876-016-0527-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Kaelan J Yao
- West Windsor Plainsboro High School South, Plainsboro, NJ, 08550, USA
| | - Salma Jabbour
- Division of Radiation Oncology, The Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, 08901, USA
| | - Niyati Parekh
- College of Global Public Health & Population Health, Langone School of Medicine, New York University, New York, NY, 10003, USA
| | - Yong Lin
- Biometrics Division, The Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, 08901, USA
| | - Rebecca A Moss
- Division of Medical Oncology, The Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, 08901, USA.
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Bagante F, Gani F, Spolverato G, Xu L, Alexandrescu S, Marques HP, Lamelas J, Aldrighetti L, Gamblin TC, Maithel SK, Pulitano C, Bauer TW, Shen F, Poultsides GA, Marsh JW, Pawlik TM. Intrahepatic Cholangiocarcinoma: Prognosis of Patients Who Did Not Undergo Lymphadenectomy. J Am Coll Surg 2015; 221:1031-40.e1-4. [DOI: 10.1016/j.jamcollsurg.2015.09.012] [Citation(s) in RCA: 58] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2015] [Revised: 09/08/2015] [Accepted: 09/09/2015] [Indexed: 10/23/2022]
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Hwang S, Lee YJ, Song GW, Park KM, Kim KH, Ahn CS, Moon DB, Lee SG. Prognostic Impact of Tumor Growth Type on 7th AJCC Staging System for Intrahepatic Cholangiocarcinoma: a Single-Center Experience of 659 Cases. J Gastrointest Surg 2015; 19:1291-304. [PMID: 25820487 DOI: 10.1007/s11605-015-2803-6] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2015] [Accepted: 03/15/2015] [Indexed: 01/31/2023]
Abstract
OBJECTIVE Because noticeable changes were made to the 7th American Joint Committee on Cancer (AJCC) tumor-node-metastasis (TNM) staging for intrahepatic cholangiocarcinoma (IHCC), we validated the prognostic impact of tumor staging after macroscopic curative resection of IHCC. METHODS A cohort of 659 IHCC patients who underwent R0 (n = 539) or R1 (n = 120) resection were selected with exclusion of R2 resection (n = 111). Study patients were followed up for ≥24 months or until death with no patient lost during survival analysis. RESULTS Anatomical resection was performed in 599 (90.9%) and concurrent bile duct resection was conducted in 97 (14.7%). Median survival periods following R0, R1, and R2 resections were 28, 12, and 3 months, respectively (p = 0.000). In the R0 resection group, the 1-, 3-, 5-, and 10-year tumor recurrence rates were 36.4%, 57.9%, 64.7%, and 65.0%, respectively, and the 1-, 3-, 5-, and 10-year patient survival rates were 73.1%, 44.2%, 33.0%, and 23.1%, respectively. Independent risk factors for tumor recurrence and patient survival were tumor growth type, tumor size > 5 cm, perineural invasion, and lymph node metastasis. According to the 7th AJCC staging system, the prognostic contrast was marginal in stage T2-4 tumors without lymph node metastasis (p > 0.8). With our redefined staging system with tumor growth types and risk factors including tumor number and perineural/lymphovascular invasion, clear prognostic contrast was achieved among T1-3 stages (p = 0.000). CONCLUSION Growth type of IHCC seems to be essential for determining tumor stage. Although the stratification of the 7th AJCC IHCC staging system seems reasonably established, refinements and further validation could improve prognostic predictability.
