Clinical efficacy of gemcitabine and cisplatin-based transcatheter arterial chemoembolization combined with radiotherapy in hilar cholangiocarcinoma
|
摘要
BACKGROUND Radical surgical resection is regarded as the best treatment for hepatic hilar cholangiocarcinoma. However, 60%-70% of patients have lost the chance of surgery at the time of diagnosis. Simple biliary stent or drainage tube placement may fail in a short time due to tumor invasion or overgrowth, bile accumulation,or biofilm formation. Effective palliative treatments to extend the effective drainage time are of great significance for improving the quality of life of patients and changing the prognosis of patients.AIM To investigate the clinical efficacy of gemcitabine and cisplatin-based transcatheter arterial chemoembolization(TACE) combined with radiotherapy in hilar cholangiocarcinoma.METHODS A retrospective analysis was conducted on patients clinically diagnosed with hilar cholangiocarcinoma from June 2014 to January 2017 at the Liaoning Provincial Cancer Hospital. Patients were evaluated by specialists, and those who were not suitable for surgery or unwilling to undergo surgery and met the inclusion criteria were included in the study. There were a total of 72 patients(34 males and 38 females) with an average age of 59.9 years(range, 40-72 years).According to percutaneous transhepatic biliary angiography and the patients' wishes, stent implantation or biliary drainage tube implantation was used to relieve biliary obstruction. The patients were divided into either a control group or a combined treatment group according to their follow-up treatment. The control group consisted of a total of 35 patients who received simple biliary drainage tube placement and biliary stent implantation(7 patients with bilateral stents and 6 with a unilateral stent) and 22 patients receiving biliary drainage tube placement alone. The combined treatment group received TACE and extracorporeal radiotherapy after biliary drainage or biliary stent implantation and consisted of a total of 37 patients, including 21 patients receiving combined treatment after biliary stent placement(14 patients with bilateral stents and 7 with a unilateral stent) and 16 undergoing combined therapy after implanting the biliary drainage tube. In the combination treatment group, the TACE chemotherapy regimen employed gemcitabine and cisplatin, and the embolic agent was iodized oil. A particular dose was determined according to the patient's body surface area and the tumor staining indicated by DSA. In vitro radiotherapy was performed with intensity-modulated radiotherapy or threedimensional conformal radiotherapy at an average dose of 48.3 Gy. Both groups were followed from stent implantation or drainage tube implantation until the patient quitted or died. The median length of follow-up observation was 13 mo.The differences in overall survival time and the effect of different jaundice reducing methods(single stent, double stent, or biliary drainage) on the patency time and survival time of biliary stents were compared between the two groups;the related factors affecting overall survival time were analyzed.RESULTS The median survival time of the control group was 10.5 mo; the median survival time of patients with biliary stent implantation and those with percutaneous biliary drainage was 9.6 mo and 11.4 mo, respectively, and there was no statistically significant difference between them. The median survival time of the combined treatment group was 20.0 mo, which was significantly higher than that of the control group(P < 0.05). Among patients in the combined treatment group,the median survival time of patients who underwent biliary stent implantation and those who accepted percutaneous biliary drainage before the combination therapy was 19.5 mo and 20.1 mo, respectively, and there was no significant difference between them. In the combination treatment group, the mean time of median stent patency was 15.6 mo, which was significantly higher than that of the control group(7.0 mo; P < 0.05). The independent factors affecting survival time included age, whether to receive combination therapy, percutaneous biliary drainage tube implantation, and Bismuth-Corlette classification as type IV.CONCLUSION Gemcitabine and cisplatin-based TACE combined with radiotherapy can prolong the survival of patients with hilar cholangiocarcinoma. Independent predictors of survival include selection of combination therapy, Bismuth-Corlette classification as type IV, selection of percutaneous biliary drainage tube implantation, and age.
