Synchronous Primary Colonic and Early Gallbladder Carcinomas: Report of a Rare Case
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Colon Metastasis from Recurrent Gallbladder Cancer: a Case Report
6 Case Report Page 1 of 6 Colon metastasis from recurrent gallbladder cancer: a case report Carlo Signorelli1^, Eleonora Marrucci1, Emanuela Cristi2, Alfredo Pastorelli3, Paolo Cardello4, Mario Giovanni Chilelli1, Costantino Zampaletta3, Enzo Maria Ruggeri1 1Medical Oncology Unit, Belcolle Hospital, ASL Viterbo, Viterbo, Italy; 2Pathology Unit, Belcolle Hospital, ASL Viterbo, Viterbo, Italy; 3Gastroenterology Unit, Belcolle Hospital, ASL Viterbo, Viterbo, Italy; 4Radiology Unit, Belcolle Hospital, ASL Viterbo, Viterbo, Italy Correspondence to: Carlo Signorelli. Oncology and Haematology Department, Medical Oncology Unit, Belcolle Hospital, ASL Viterbo, Strada Sammartinese snc, Viterbo 01100, Italy. Email: [email protected]. Abstract: Gallbladder cancer (GBC) is associated with a poor prognosis. Colonic metastases representing approximately 1% of total colorectal cancers, are very rarely reported. According to more recent data in the literature, cases of colon metastases from GBC have not been reported. We report the case of a 78-year-old woman who underwent a cholecystectomy in 2017, for a diffuse carcinoma in situ and an infiltrating adenocarcinoma pT2a G2; she completed six months of adjuvant gemcitabine chemotherapy and started a regular follow up in our institution. Three years later she came to our observation after having developed severe anemia and she was diagnosed synchronous liver and colonic metastases from GBC immunohistologically confirmed. The case was collegially evaluated by a multidisciplinary team. In consideration of the progressive deterioration of the clinical conditions, the extension of the primary GBC and the patient’s age, it was decided to start in July 2020 a first-line mono-chemotherapy treatment with gemcitabine. This is probably the first reported case of colonic metastasis in a patient with a recurrent GBC with synchronous liver involvement. -
Does Liver Cirrhosis Affect the Surgical Outcome of Primary Colorectal
Cheng et al. World Journal of Surgical Oncology (2021) 19:167 https://doi.org/10.1186/s12957-021-02267-6 RESEARCH Open Access Does liver cirrhosis affect the surgical outcome of primary colorectal cancer surgery? A meta-analysis Yu-Xi Cheng†, Wei Tao†, Hua Zhang, Dong Peng* and Zheng-Qiang Wei Abstract Purpose: The purpose of this meta-analysis was to evaluate the effect of liver cirrhosis (LC) on the short-term and long-term surgical outcomes of colorectal cancer (CRC). Methods: The PubMed, Embase, and Cochrane Library databases were searched from inception to March 23, 2021. The Newcastle-Ottawa Scale (NOS) was used to assess the quality of enrolled studies, and RevMan 5.3 was used for data analysis in this meta-analysis. The registration ID of this current meta-analysis on PROSPERO is CRD42021238042. Results: In total, five studies with 2485 patients were included in this meta-analysis. For the baseline information, no significant differences in age, sex, tumor location, or tumor T staging were noted. Regarding short-term outcomes, the cirrhotic group had more major complications (OR=5.15, 95% CI=1.62 to 16.37, p=0.005), a higher re- operation rate (OR=2.04, 95% CI=1.07 to 3.88, p=0.03), and a higher short-term mortality rate (OR=2.85, 95% CI=1.93 to 4.20, p<0.00001) than the non-cirrhotic group. However, no significant differences in minor complications (OR= 1.54, 95% CI=0.78 to 3.02, p=0.21) or the rate of intensive care unit (ICU) admission (OR=0.76, 95% CI=0.10 to 5.99, p=0.80) were noted between the two groups. -
Gallbladder Cancer
