Current Advances and Perspectives in Intrahepatic Cholangiocarcinoma

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Oncology".

Deadline for manuscript submissions: closed (30 June 2022) | Viewed by 3383

Special Issue Editors


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Guest Editor
HPB Hub Reference Center, First General Surgery Unit, Department of Surgery, Azienda ULSS2 Marca Trevigiana, 31100 Treviso, Italy
Interests: pancreas; liver; HCC; cholangiocarcinoma; minimally invasive liver and pancreatic surgery; blunt liver and splenic trauma; CT-HAI; liver volumetry; ICG; colorectal surgery

E-Mail Website
Guest Editor
HPB Hub Reference Center, First General Surgery Unit, Department of Surgery, Azienda ULSS2 Marca Trevigiana, 31100 Treviso, Italy
Interests: HPB; cholangiocarcinoma; hepatocarcinoma; hepatic arterial infusion pump chemotherapy; colorectal liver metasases; radiomics; emergency surgery

Special Issue Information

Dear Colleagues,

We are pleased to invite you to contribute to the upcoming Special Issue on “current advances and perspectives in intrahepatic cholangiocarcinoma”.

Cholangiocarcinoma (CCA) is the second most common primitive liver cancer. Despite recent advances in its surgical management, the prognosis remains poor, with a 5-year survival rate of less than 5%. Intrahepatic CCA (iCCA) has a median survival of between 18 and 30 months, but if deemed unresectable this decreases to 6 months. Most patients experience a liver-confined disease that is considered unresectable because of its localization, the infiltration of vascular structures, or its multifocality.

Cholangiocarcinogenesis is affected by a complex interplay in the tumour microenvironment between extracellular ligands, cell surface receptors, and intracellular signalling pathways, finally leading to cell proliferation and survival and genetic alterations. Recent advances in this area are enabling the discovery of new and promising biomarkers that could change the paradigm in disease diagnosis and management in the upcoming years. The high heterogeneity and chemoresistance of CCAs represent a limitation for common therapeutic strategies, but this disease presents a unique opportunity for the development of personalized, targeted therapies. Risk models and nomograms have been developed to more accurately predict the survival of individual patients based on their clinical parameters. The goal of surgery is to complete a complete margin-negative resection with an adequate future liver remnant. Most patients require an (extended) hemi-hepatectomy with lymphadenectomy. For patients with locally advanced disease, several treatment strategies are being evaluated. Both hepatic arterial infusion chemotherapy with floxuridine and yttrium-90 embolization aim to downstage locally advanced ICC. Selected patients have resectable disease after downstaging, and other patients might benefit from the postponing pf widespread dissemination and biliary obstruction.

Currently, CCA management requires dedicated centres with multidisciplinary expertise because of the large differences in disease course between individual patients, both across and within tumor stages.

Aim of the Special issue: The purpose of this Special Issue is to provide an overview of the current state of knowledge regarding intrahepatic cholangiocarcinoma from the point of view of basic and translational research, pathological anatomy, oncology, and surgery.

In this Special Issue, original research articles and reviews are welcome. Research areas of interest include the following: the tumour microenvironment, diagnostic and prognostic biomarkers, surgery, resectable disease, the role of adjuvant therapy, liver-directed therapies, the management of oligometastatic disease, targeted therapies, and future directions

We look forward to receiving your contributions.

Dr. Marco Massani
Dr. Tommaso Stecca
Guest Editors

Manuscript Submission Information

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Keywords

  • cholangiocarcinoma
  • tumour microenvironment
  • diagnostic and prognostic biomarkers
  • surgery
  • resectable disease
  • the role of adjuvant therapy
  • liver-directed therapies
  • the management of oligometastatic disease
  • targeted therapies
  • future directions

Published Papers (2 papers)