BACKGROUND Radical surgical resection is regarded as the best treatment for hepatic hilar cholangiocarcinoma. However, 60%-70% of patients have lost the chance of surgery at the time of diagnosis. Simple biliary stent or drainage tube placement may fail in a short time due to tumor invasion or overgrowth, bile accumulation,or biofilm formation. Effective palliative treatments to extend the effective drainage time are of great significance for improving the quality of life of patients and changing the prognosis of patients.AIM To investigate the clinical efficacy of gemcitabine and cisplatin-based transcatheter arterial chemoembolization(TACE) combined with radiotherapy in hilar cholangiocarcinoma.METHODS A retrospective analysis was conducted on patients clinically diagnosed with hilar cholangiocarcinoma from June 2014 to January 2017 at the Liaoning Provincial Cancer Hospital. Patients were evaluated by specialists, and those who were not suitable for surgery or unwilling to undergo surgery and met the inclusion criteria were included in the study. There were a total of 72 patients(34 males and 38 females) with an average age of 59.9 years(range, 40-72 years).According to percutaneous transhepatic biliary angiography and the patients' wishes, stent implantation or biliary drainage tube implantation was used to relieve biliary obstruction. The patients were divided into either a control group or a combined treatment group according to their follow-up treatment. The control group consisted of a total of 35 patients who received simple biliary drainage tube placement and biliary stent implantation(7 patients with bilateral stents and 6 with a unilateral stent) and 22 patients receiving biliary drainage tube placement alone. The combined treatment group received TACE and extracorporeal radiotherapy after biliary drainage or biliary stent implantation and consisted of a total of 37 patients, including 21 patients receiving combined treatment after biliary stent placement(14 patients with bilateral stents and 7 with a unilateral stent) and 16 undergoing combined therapy after implanting the biliary drainage tube. In the combination treatment group, the TACE chemotherapy regimen employed gemcitabine and cisplatin, and the embolic agent was iodized oil. A particular dose was determined according to the patient's body surface area and the tumor staining indicated by DSA. In vitro radiotherapy was performed with intensity-modulated radiotherapy or threedimensional conformal radiotherapy at an average dose of 48.3 Gy. Both groups were followed from stent implantation or drainage tube implantation until the patient quitted or died. The median length of follow-up observation was 13 mo.The differences in overall survival time and the effect of different jaundice reducing methods(single stent, double stent, or biliary drainage) on the patency time and survival time of biliary stents were compared between the two groups;the related factors affecting overall survival time were analyzed.RESULTS The median survival time of the control group was 10.5 mo; the median survival time of patients with biliary stent implantation and those with percutaneous biliary drainage was 9.6 mo and 11.4 mo, respectively, and there was no statistically significant difference between them. The median survival time of the combined treatment group was 20.0 mo, which was significantly higher than that of the control group(P < 0.05). Among patients in the combined treatment group,the median survival time of patients who underwent biliary stent implantation and those who accepted percutaneous biliary drainage before the combination therapy was 19.5 mo and 20.1 mo, respectively, and there was no significant difference between them. In the combination treatment group, the mean time of median stent patency was 15.6 mo, which was significantly higher than that of the control group(7.0 mo; P < 0.05). The independent factors affecting survival time included age, whether to receive combination therapy, percutaneous biliary drainage tube implantation, and Bismuth-Corlette classification as type IV.CONCLUSION Gemcitabine and cisplatin-based TACE combined with radiotherapy can prolong the survival of patients with hilar cholangiocarcinoma. Independent predictors of survival include selection of combination therapy, Bismuth-Corlette classification as type IV, selection of percutaneous biliary drainage tube implantation, and age.
BACKGROUND Radical surgical resection is regarded as the best treatment for hepatic hilar cholangiocarcinoma. However, 60%-70% of patients have lost the chance of surgery at the time of diagnosis. Simple biliary stent or drainage tube placement may fail in a short time due to tumor invasion or overgrowth, bile accumulation,or biofilm formation. Effective palliative treatments to extend the effective drainage time are of great significance for improving the quality of life of patients and changing the prognosis of patients.AIM To investigate the clinical efficacy of gemcitabine and cisplatin-based transcatheter arterial chemoembolization(TACE) combined with radiotherapy in hilar cholangiocarcinoma.METHODS A retrospective analysis was conducted on patients clinically diagnosed with hilar cholangiocarcinoma from June 2014 to January 2017 at the Liaoning Provincial Cancer Hospital. Patients were evaluated by specialists, and those who were not suitable for surgery or unwilling to undergo surgery and met the inclusion criteria were included in the study. There were a total of 72 patients(34 males and 38 females) with an average age of 59.9 years(range, 40-72 years).According to percutaneous transhepatic biliary angiography and the patients' wishes, stent implantation or biliary drainage tube implantation was used to relieve biliary obstruction. The patients were divided into either a control group or a combined treatment group according to their follow-up treatment. The control group consisted of a total of 35 patients who received simple biliary drainage tube placement and biliary stent implantation(7 patients with bilateral stents and 6 with a unilateral stent) and 22 patients receiving biliary drainage tube placement alone. The combined treatment group received TACE and extracorporeal radiotherapy after biliary drainage or biliary stent implantation and consisted of a total of 37 patients, including 21 patients receiving combined treatment after biliary stent placement(14 patients with bilateral stents and 7 with a unilateral stent) and 16 undergoing combined therapy after implanting the biliary drainage tube. In the combination treatment group, the TACE chemotherapy regimen employed gemcitabine and cisplatin, and the embolic agent was iodized oil. A particular dose was determined according to the patient's body surface area and the tumor staining indicated by DSA. In vitro radiotherapy was performed with intensity-modulated radiotherapy or threedimensional conformal radiotherapy at an average dose of 48.3 Gy. Both groups were followed from stent implantation or drainage tube implantation until the patient quitted or died. The median length of follow-up observation was 13 mo.The differences in overall survival time and the effect of different jaundice reducing methods(single stent, double stent, or biliary drainage) on the patency time and survival time of biliary stents were compared between the two groups;the related factors affecting overall survival time were analyzed.RESULTS The median survival time of the control group was 10.5 mo; the median survival time of patients with biliary stent implantation and those with percutaneous biliary drainage was 9.6 mo and 11.4 mo, respectively, and there was no statistically significant difference between them. The median survival time of the combined treatment group was 20.0 mo, which was significantly higher than that of the control group(P < 0.05). Among patients in the combined treatment group,the median survival time of patients who underwent biliary stent implantation and those who accepted percutaneous biliary drainage before the combination therapy was 19.5 mo and 20.1 mo, respectively, and there was no significant difference between them. In the combination treatment group, the mean time of median stent patency was 15.6 mo, which was significantly higher than that of the control group(7.0 mo; P < 0.05). The independent factors affecting survival time included age, whether to receive combination therapy, percutaneous biliary drainage tube implantation, and Bismuth-Corlette classification as type IV.CONCLUSION Gemcitabine and cisplatin-based TACE combined with radiotherapy can prolong the survival of patients with hilar cholangiocarcinoma. Independent predictors of survival include selection of combination therapy, Bismuth-Corlette classification as type IV, selection of percutaneous biliary drainage tube implantation, and age.