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Affiliation(s)
- Shin Hwang
- Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 138-736, South Korea,
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Ali SM, Clark CJ, Mounajjed T, Wu TT, Harmsen WS, Reid-Lombardo KM, Truty MJ, Kendrick ML, Farnell MB, Nagorney DM, Que FG. Model to predict survival after surgical resection of intrahepatic cholangiocarcinoma: the Mayo Clinic experience. HPB (Oxford) 2015; 17:244-50. [PMID: 25410716 PMCID: PMC4333786 DOI: 10.1111/hpb.12333] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2014] [Accepted: 08/04/2014] [Indexed: 12/12/2022]
Abstract
BACKGROUND The 7th edition of the American Joint Committee on Cancer (AJCC) staging system has recently been validated and shown to predict survival in patients with intrahepatic cholangiocarcinoma (ICC). The present study attempted to investigate the validity of these findings. METHODS A single-centre, retrospective cohort study was conducted. Histopathological restaging of disease subsequent to primary surgical resection was carried out in all consecutive ICC patients. Overall survival was compared using Kaplan-Meier estimates and log-rank tests. RESULTS A total of 150 patients underwent surgery, 126 (84%) of whom met the present study's inclusion criteria. Of these 126 patients, 68 (54%) were female. The median length of follow-up was 4.5 years. The median patient age was 58 years (range: 24-79 years). Median body mass index was 27 kg/m(2) (range: 17-46 kg/m(2) ). Staging according to the AJCC 7th edition categorized 33 (26%) patients with stage I disease, 27 (21%) with stage II disease, five (4%) with stage III disease, and 61 (48%) with stage IVa disease. The AJCC 7th edition failed to accurately stratify survival in the current cohort; analysis revealed significantly worse survival in those with microvascular invasion, tumour size of >5 cm, grade 4 disease, multiple tumours and positive lymph nodes (P < 0.001). A negative resection margin was associated with improved survival (P < 0.001). CONCLUSIONS The AJCC 7th edition did not accurately predict survival in patients with ICC. A multivariable model including tumour size and differentiation in addition to the criteria used in the AJCC 7th edition may offer a more accurate method of predicting survival in patients with ICC.
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Affiliation(s)
- Shahzad M Ali
- Department of Surgery, Mayo Clinic College of Medicine, Mayo ClinicRochester, MN, USA
| | - Clancy J Clark
- Department of Surgery, Mayo Clinic College of Medicine, Mayo ClinicRochester, MN, USA
| | - Taofic Mounajjed
- Department of Anatomic Pathology, Mayo Clinic College of Medicine, Mayo ClinicRochester, MN, USA
| | - Tsung-Teh Wu
- Department of Anatomic Pathology, Mayo Clinic College of Medicine, Mayo ClinicRochester, MN, USA
| | - William S Harmsen
- Department of Biomedical Statistics and Informatics, Mayo Clinic College of Medicine, Mayo ClinicRochester, MN, USA
| | - KMarie Reid-Lombardo
- Department of Surgery, Mayo Clinic College of Medicine, Mayo ClinicRochester, MN, USA
| | - Mark J Truty
- Department of Surgery, Mayo Clinic College of Medicine, Mayo ClinicRochester, MN, USA
| | - Michael L Kendrick
- Department of Surgery, Mayo Clinic College of Medicine, Mayo ClinicRochester, MN, USA
| | - Michael B Farnell
- Department of Surgery, Mayo Clinic College of Medicine, Mayo ClinicRochester, MN, USA
| | - David M Nagorney
- Department of Surgery, Mayo Clinic College of Medicine, Mayo ClinicRochester, MN, USA
| | - Florencia G Que
- Department of Surgery, Mayo Clinic College of Medicine, Mayo ClinicRochester, MN, USA,Correspondence, Florencia G. Que, Department of Surgery, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA. Tel: + 1 507 284 1529. Fax: + 1 507 284 5196. E-mail:
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Multigene mutational profiling of cholangiocarcinomas identifies actionable molecular subgroups. Oncotarget 2015; 5:2839-52. [PMID: 24867389 PMCID: PMC4058049 DOI: 10.18632/oncotarget.1943] [Citation(s) in RCA: 147] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
One-hundred-fifty-three biliary cancers, including 70 intrahepatic cholangiocarcinomas (ICC), 57 extrahepatic cholangiocarcinomas (ECC) and 26 gallbladder carcinomas (GBC) were assessed for mutations in 56 genes using multigene next-generation sequencing. Expression of EGFR and mTOR pathway genes was investigated by immunohistochemistry. At least one mutated gene was observed in 118/153 (77%) cancers. The genes most frequently involved were KRAS (28%), TP53 (18%), ARID1A (12%), IDH1/2 (9%), PBRM1 (9%), BAP1 (7%), and PIK3CA (7%). IDH1/2 (p=0.0005) and BAP1 (p=0.0097) mutations were characteristic of ICC, while KRAS (p=0.0019) and TP53 (p=0.0019) were more frequent in ECC and GBC. Multivariate analysis identified tumour stage and TP53 mutations as independent predictors of survival. Alterations in chromatin remodeling genes (ARID1A, BAP1, PBRM1, SMARCB1) were seen in 31% of cases. Potentially actionable mutations were seen in 104/153 (68%) cancers: i) KRAS/NRAS/BRAF mutations were found in 34% of cancers; ii) mTOR pathway activation was documented by immunohistochemistry in 51% of cases and by mutations in mTOR pathway genes in 19% of cancers; iii) TGF-ß/Smad signaling was altered in 10.5% cancers; iv) mutations in tyrosine kinase receptors were found in 9% cases. Our study identified molecular subgroups of cholangiocarcinomas that can be explored for specific drug targeting in clinical trials.