Form: D-5137 Quick Facts About Gallbladder Cancer What is the gallbladder? The gallbladder is a small, pear-shaped organ located under right side of the liver. The gallbladder concentrates and stores bile, a fluid produced in the liver. Bile helps digest fats in food as they pass through the small intestine. Although the gallbladder is helpful, most people live normal lives after having their gallbladder removed. What is gallbladder cancer? Gallbladder cancer starts when normal gallbladder cells become abnormal and start to grow out of control. This can form a mass of cells called a tumour. At first, the cells are precancerous, meaning they are abnormal but are not yet cancerous. If the precancerous cells change into cancerous or malignant cells, and/or spread to other areas of the body, this is called gallbladder cancer. The most common type of gallbladder cancer is adenocarcinoma. Gallbladder adenocarcinoma is a cancer that starts in cells that line the inside of the gallbladder. What are the common symptoms of gallbladder cancer? • Abdomen pain • Nausea or vomiting • Jaundice (yellow skin) • Larger gallbladder • Loss of appetite • Weight loss • Swollen abdomen area • Severe itching • Black tarry stool What does stage mean? Once a diagnosis of cancer has been made, the cancer will be given a stage, such as: • where the cancer is located • if or where it has spread • if it is affecting other organs in the body (like the liver) 2 There are 5 stages for gallbladder cancer: Stage 0: There is no sign of cancer in the gallbladder. Stage 1: Cancer has formed and the tumour has spread to a layer of tissue with blood vessels or to the muscle layer, but not outside of the gallbladder. -
Gallbladder Cancer in the 21St Century
Hindawi Publishing Corporation Journal of Oncology Volume 2015, Article ID 967472, 26 pages http://dx.doi.org/10.1155/2015/967472 Review Article Gallbladder Cancer in the 21st Century Rani Kanthan,1 Jenna-Lynn Senger,2 Shahid Ahmed,3 and Selliah Chandra Kanthan4 1 Department of Pathology & Laboratory Medicine, University of Saskatchewan, Saskatoon, SK, Canada S7N 0W8 2Department of Surgery, University of Alberta, Edmonton, AB, Canada T6G 2B7 3Division of Medical Oncology, Division of Medical Oncology, University of Saskatchewan, Saskatoon, SK, Canada S7N 0W8 4Department of Surgery, University of Saskatchewan, Saskatoon, SK, Canada S7N 0W8 Correspondence should be addressed to Rani Kanthan; [email protected] Received 13 June 2015; Revised 7 August 2015; Accepted 12 August 2015 Academic Editor: Massimo Aglietta Copyright © 2015 Rani Kanthan et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Gallbladder cancer (GBC) is an uncommon disease in the majority of the world despite being the most common and aggressive malignancy of the biliary tree. Early diagnosis is essential for improved prognosis; however, indolent and nonspecific clinical presentations with a paucity of pathognomonic/predictive radiological features often preclude accurate identification of GBC at an early stage. As such, GBC remains a highly lethal disease, with only 10% of all patients presenting at a stage amenable to surgical resection. Among this select population, continued improvements in survival during the 21st century are attributable to aggressive radical surgery with improved surgical techniques. This paper reviews the current available literature of the 21st century on PubMed and Medline to provide a detailed summary of the epidemiology and risk factors, pathogenesis, clinical presentation, radiology, pathology, management, and prognosis of GBC. -
(NCCN Guidelines®) Hepatobiliary Cancers
NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) Hepatobiliary Cancers Version 2.2015 NCCN.org Continue Version 2.2015, 02/06/15 © National Comprehensive Cancer Network, Inc. 2015, All rights reserved. The NCCN Guidelines® and this illustration may not be reproduced in any form without the express written permission of NCCN®. Printed by Alexandre Ferreira on 10/25/2015 6:11:23 AM. For personal use only. Not approved for distribution. Copyright © 2015 National Comprehensive Cancer Network, Inc., All Rights Reserved. NCCN Guidelines Index NCCN Guidelines Version 2.2015 Panel Members Hepatobiliary Cancers Table of Contents Hepatobiliary Cancers Discussion *Al B. Benson, III, MD/Chair † Renuka Iyer, MD Þ † Elin R. Sigurdson, MD, PhD ¶ Robert H. Lurie Comprehensive