引文
1 Gupta A,Dixon E.Epidemiology and risk factors:intrahepatic cholangiocarcinoma.Hepatobiliary Surg Nutr 2017;6:101-104[PMID:28503557 DOI:10.21037/hbsn.2017.01.02]
2 Weiss MJ,Cosgrove D,Herman JM,Rastegar N,Kamel I,Pawlik TM.Multimodal treatment strategies for advanced hilar cholangiocarcinoma.Langenbecks Arch Surg 2014;399:679-692[PMID:24962146DOI:10.1007/s00423-014-1219-1]
3 Launois B,Reding R,Lebeau G,Buard JL.Surgery for hilar cholangiocarcinoma:French experience in a collective survey of 552 extrahepatic bile duct cancers.J Hepatobiliary Pancreat Surg 2000;7:128-134[PMID:10982604 DOI:10.1007/s005340000070128.534]
4 Welzel TM,McGlynn KA,Hsing AW,O'Brien TR,Pfeiffer RM.Impact of classification of hilar cholangiocarcinomas(Klatskin tumors)on the incidence of intra-and extrahepatic cholangiocarcinoma in the United States.J Natl Cancer Inst 2006;98:873-875[PMID:16788161 DOI:10.1093/jnci/djj234]
5 DeOliveira ML,Cunningham SC,Cameron JL,Kamangar F,Winter JM,Lillemoe KD,Choti MA,Yeo CJ,Schulick RD.Cholangiocarcinoma:thirty-one-year experience with 564 patients at a single institution.Ann Surg 2007;245:755-762[PMID:17457168 DOI:10.1097/01.sla.0000251366.62632.d3]
6 Squires MH,Cloyd JM,Dillhoff M,Schmidt C,Pawlik TM.Challenges of surgical management of intrahepatic cholangiocarcinoma.Expert Rev Gastroenterol Hepatol 2018;12:671-681[PMID:29911912DOI:10.1080/17474124.2018.1489229]
7 Poultsides GA,Zhu AX,Choti MA,Pawlik TM.Intrahepatic cholangiocarcinoma.Surg Clin North Am2010;90:817-837[PMID:20637950 DOI:10.1016/j.suc.2010.04.011]
8 Covey AM,Brown KT.Palliative percutaneous drainage in malignant biliary obstruction.Part 2:Mechanisms and postprocedure management.J Support Oncol 2006;4:329-335[PMID:16892694]
9 Deipolyi AR,Covey AM.Palliative Percutaneous Biliary Interventions in Malignant High Bile Duct Obstruction.Semin Intervent Radiol 2017;34:361-368[PMID:29249860 DOI:10.1055/s-0037-1608827]
10 Abraham NS,Barkun JS,Barkun AN.Palliation of malignant biliary obstruction:a prospective trial examining impact on quality of life.Gastrointest Endosc 2002;56:835-841[PMID:12447294 DOI:10.1067/mge.2002.129868]
11 Tuqan W,Innabi A,Alawneh A,Farsakh FA,Al-Khatib M.Prediction of Survival Following Percutaneous Biliary Drainage for Malignant Biliary Obstruction.J Transl Int Med 2017;5:127-131[PMID:28721346 DOI:10.1515/jtim-2017-0014]
12 Robson PC,Heffernan N,Gonen M,Thornton R,Brody LA,Holmes R,Brown KT,Covey AM,Fleischer D,Getrajdman GI,Jarnagin W,Sofocleous C,Blumgart L,D'Angelica M.Prospective study of outcomes after percutaneous biliary drainage for malignant biliary obstruction.Ann Surg Oncol 2010;17:2303-2311[PMID:20358300 DOI:10.1245/s10434-010-1045-9]
13 Saluja SS,Gulati M,Garg PK,Pal H,Pal S,Sahni P,Chattopadhyay TK.Endoscopic or percutaneous biliary drainage for gallbladder cancer:a randomized trial and quality of life assessment.Clin Gastroenterol Hepatol 2008;6:944-950.e3[PMID:18585976 DOI:10.1016/j.cgh.2008.03.028]
14 Sharaiha RZ,Natov N,Glockenberg KS,Widmer J,Gaidhane M,Kahaleh M.Comparison of metal stenting with radiofrequency ablation versus stenting alone for treating malignant biliary strictures:is there an added benefit?Dig Dis Sci 2014;59:3099-3102[PMID:25033929 DOI:10.1007/s10620-014-3264-6]
15 Shim DJ,Gwon DI,Han K,Kim Y,Ko GY,Shin JH,Ko HK,Kim JH,Kim JW,Yoon HK,Sung KB.Percutaneous Metallic Stent Placement for Palliative Management of Malignant Biliary Hilar Obstruction.Korean J Radiol 2018;19:597-605[PMID:29962866 DOI:10.3348/kjr.2018.19.4.597]