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Ma J, Shi J, Zhao D, Cheng L, Wang W, Li F, Jiang X, Jiang H. Raf kinase inhibitor protein inhibits cholangiocarcinoma cell metastasis by downregulating matrix metalloproteinase 9 and upregulating tissue inhibitor of metalloproteinase 4 expression. Oncol Lett 2014; 9:15-24. [PMID: 25435928 PMCID: PMC4246646 DOI: 10.3892/ol.2014.2637] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2014] [Accepted: 08/15/2014] [Indexed: 12/26/2022] Open
Abstract
Cholangiocarcinoma cells originate in the biliary epithelium. The cells easily metastasize and cause relapse. The effect of Raf kinase inhibitor protein (RKIP) on the biological behavior of cholangiocarcinoma cells is not yet clear. In the present study, RKIP and cytokeratin 19 expression was detected in the extrahepatic tissues of cholangiocarcinoma patients by immunohistochemistry. RKIP small interfering (si)RNA or an RKIP-overexpressing adenoviral vector were used to infect the human cholangiocarcinoma RBE cell line. RKIP protein or gene expression was analyzed by western blotting or reverse transcription-quantitative polymerase chain reaction (RT-qPCR), respectively. The cells were assayed for proliferation, apoptosis, invasion and migration. Matrix metalloproteinase 9 (MMP-9) and tissue inhibitor of metalloproteinase 4 (TIMP-4) mRNA was assayed by RT-qPCR. RKIP expression was reduced in the extrahepatic cholangiocarcinoma tumor compared with the adjacent uninvolved peritumoral tissues. The current study revealed that RKIP expression was positively correlated with cell differentiation, but negatively correlated with lymph node or distant metastasis (P<0.05). RKIP siRNA treatment promoted RBE cell invasion, but RKIP overexpression prevented cell invasion. In the pDC316-siRNA recombinant vector group, the cells migrated more quickly compared with the siRNA-negative control group, and in the RKIP-expressing adenoviral vector group, the cells migrated more slowly compared with the adenoviral negative control group. RKIP inhibited the invasive and metastatic ability of the cholangiocarcinoma cell line, RBE, by downregulating MMP-9 and upregulating TIMP-4 mRNA expression. RKIP is negatively associated with cholangiocarcinoma distant metastasis and prevents cholangiocarcinoma cell metastasis through downregulating MMP-9 expression and upregulating TIMP-4 expression.