Cancer Roswell Park Cancer Institute Fox Chase Cancer Center Center of Northwestern University R. Kate Kelley, MD † ‡ Stacey Stein, MD, PhD *Michael I. D’Angelica, MD/Vice-Chair ¶ UCSF Helen Diller Family Yale Cancer Center/Smilow Cancer Hospital Memorial Sloan Kettering Cancer Center Comprehensive Cancer Center G. Gary Tian, MD, PhD † Thomas A. Abrams, MD † Mokenge P. Malafa, MD ¶ St. Jude Children’s Dana-Farber/Brigham and Women’s Moffitt Cancer Center Research Hospital/ Cancer Center The University of Tennessee James O. Park, MD ¶ Health Science Center Fred Hutchinson Cancer Research Center/ Steven R. Alberts, MD, MPH Seattle Cancer Care Alliance Mayo Clinic Cancer Center Jean-Nicolas Vauthey, MD ¶ Timothy Pawlik, MD, MPH, PhD ¶ The University of Texas Chandrakanth Are, MD ¶ The Sidney Kimmel Comprehensive MD Anderson Cancer Center Fred & Pamela Buffett Cancer Center at Cancer Center at Johns Hopkins The Nebraska Medical Center Alan P. -
Risk of Colorectal Cancer and Other Cancers in Patients with Gall Stones
Gut 1996; 39:439-443 439 Risk of colorectal cancer and other cancers in patients with gall stones Gut: first published as 10.1136/gut.39.3.439 on 1 September 1996. Downloaded from C Johansen, Wong-Ho Chow, T J0rgensen, L Mellemkjaer, G Engholm, J H Olsen Abstract Although the relation between cholecystec- Background-The occurrence of gall tomy and colorectal cancer has been con- stones has repeatedly been associated with sidered in many studies, the results are equi- an increased risk for cancer of the colon, vocal"; most of the case-control studies but risk associated with cholecystectomy showed a positive relation, but only the two remains unclear. largest cohort studies showed significantly Aims-To evaluate the hypothesis in a increased risks, which were restricted to nationwide cohort ofmore than 40 000 gall women and to the proximal part of the stone patients with complete follow up colon.'4 15 including information of cholecystectomy These results suggest that gall stones, and and obesity. possibly cholecystectomy, which are done Patients-In the population based study mainly as a result ofgall stones increase the risk described here, 42098 patients with gall for colon cancer, particularly among women stones in 1977-1989 were identified in the and in the proximal part of the colon. One Danish Hospital Discharge Register. hypothesis is that post-cholecystectomy Methods-These patients were linked to changes in the composition and secretion of the Danish Cancer Registry to assess their bile salts affect enterohepatic circulation and risks for colorectal and other cancers exposure of the colon to bile acids,'6 '` which during follow up to the end of 1992. -
Review of Intra-Arterial Therapies for Colorectal Cancer Liver Metastasis
cancers Review Review of Intra-Arterial Therapies for Colorectal Cancer Liver Metastasis Justin Kwan * and Uei Pua Department of Vascular and Interventional Radiology, Tan Tock Seng Hospital, Singapore 388403, Singapore; [email protected] * Correspondence: [email protected] Simple Summary: Colorectal cancer liver metastasis occurs in more than 50% of patients with colorectal cancer and is thought to be the most common cause of death from this cancer. The mainstay of treatment for inoperable liver metastasis has been combination systemic chemotherapy with or without the addition of biological targeted therapy with a goal for disease downstaging, for potential curative resection, or more frequently, for disease control. For patients with dominant liver metastatic disease or limited extrahepatic disease, liver-directed intra-arterial therapies including hepatic arterial chemotherapy infusion, chemoembolization and radioembolization are alternative treatment strategies that have shown promising results, most commonly in the salvage setting in patients with chemo-refractory disease. In recent years, their role in the first-line setting in conjunction with concurrent systemic chemotherapy has also been explored. This review aims to provide an update on the current evidence regarding liver-directed intra-arterial treatment strategies and to discuss potential trends for the future. Abstract: The liver is frequently the most common site of metastasis in patients with colorectal cancer, occurring in more than 50% of patients. While surgical resection remains the only potential Citation: Kwan, J.; Pua, U. Review of curative option, it is only eligible in 15–20% of patients at presentation. In the past two decades, Intra-Arterial Therapies for Colorectal major advances in modern chemotherapy and personalized biological agents have improved overall Cancer Liver Metastasis. -