16 Maybody M,Brown KT,Brody LA,Covey AM,Sofocleous CT,Thornton RH,Getrajdman GI.Primary patency of Wallstents in malignant bile duct obstruction:single vs.two or more noncoaxial stents.Cardiovasc Intervent Radiol 2009;32:707-713[PMID:19387728 DOI:10.1007/s00270-009-9577-8]
17 Brountzos EN,Ptochis N,Panagiotou I,Malagari K,Tzavara C,Kelekis D.A survival analysis of patients with malignant biliary strictures treated by percutaneous metallic stenting.Cardiovasc Intervent Radiol2007;30:66-73[PMID:17031733 DOI:10.1007/s00270-005-0379-3]
18 De Palma GD,Galloro G,Siciliano S,Iovino P,Catanzano C.Unilateral versus bilateral endoscopic hepatic duct drainage in patients with malignant hilar biliary obstruction:results of a prospective,randomized,and controlled study.Gastrointest Endosc 2001;53:547-553[PMID:11323577]
19 Eckel F,Schmid RM.Chemotherapy and targeted therapy in advanced biliary tract carcinoma:a pooled analysis of clinical trials.Chemotherapy 2014;60:13-23[PMID:25341559 DOI:10.1159/000365781]
20 Valle J,Wasan H,Palmer DH,Cunningham D,Anthoney A,Maraveyas A,Madhusudan S,Iveson T,Hughes S,Pereira SP,Roughton M,Bridgewater J;ABC-02 Trial Investigators.Cisplatin plus gemcitabine versus gemcitabine for biliary tract cancer.N Engl J Med 2010;362:1273-1281[PMID:20375404 DOI:10.1056/NEJMoa0908721]
21 Boehm LM,Jayakrishnan TT,Miura JT,Zacharias AJ,Johnston FM,Turaga KK,Gamblin TC.Comparative effectiveness of hepatic artery based therapies for unresectable intrahepatic cholangiocarcinoma.J Surg Oncol 2015;111:213-220[PMID:25176325 DOI:10.1002/jso.23781]
22 Kim JH,Yoon HK,Sung KB,Ko GY,Gwon DI,Shin JH,Song HY.Transcatheter arterial chemoembolization or chemoinfusion for unresectable intrahepatic cholangiocarcinoma:clinical efficacy and factors influencing outcomes.Cancer 2008;113:1614-1622[PMID:18704990 DOI:10.1002/cncr.23787]
23 Gusani NJ,Balaa FK,Steel JL,Geller DA,Marsh JW,Zajko AB,Carr BI,Gamblin TC.Treatment of unresectable cholangiocarcinoma with gemcitabine-based transcatheter arterial chemoembolization(TACE):a single-institution experience.J Gastrointest Surg 2008;12:129-137[PMID:17851723 DOI:10.1007/s11605-007-0312-y]
24 Park SY,Kim JH,Yoon HJ,Lee IS,Yoon HK,Kim KP.Transarterial chemoembolization versus supportive therapy in the palliative treatment of unresectable intrahepatic cholangiocarcinoma.Clin Radiol2011;66:322-328[PMID:21356394 DOI:10.1016/j.crad.2010.11.002]
25 Mahadevan A,Dagoglu N,Mancias J,Raven K,Khwaja K,Tseng JF,Ng K,Enzinger P,Miksad R,Bullock A,Evenson A.Stereotactic Body Radiotherapy(SBRT)for Intrahepatic and Hilar Cholangiocarcinoma.J Cancer 2015;6:1099-1104[PMID:26516357 DOI:10.7150/jca.13032]
26 Kopek N,Holt MI,Hansen AT,H?yer M.Stereotactic body radiotherapy for unresectable cholangiocarcinoma.Radiother Oncol 2010;94:47-52[PMID:19963295 DOI:10.1016/j.radonc.2009.11.004]
27 Bonnel D,AndréT,Mader B,Lefebvre JF,Bensoussan E,Liguory C.[Malignant biliary obstruction,general review and clinical practice].Bull Cancer 2013;100:443-452[PMID:23644517 DOI:10.1684/bdc.2013.1736]
28 Kogure H,Isayama H,Nakai Y,Tsujino T,Matsubara S,Yashima Y,Ito Y,Hamada T,Takahara N,Miyabayashi K,Mizuno S,Mohri D,Kawakubo K,Sasaki T,Yamamoto N,Hirano K,Sasahira N,Tada M,Koike K.High single-session success rate of endoscopic bilateral stent-in-stent placement with modified large cell Niti-S stents for malignant hilar biliary obstruction.Dig Endosc 2014;26:93-99[PMID:23517109 DOI:10.1111/den.12055]
29 Song T,Jia Z,Guo X,Zhao H,Bao W,Han D,Zhou X,Qi X.Does Hepatic Impairment Influence Renal Function Parameters in Liver Cirrhosis?J Transl Int Med 2018;6:90-92[PMID:29984204 DOI:10.2478/jtim-2018-0017]