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Affiliation(s)
- Junji Ma
- Department of Gastroenterology, The Second Hospital of Hebei Medical University, Hebei Key Laboratory of Gastroenterology, Hebei Institute of Gastroenterology, Shijiazhuang, Hebei 050000, P.R. China
| | - Junli Shi
- Department of Gastroenterology, The Second Hospital of Hebei Medical University, Hebei Key Laboratory of Gastroenterology, Hebei Institute of Gastroenterology, Shijiazhuang, Hebei 050000, P.R. China
| | - Dongqiang Zhao
- Department of Gastroenterology, The Second Hospital of Hebei Medical University, Hebei Key Laboratory of Gastroenterology, Hebei Institute of Gastroenterology, Shijiazhuang, Hebei 050000, P.R. China
| | - Lijuan Cheng
- Department of Gastroenterology, The Second Hospital of Hebei Medical University, Hebei Key Laboratory of Gastroenterology, Hebei Institute of Gastroenterology, Shijiazhuang, Hebei 050000, P.R. China
| | - Wenbin Wang
- Department of Hepatobiliary Surgery, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei 050000, P.R. China
| | - Fangfang Li
- Department of Biochemistry and Molecular Biology, Basic Medical College of Hebei Medical University, Shijiazhuang, Hebei 050017, P.R. China
| | - Xiaoyu Jiang
- Department of Anatomy and Cell Biology, Wayne State University School of Medicine, Detroit, MI 48201, USA
| | - Huiqing Jiang
- Department of Gastroenterology, The Second Hospital of Hebei Medical University, Hebei Key Laboratory of Gastroenterology, Hebei Institute of Gastroenterology, Shijiazhuang, Hebei 050000, P.R. China
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Carum copticum L.: a herbal medicine with various pharmacological effects. BIOMED RESEARCH INTERNATIONAL 2014; 2014:569087. [PMID: 25089273 PMCID: PMC4096002 DOI: 10.1155/2014/569087] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/27/2014] [Revised: 05/25/2014] [Accepted: 05/27/2014] [Indexed: 11/18/2022]
Abstract
Carum copticum L. commonly known as “Ajwain” is cultivated in many regions of the world including Iran and India, states of Gujarat and Rajasthan. Traditionally, C. copticum has been used in the past for various therapeutic effects including bloating, fatigue, diarrhea, abdominal tumors, abdominal pain, respiratory distress, and loss of appetite. It has other health benefits such as antifungal, antioxidant, antibacterial, antiparasitic, and hypolipidemic effects. This plant contains different important components such as carbohydrates, glucosides, saponins and phenolic compounds (carvacrol), volatile oils (thymol), terpiene, paracymene and beta-pinene, protein, fat, fiber, and minerals including calcium, phosphorus, iron, and nicotinic acid (niacin). In the previous studies, several pharmacological effects were shown for C. copticum. Therefore, in this paper, the pharmacological effects of the plant were reviewed.
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Cholangiocarcinoma: Biology, Clinical Management, and Pharmacological Perspectives. ISRN HEPATOLOGY 2014; 2014:828074. [PMID: 27335842 PMCID: PMC4890896 DOI: 10.1155/2014/828074] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/05/2013] [Accepted: 01/02/2014] [Indexed: 12/14/2022]
Abstract
Cholangiocarcinoma (CCA), or tumor of the biliary tree, is a rare and heterogeneous group of malignancies associated with a very poor prognosis. Depending on their localization along the biliary tree, CCAs are classified as intrahepatic, perihilar, and distal, and these subtypes are now considered different entities that differ in tumor biology, the staging system, management, and prognosis. When diagnosed, an evaluation by a multidisciplinary team is essential; the team must decide on the best therapeutic option. Surgical resection of tumors with negative margins is the best option for all subtypes of CCA, although this is only achieved in less than 50% of cases. Five-year survival rates have increased in the recent past owing to improvements in imaging techniques, which permits resectability to be predicted more accurately, and in surgery. Chemotherapy and radiotherapy are relatively ineffective in treating nonoperable tumors and the resistance of CCA to these therapies is a major problem. Although the combination of gemcitabine plus platinum derivatives is the pharmacological treatment most widely used, to date there is no standard chemotherapy, and new combinations with targeted drugs are currently being tested in ongoing clinical trials. This review summarizes the biology, clinical management, and pharmacological perspectives of these complex tumors.
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Surgical treatment for intrahepatic cholangiocarcinoma. Clin J Gastroenterol 2014; 7:87-93. [PMID: 26183622 DOI: 10.1007/s12328-014-0460-z] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2014] [Accepted: 01/26/2014] [Indexed: 12/15/2022]
Abstract
Despite surgical treatment for intrahepatic cholangiocarcinoma (ICC) becoming more widely available, the prognosis after hepatic resection for ICC remains poor. Because ICC is relatively rare, the TNM staging system for ICC was finally established in the 2000s. Resection margin status and lymph node metastases are important prognostic factors after surgery for ICC; however, the true impact of wide resection margins or lymph node dissection on postoperative survival is unclear. Although adjuvant chemotherapy can improve the postoperative prognosis of patients with various types of cancer, no standard regimen has been developed for ICC. Over 50 % of patients suffer postoperative recurrence, even after curative resection, and no effective treatment for recurrent ICC has been established. Therefore, despite advances in imaging studies and hepatobiliary surgery, significant challenges remain in improving the prognosis of patients with ICC.