Modern Perspectives on Factors Predisposing to the Development of Gallbladder Cancer
View metadata, citation and similar papers at core.ac.uk brought to you by CORE provided by Elsevier - Publisher Connector DOI:10.1111/hpb.12046 HPB REVIEW ARTICLE Modern perspectives on factors predisposing to the development of gallbladder cancer Charles H. C. Pilgrim, Ryan T. Groeschl, Kathleen K. Christians & T. Clark Gamblin Department of Surgery, Division of Surgical Oncology, Medical College of Wisconsin, Milwaukee, WI, USA Abstract Background: Gallbladder cancer (GBC) is a rare malignancy, yet certain groups are at higher risk. Knowledge of predisposing factors may facilitate earlier diagnosis by enabling targeted investigations into otherwise non-specific presenting signs and symptoms. Detecting GBC in its initial stages offers patients their best chance of cure. Methods: PubMed was searched for recent articles (2008–2012) on the topic of risk factors for GBC. Of 1490 initial entries, 32 manuscripts reporting on risk factors for GBC were included in this review. Results: New molecular perspectives on cholesterol cycling, hormonal factors and bacterial infection provide fresh insights into the established risk factors of gallstones, female gender and geographic locality. The significance of polyps in predisposing to GBC is probably overstated given the known dysplasia–carcinoma and adenoma–carcinoma sequences active in this disease. Bacteria such as Sal- monella species may contribute to regional variations in disease prevalence and might represent powerful targets of therapy to reduce incidences in high-risk areas. Traditional risk factors such as porcelain gallbladder, Mirizzi's syndrome and bile reflux remain important as predisposing factors. Conclusions: Subcentimetre gallbladder polyps rarely become cancerous. Because gallbladder wall thickening is often the first sign of malignancy, all gallbladder imaging should be scrutinized carefully for this feature. -
Sporadic (Nonhereditary) Colorectal Cancer: Introduction
Sporadic (Nonhereditary) Colorectal Cancer: Introduction Colorectal cancer affects about 5% of the population, with up to 150,000 new cases per year in the United States alone. Cancer of the large intestine accounts for 21% of all cancers in the US, ranking second only to lung cancer in mortality in both males and females. It is, however, one of the most potentially curable of gastrointestinal cancers. Colorectal cancer is detected through screening procedures or when the patient presents with symptoms. Screening is vital to prevention and should be a part of routine care for adults over the age of 50 who are at average risk. High-risk individuals (those with previous colon cancer , family history of colon cancer , inflammatory bowel disease, or history of colorectal polyps) require careful follow-up. There is great variability in the worldwide incidence and mortality rates. Industrialized nations appear to have the greatest risk while most developing nations have lower rates. Unfortunately, this incidence is on the increase. North America, Western Europe, Australia and New Zealand have high rates for colorectal neoplasms (Figure 2). Figure 1. Location of the colon in the body. Figure 2. Geographic distribution of sporadic colon cancer . Symptoms Colorectal cancer does not usually produce symptoms early in the disease process. Symptoms are dependent upon the site of the primary tumor. Cancers of the proximal colon tend to grow larger than those of the left colon and rectum before they produce symptoms. Abnormal vasculature and trauma from the fecal stream may result in bleeding as the tumor expands in the intestinal lumen. -