30 Djiambou-Nganjeu H.Hepatic Encephalopathy in Liver Cirrhosis.J Transl Int Med 2017;5:64-67[PMID:28680841 DOI:10.1515/jtim-2017-0013]
31 Hwang JC,Kim JH,Lim SG,Kim SS,Yoo BM,Cho SW.Y-shaped endoscopic bilateral metal stent placement for malignant hilar biliary obstruction:prospective long-term study.Scand J Gastroenterol2011;46:326-332[PMID:21082874 DOI:10.3109/00365521.2010.536253]
32 Rerknimitr R,Angsuwatcharakon P,Ratanachu-ek T,Khor CJ,Ponnudurai R,Moon JH,Seo DW,Pantongrag-Brown L,Sangchan A,Pisespongsa P,Akaraviputh T,Reddy ND,Maydeo A,Itoi T,Pausawasdi N,Punamiya S,Attasaranya S,Devereaux B,Ramchandani M,Goh KL;Asia-Pacific Working Group on Hepatobiliary Cancers.Asia-Pacific consensus recommendations for endoscopic and interventional management of hilar cholangiocarcinoma.J Gastroenterol Hepatol 2013;28:593-607[PMID:23350673 DOI:10.1111/jgh.12128]
33 Vienne A,Hobeika E,Gouya H,Lapidus N,Fritsch J,Choury AD,Chryssostalis A,Gaudric M,Pelletier G,Buffet C,Chaussade S,Prat F.Prediction of drainage effectiveness during endoscopic stenting of malignant hilar strictures:the role of liver volume assessment.Gastrointest Endosc 2010;72:728-735[PMID:20883850 DOI:10.1016/j.gie.2010.06.040]
34 Pranculis A,Kievi?as M,Kievi?ien?L,Vai?ius A,Vanagas T,Kaupas RS,Dambrauskas?.Percutaneous Transhepatic Biliary Stenting with Uncovered Self-Expandable Metallic Stents in Patients with Malignant Biliary Obstruction-Efficacy and Survival Analysis.Pol J Radiol 2017;82:431-440[PMID:29662569DOI:10.12659/PJR.901785]
35 Paul A,Kaiser GM,Molmenti EP,Schroeder T,Vernadakis S,Oezcelik A,Baba HA,Cicinnati VR,Sotiropoulos GC.Klatskin tumors and the accuracy of the Bismuth-Corlette classification.Am Surg 2011;77:1695-1699[PMID:22273233]
36 Adler DG.EUS-guided gallbladder drainage:Current status and future prospects.Endosc Ultrasound2018;7:1-3[PMID:29451163 DOI:10.4103/eus.eus_3_18]
37 Baars JE,Kaffes AJ,Saxena P.EUS-guided biliary drainage:A comprehensive review of the literature.Endosc Ultrasound 2018;7:4-9[PMID:29451164 DOI:10.4103/eus.eus_105_17]
38 Coro O,Caillol F,Poincloux L,Bories E,Pesenti C,Ratone JP,Giovannini M.Hepaticogastrostomy under EUS guidance for a patient with a history of bypass surgery with a new stent design(with video).Endosc Ultrasound 2019;8:66-68[PMID:30168478 DOI:10.4103/eus.eus_15_18]
39 Nam K,Kim DU,Lee TH,Iwashita T,Nakai Y,Bolkhir A,Castro LA,Vazquez-Sequeiros E,de la Serna C,Perez-Miranda M,Lee JG,Lee SS,Seo DW,Lee SK,Kim MH,Park DH.Patient perception and preference of EUS-guided drainage over percutaneous drainage when endoscopic transpapillary biliary drainage fails:An international multicenter survey.Endosc Ultrasound 2018;7:48-55[PMID:29451169DOI:10.4103/eus.eus_100_17]
40 Ogura T,Okuda A,Miyano A,Nishioka N,Higuchi K.Stent release within scope channel technique to prevent stent migration during EUS-guided hepaticogastrostomy(with video).Endosc Ultrasound 2018;7:67-68[PMID:29451173 DOI:10.4103/eus.eus_57_17]
41 Suarez-Munoz MA,Fernandez-Aguilar JL,Sanchez-Perez B,Perez-Daga JA,Garcia-Albiach B,PulidoRoa Y,Marin-Camero N,Santoyo-Santoyo J.Risk factors and classifications of hilar cholangiocarcinoma.World J Gastrointest Oncol 2013;5:132-138[PMID:23919107 DOI:10.4251/wjgo.v5.i7.132]
42 Juntermanns B,Sotiropoulos GC,Radunz S,Reis H,Heuer M,Baba HA,Canbay A,Schuler M,Gerken G,Paul A,Kaiser GM.Comparison of the sixth and the seventh editions of the UICC classification for perihilar cholangiocarcinoma.Ann Surg Oncol 2013;20:277-284[PMID:22805862 DOI:10.1245/s10434-012-2486-0]