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15
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Uenishi T, Ariizumi S, Aoki T, Ebata T, Ohtsuka M, Tanaka E, Yoshida H, Imura S, Ueno M, Kokudo N, Nagino M, Hirano S, Kubo S, Unno M, Shimada M, Yamaue H, Yamamoto M, Miyazaki M, Takada T. Proposal of a new staging system for mass-forming intrahepatic cholangiocarcinoma: a multicenter analysis by the Study Group for Hepatic Surgery of the Japanese Society of Hepato-Biliary-Pancreatic Surgery. JOURNAL OF HEPATO-BILIARY-PANCREATIC SCIENCES 2014; 21:499-508. [DOI: 10.1002/jhbp.92] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Affiliation(s)
- Takahiro Uenishi
- Department of Hepato-Biliary-Pancreatic Surgery; Osaka City University Graduate School of Medicine; Osaka Japan
| | - Shunichi Ariizumi
- Department of Surgery; Institute of Gastroenterology; Tokyo Women's Medical University; 1-4-3 Kawada-cho, Shinjuku-ku Tokyo 162-8666 Japan
| | - Taku Aoki
- Hepato-Biliary-Pancreatic Surgery Division; Department of Surgery; Tokyo University Graduate School of Medicine; Tokyo Japan
| | - Tomoki Ebata
- Division of Surgical Oncology; Department of Surgery; Nagoya University Graduate School of Medicine; Nagoya Japan
| | - Masayuki Ohtsuka
- Department of General Surgery; Chiba University Graduate School of Medicine; Chiba Japan
| | - Eiichi Tanaka
- Department of Surgical Oncology; Hokkaido University Graduate School of Medicine; Sapporo Japan
| | - Hiroshi Yoshida
- Division of Hepato-Biliary-Pancreatic Surgery; Department of Surgery; Tohoku University Graduate School of Medicine; Sendai Japan
| | - Satoru Imura
- Department of Surgery; Institute of Health Biosciences; The University of Tokushima Graduate School; Tokushima Japan
| | - Masaki Ueno
- Second Department of Surgery; Wakayama Medical University; Wakayama Japan
| | - Norihiro Kokudo
- Hepato-Biliary-Pancreatic Surgery Division; Department of Surgery; Tokyo University Graduate School of Medicine; Tokyo Japan
| | - Masato Nagino
- Division of Surgical Oncology; Department of Surgery; Nagoya University Graduate School of Medicine; Nagoya Japan
| | - Satoshi Hirano
- Department of Surgical Oncology; Hokkaido University Graduate School of Medicine; Sapporo Japan
| | - Shoji Kubo
- Department of Hepato-Biliary-Pancreatic Surgery; Osaka City University Graduate School of Medicine; Osaka Japan
| | - Michiaki Unno
- Division of Hepato-Biliary-Pancreatic Surgery; Department of Surgery; Tohoku University Graduate School of Medicine; Sendai Japan
| | - Mitsuo Shimada
- Department of Surgery; Institute of Health Biosciences; The University of Tokushima Graduate School; Tokushima Japan
| | - Hiroki Yamaue
- Second Department of Surgery; Wakayama Medical University; Wakayama Japan
| | - Masakazu Yamamoto
- Department of Surgery; Institute of Gastroenterology; Tokyo Women's Medical University; 1-4-3 Kawada-cho, Shinjuku-ku Tokyo 162-8666 Japan
| | - Masaru Miyazaki
- Department of General Surgery; Chiba University Graduate School of Medicine; Chiba Japan
| | - Tadahiro Takada
- Department of Surgery; Teikyo University School of Medicine; Tokyo Japan
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