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Research

9 pages, 1007 KiB  
Article
Safety and Efficacy of a Large-Bore Biliary Metallic Stent for Malignant Biliary Obstruction
by Min Young Do, Sung Ill Jang, Jae Hee Cho, Yonsoo Kim, In-Jung Kim, Kwang-Hun Lee, Seung-Moon Joo and Dong Ki Lee
J. Clin. Med. 2022, 11(11), 3092; https://doi.org/10.3390/jcm11113092 - 30 May 2022
Cited by 1 | Viewed by 1420
Abstract
Self-expandable metallic stents (SEMSs) are typically inserted in patients with unresectable malignant biliary obstruction. However, SEMSs are susceptible to occlusion. To overcome this issue, we developed a large-bore, dumbbell-shaped, fully covered SEMS (FCSEMS-L) and compared its efficacy and safety with those of a [...] Read more.
Self-expandable metallic stents (SEMSs) are typically inserted in patients with unresectable malignant biliary obstruction. However, SEMSs are susceptible to occlusion. To overcome this issue, we developed a large-bore, dumbbell-shaped, fully covered SEMS (FCSEMS-L) and compared its efficacy and safety with those of a conventional FCSEMS (FCSEMS-C) in patients with malignant biliary obstruction. Methods: Patients with unresectable distal malignant biliary obstruction were retrospectively enrolled between January 2011 and February 2021. All patients underwent endoscopic insertion of FCSEMSs. Recurrent biliary obstruction (RBO), patient survival time, complications, and prognosis were analyzed. Results: RBO occurred in 31 patients (35.6%) who received an FCSEMS-L, and in 34 (45.9%) who received an FCSEMS-C. Stent occlusion occurred in 19 patients (21.8%) who received an FCSEMS-L, and in 22 (29.7%) who received an FCSEMS-C. Stent migration occurred in 12 patients (13.8%) with an FCSEMS-L and 12 (16.2%) with an FCSEMS-C. The median time to RBO (TRBO) was 301 days with an FCSEMS-L and 203 days with an FCSEMS-C. The median survival time was 479 days with an FCSEMS-L and 523 days with an FCSEMS-C. The TRBO and patient survival time did not significantly differ between the two groups. Conclusions: There were no significant differences in efficacy and complication rates between the fully covered large bore SEMSs and conventional fully covered SEMSs. Full article
(This article belongs to the Special Issue Current Advances and Perspectives in Intrahepatic Cholangiocarcinoma)
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10 pages, 246 KiB  
Article
Comparison of the Malignant Predictors in Intrahepatic and Extrahepatic Intraductal Papillary Neoplasm of the Bile Duct
by Sung Yong Han, Dong Uk Kim, Hyeong Seok Nam, Dae Hwan Kang, Sung Ill Jang, Dong Ki Lee, Dong Woo Shin, Kwang Bum Cho, Min Jae Yang, Jae Chul Hwang, Jin Hong Kim, Hoonsub So, Sung Jo Bang, Min Je Sung, Chang-Il Kwon, Dong Wook Lee, Chang-Min Cho and Jae Hee Cho
J. Clin. Med. 2022, 11(7), 1985; https://doi.org/10.3390/jcm11071985 - 2 Apr 2022
Cited by 5 | Viewed by 1488
Abstract
Background: Intraductal papillary neoplasm of the bile duct (IPNB) is a precancerous lesion of cholangiocarcinoma, for which surgical resection is the most effective treatment. We evaluated the predictors of malignancy in IPNB according to anatomical location and the prognosis without surgery. Methods: A [...] Read more.
Background: Intraductal papillary neoplasm of the bile duct (IPNB) is a precancerous lesion of cholangiocarcinoma, for which surgical resection is the most effective treatment. We evaluated the predictors of malignancy in IPNB according to anatomical location and the prognosis without surgery. Methods: A total of 196 IPNB patients who underwent pathologic confirmation by surgical resection or endoscopic retrograde cholangiography or percutaneous transhepatic cholangioscopic biopsy were included. Clinicopathological findings of IPNB with invasive carcinoma or mucosal dysplasia were analyzed according to anatomical location. Results: Of the 116 patients with intrahepatic IPNB (I-IPNB) and 80 patients with extrahepatic IPNB (E-IPNB), 62 (53.4%) and 61 (76.3%) were diagnosed with invasive carcinoma, respectively. Multivariate analysis revealed that mural nodule > 12 mm (p = 0.043) in I-IPNB and enhancement of mural nodule (p = 0.044) in E-IPNB were predictive factors for malignancy. For pathologic discrepancy before and after surgery, IPNB has a 71.2% sensitivity and 82.3% specificity. In the non-surgical IPNB group, composed of nine I-IPNB and seven E-IPNB patients, 43.7% progressed to IPNB with invasive carcinoma within 876 days. Conclusions: E-IPNB has a higher rate of malignancy than I-IPNB. The predictive factor for malignancy is mural nodule > 12 mm in I-IPNB and mural nodule enhancement in E-IPNB. Full article
(This article belongs to the Special Issue Current Advances and Perspectives in Intrahepatic Cholangiocarcinoma)
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