2 Weiss MJ,Cosgrove D,Herman JM,Rastegar N,Kamel I,Pawlik TM.Multimodal treatment strategies for advanced hilar cholangiocarcinoma.Langenbecks Arch Surg 2014;399:679-692[PMID:24962146DOI:10.1007/s00423-014-1219-1]
3 Launois B,Reding R,Lebeau G,Buard JL.Surgery for hilar cholangiocarcinoma:French experience in a collective survey of 552 extrahepatic bile duct cancers.J Hepatobiliary Pancreat Surg 2000;7:128-134[PMID:10982604 DOI:10.1007/s005340000070128.534]
4 Welzel TM,McGlynn KA,Hsing AW,O'Brien TR,Pfeiffer RM.Impact of classification of hilar cholangiocarcinomas(Klatskin tumors)on the incidence of intra-and extrahepatic cholangiocarcinoma in the United States.J Natl Cancer Inst 2006;98:873-875[PMID:16788161 DOI:10.1093/jnci/djj234]
5 DeOliveira ML,Cunningham SC,Cameron JL,Kamangar F,Winter JM,Lillemoe KD,Choti MA,Yeo CJ,Schulick RD.Cholangiocarcinoma:thirty-one-year experience with 564 patients at a single institution.Ann Surg 2007;245:755-762[PMID:17457168 DOI:10.1097/01.sla.0000251366.62632.d3]
6 Squires MH,Cloyd JM,Dillhoff M,Schmidt C,Pawlik TM.Challenges of surgical management of intrahepatic cholangiocarcinoma.Expert Rev Gastroenterol Hepatol 2018;12:671-681[PMID:29911912DOI:10.1080/17474124.2018.1489229]
7 Poultsides GA,Zhu AX,Choti MA,Pawlik TM.Intrahepatic cholangiocarcinoma.Surg Clin North Am2010;90:817-837[PMID:20637950 DOI:10.1016/j.suc.2010.04.011]
8 Covey AM,Brown KT.Palliative percutaneous drainage in malignant biliary obstruction.Part 2:Mechanisms and postprocedure management.J Support Oncol 2006;4:329-335[PMID:16892694]
9 Deipolyi AR,Covey AM.Palliative Percutaneous Biliary Interventions in Malignant High Bile Duct Obstruction.Semin Intervent Radiol 2017;34:361-368[PMID:29249860 DOI:10.1055/s-0037-1608827]
10 Abraham NS,Barkun JS,Barkun AN.Palliation of malignant biliary obstruction:a prospective trial examining impact on quality of life.Gastrointest Endosc 2002;56:835-841[PMID:12447294 DOI:10.1067/mge.2002.129868]
11 Tuqan W,Innabi A,Alawneh A,Farsakh FA,Al-Khatib M.Prediction of Survival Following Percutaneous Biliary Drainage for Malignant Biliary Obstruction.J Transl Int Med 2017;5:127-131[PMID:28721346 DOI:10.1515/jtim-2017-0014]
12 Robson PC,Heffernan N,Gonen M,Thornton R,Brody LA,Holmes R,Brown KT,Covey AM,Fleischer D,Getrajdman GI,Jarnagin W,Sofocleous C,Blumgart L,D'Angelica M.Prospective study of outcomes after percutaneous biliary drainage for malignant biliary obstruction.Ann Surg Oncol 2010;17:2303-2311[PMID:20358300 DOI:10.1245/s10434-010-1045-9]
13 Saluja SS,Gulati M,Garg PK,Pal H,Pal S,Sahni P,Chattopadhyay TK.Endoscopic or percutaneous biliary drainage for gallbladder cancer:a randomized trial and quality of life assessment.Clin Gastroenterol Hepatol 2008;6:944-950.e3[PMID:18585976 DOI:10.1016/j.cgh.2008.03.028]
14 Sharaiha RZ,Natov N,Glockenberg KS,Widmer J,Gaidhane M,Kahaleh M.Comparison of metal stenting with radiofrequency ablation versus stenting alone for treating malignant biliary strictures:is there an added benefit?Dig Dis Sci 2014;59:3099-3102[PMID:25033929 DOI:10.1007/s10620-014-3264-6]
15 Shim DJ,Gwon DI,Han K,Kim Y,Ko GY,Shin JH,Ko HK,Kim JH,Kim JW,Yoon HK,Sung KB.Percutaneous Metallic Stent Placement for Palliative Management of Malignant Biliary Hilar Obstruction.Korean J Radiol 2018;19:597-605[PMID:29962866 DOI:10.3348/kjr.2018.19.4.597]
16 Maybody M,Brown KT,Brody LA,Covey AM,Sofocleous CT,Thornton RH,Getrajdman GI.Primary patency of Wallstents in malignant bile duct obstruction:single vs.two or more noncoaxial stents.Cardiovasc Intervent Radiol 2009;32:707-713[PMID:19387728 DOI:10.1007/s00270-009-9577-8]
17 Brountzos EN,Ptochis N,Panagiotou I,Malagari K,Tzavara C,Kelekis D.A survival analysis of patients with malignant biliary strictures treated by percutaneous metallic stenting.Cardiovasc Intervent Radiol2007;30:66-73[PMID:17031733 DOI:10.1007/s00270-005-0379-3]
18 De Palma GD,Galloro G,Siciliano S,Iovino P,Catanzano C.Unilateral versus bilateral endoscopic hepatic duct drainage in patients with malignant hilar biliary obstruction:results of a prospective,randomized,and controlled study.Gastrointest Endosc 2001;53:547-553[PMID:11323577]
19 Eckel F,Schmid RM.Chemotherapy and targeted therapy in advanced biliary tract carcinoma:a pooled analysis of clinical trials.Chemotherapy 2014;60:13-23[PMID:25341559 DOI:10.1159/000365781]
20 Valle J,Wasan H,Palmer DH,Cunningham D,Anthoney A,Maraveyas A,Madhusudan S,Iveson T,Hughes S,Pereira SP,Roughton M,Bridgewater J;ABC-02 Trial Investigators.Cisplatin plus gemcitabine versus gemcitabine for biliary tract cancer.N Engl J Med 2010;362:1273-1281[PMID:20375404 DOI:10.1056/NEJMoa0908721]
21 Boehm LM,Jayakrishnan TT,Miura JT,Zacharias AJ,Johnston FM,Turaga KK,Gamblin TC.Comparative effectiveness of hepatic artery based therapies for unresectable intrahepatic cholangiocarcinoma.J Surg Oncol 2015;111:213-220[PMID:25176325 DOI:10.1002/jso.23781]
22 Kim JH,Yoon HK,Sung KB,Ko GY,Gwon DI,Shin JH,Song HY.Transcatheter arterial chemoembolization or chemoinfusion for unresectable intrahepatic cholangiocarcinoma:clinical efficacy and factors influencing outcomes.Cancer 2008;113:1614-1622[PMID:18704990 DOI:10.1002/cncr.23787]
23 Gusani NJ,Balaa FK,Steel JL,Geller DA,Marsh JW,Zajko AB,Carr BI,Gamblin TC.Treatment of unresectable cholangiocarcinoma with gemcitabine-based transcatheter arterial chemoembolization(TACE):a single-institution experience.J Gastrointest Surg 2008;12:129-137[PMID:17851723 DOI:10.1007/s11605-007-0312-y]
24 Park SY,Kim JH,Yoon HJ,Lee IS,Yoon HK,Kim KP.Transarterial chemoembolization versus supportive therapy in the palliative treatment of unresectable intrahepatic cholangiocarcinoma.Clin Radiol2011;66:322-328[PMID:21356394 DOI:10.1016/j.crad.2010.11.002]
25 Mahadevan A,Dagoglu N,Mancias J,Raven K,Khwaja K,Tseng JF,Ng K,Enzinger P,Miksad R,Bullock A,Evenson A.Stereotactic Body Radiotherapy(SBRT)for Intrahepatic and Hilar Cholangiocarcinoma.J Cancer 2015;6:1099-1104[PMID:26516357 DOI:10.7150/jca.13032]
26 Kopek N,Holt MI,Hansen AT,H?yer M.Stereotactic body radiotherapy for unresectable cholangiocarcinoma.Radiother Oncol 2010;94:47-52[PMID:19963295 DOI:10.1016/j.radonc.2009.11.004]
27 Bonnel D,AndréT,Mader B,Lefebvre JF,Bensoussan E,Liguory C.[Malignant biliary obstruction,general review and clinical practice].Bull Cancer 2013;100:443-452[PMID:23644517 DOI:10.1684/bdc.2013.1736]
28 Kogure H,Isayama H,Nakai Y,Tsujino T,Matsubara S,Yashima Y,Ito Y,Hamada T,Takahara N,Miyabayashi K,Mizuno S,Mohri D,Kawakubo K,Sasaki T,Yamamoto N,Hirano K,Sasahira N,Tada M,Koike K.High single-session success rate of endoscopic bilateral stent-in-stent placement with modified large cell Niti-S stents for malignant hilar biliary obstruction.Dig Endosc 2014;26:93-99[PMID:23517109 DOI:10.1111/den.12055]
29 Song T,Jia Z,Guo X,Zhao H,Bao W,Han D,Zhou X,Qi X.Does Hepatic Impairment Influence Renal Function Parameters in Liver Cirrhosis?J Transl Int Med 2018;6:90-92[PMID:29984204 DOI:10.2478/jtim-2018-0017]
30 Djiambou-Nganjeu H.Hepatic Encephalopathy in Liver Cirrhosis.J Transl Int Med 2017;5:64-67[PMID:28680841 DOI:10.1515/jtim-2017-0013]
31 Hwang JC,Kim JH,Lim SG,Kim SS,Yoo BM,Cho SW.Y-shaped endoscopic bilateral metal stent placement for malignant hilar biliary obstruction:prospective long-term study.Scand J Gastroenterol2011;46:326-332[PMID:21082874 DOI:10.3109/00365521.2010.536253]
32 Rerknimitr R,Angsuwatcharakon P,Ratanachu-ek T,Khor CJ,Ponnudurai R,Moon JH,Seo DW,Pantongrag-Brown L,Sangchan A,Pisespongsa P,Akaraviputh T,Reddy ND,Maydeo A,Itoi T,Pausawasdi N,Punamiya S,Attasaranya S,Devereaux B,Ramchandani M,Goh KL;Asia-Pacific Working Group on Hepatobiliary Cancers.Asia-Pacific consensus recommendations for endoscopic and interventional management of hilar cholangiocarcinoma.J Gastroenterol Hepatol 2013;28:593-607[PMID:23350673 DOI:10.1111/jgh.12128]
33 Vienne A,Hobeika E,Gouya H,Lapidus N,Fritsch J,Choury AD,Chryssostalis A,Gaudric M,Pelletier G,Buffet C,Chaussade S,Prat F.Prediction of drainage effectiveness during endoscopic stenting of malignant hilar strictures:the role of liver volume assessment.Gastrointest Endosc 2010;72:728-735[PMID:20883850 DOI:10.1016/j.gie.2010.06.040]
34 Pranculis A,Kievi?as M,Kievi?ien?L,Vai?ius A,Vanagas T,Kaupas RS,Dambrauskas?.Percutaneous Transhepatic Biliary Stenting with Uncovered Self-Expandable Metallic Stents in Patients with Malignant Biliary Obstruction-Efficacy and Survival Analysis.Pol J Radiol 2017;82:431-440[PMID:29662569DOI:10.12659/PJR.901785]
35 Paul A,Kaiser GM,Molmenti EP,Schroeder T,Vernadakis S,Oezcelik A,Baba HA,Cicinnati VR,Sotiropoulos GC.Klatskin tumors and the accuracy of the Bismuth-Corlette classification.Am Surg 2011;77:1695-1699[PMID:22273233]
36 Adler DG.EUS-guided gallbladder drainage:Current status and future prospects.Endosc Ultrasound2018;7:1-3[PMID:29451163 DOI:10.4103/eus.eus_3_18]
37 Baars JE,Kaffes AJ,Saxena P.EUS-guided biliary drainage:A comprehensive review of the literature.Endosc Ultrasound 2018;7:4-9[PMID:29451164 DOI:10.4103/eus.eus_105_17]
38 Coro O,Caillol F,Poincloux L,Bories E,Pesenti C,Ratone JP,Giovannini M.Hepaticogastrostomy under EUS guidance for a patient with a history of bypass surgery with a new stent design(with video).Endosc Ultrasound 2019;8:66-68[PMID:30168478 DOI:10.4103/eus.eus_15_18]
39 Nam K,Kim DU,Lee TH,Iwashita T,Nakai Y,Bolkhir A,Castro LA,Vazquez-Sequeiros E,de la Serna C,Perez-Miranda M,Lee JG,Lee SS,Seo DW,Lee SK,Kim MH,Park DH.Patient perception and preference of EUS-guided drainage over percutaneous drainage when endoscopic transpapillary biliary drainage fails:An international multicenter survey.Endosc Ultrasound 2018;7:48-55[PMID:29451169DOI:10.4103/eus.eus_100_17]
40 Ogura T,Okuda A,Miyano A,Nishioka N,Higuchi K.Stent release within scope channel technique to prevent stent migration during EUS-guided hepaticogastrostomy(with video).Endosc Ultrasound 2018;7:67-68[PMID:29451173 DOI:10.4103/eus.eus_57_17]
41 Suarez-Munoz MA,Fernandez-Aguilar JL,Sanchez-Perez B,Perez-Daga JA,Garcia-Albiach B,PulidoRoa Y,Marin-Camero N,Santoyo-Santoyo J.Risk factors and classifications of hilar cholangiocarcinoma.World J Gastrointest Oncol 2013;5:132-138[PMID:23919107 DOI:10.4251/wjgo.v5.i7.132]
42 Juntermanns B,Sotiropoulos GC,Radunz S,Reis H,Heuer M,Baba HA,Canbay A,Schuler M,Gerken G,Paul A,Kaiser GM.Comparison of the sixth and the seventh editions of the UICC classification for perihilar cholangiocarcinoma.Ann Surg Oncol 2013;20:277-284[PMID:22805862 DOI:10.1245/s10434-012-2486-0]