The Biology of Hepatocellular Carcinoma: Implications for Genomic and Immune Therapies Galina Khemlina1,4*, Sadakatsu Ikeda2,3 and Razelle Kurzrock2
Khemlina et al. Molecular Cancer (2017) 16:149 DOI 10.1186/s12943-017-0712-x REVIEW Open Access The biology of Hepatocellular carcinoma: implications for genomic and immune therapies Galina Khemlina1,4*, Sadakatsu Ikeda2,3 and Razelle Kurzrock2 Abstract Hepatocellular carcinoma (HCC), the most common type of primary liver cancer, is a leading cause of cancer-related death worldwide. It is highly refractory to most systemic therapies. Recently, significant progress has been made in uncovering genomic alterations in HCC, including potentially targetable aberrations. The most common molecular anomalies in this malignancy are mutations in the TERT promoter, TP53, CTNNB1, AXIN1, ARID1A, CDKN2A and CCND1 genes. PTEN loss at the protein level is also frequent. Genomic portfolios stratify by risk factors as follows: (i) CTNNB1 with alcoholic cirrhosis; and (ii) TP53 with hepatitis B virus-induced cirrhosis. Activating mutations in CTNNB1 and inactivating mutations in AXIN1 both activate WNT signaling. Alterations in this pathway, as well as in TP53 and the cell cycle machinery, and in the PI3K/Akt/mTor axis (the latter activated in the presence of PTEN loss), as well as aberrant angiogenesis and epigenetic anomalies, appear to be major events in HCC. Many of these abnormalities may be pharmacologically tractable. Immunotherapy with checkpoint inhibitors is also emerging as an important treatment option. Indeed, 82% of patients express PD-L1 (immunohistochemistry) and response rates to anti-PD-1 treatment are about 19%, and include about 5% complete remissions as well as durable benefit in some patients. Biomarker-matched trials are still limited in this disease, and many of the genomic alterations in HCC remain challenging to target. -
Gallstones, Cholecystectomy and the Risk of Hepatobiliary and Pancreatic Cancer: a Nationwide Population-Based Cohort Study in Korea
http://www.jcpjournal.org pISSN 2288-3649 · eISSN 2288-3657 Original Article https://doi.org/10.15430/JCP.2020 .25.3.164 Gallstones, Cholecystectomy and the Risk of Hepatobiliary and Pancreatic Cancer: A Nationwide Population-based Cohort Study in Korea Dan Huang1,2, Joonki Lee1,2, Nan Song3,4, Sooyoung Cho1, Sunho Choe1, Aesun Shin1,3 1Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, 2Division of Cancer Control and Policy, National Cancer Control Institute, National Cancer Center, Goyang, 3Cancer Research Institute, Seoul National University, Seoul, Korea, 4Department of Epidemiology and Cancer Control, St. Jude Children’s Research Hospital, Memphis, TN, USA Several epidemiological studies suggest a potential association between gallstones or cholecystectomy and hepatobiliary and pancreatic cancers (HBPCs). The aim of this study was to evaluate the risk of HBPCs in patients with gallstones or patients who underwent cholecystectomy in the Korean population. A retrospective cohort was constructed using the National Health Insurance Service-National Sample Cohort (NHIS-NSC). Gallstones and cholecystectomy were defined by diagnosis and procedure codes and treated as time-varying covariates. Hazard ratios (HRs) in relation to the risk of HBPCs were estimated by Cox proportional hazard models. Among the 704,437 individuals who were included in the final analysis, the gallstone prevalence was 2.4%, and 1.4% of individuals underwent cholecystectomy. Between 2002 and 2015, 487 and 189 individuals developed HBPCs in the gallstone and cholecystectomy groups, respectively. A significant association was observed between gallstones and all HBPCs (HR 2.16; 95% CI 1.92-2.42) and cholecystectomy and all HBPCs (HR 2.03; 95% CI 1.72-2.39). -
Precision Oncology for Gallbladder Cancer: Insights from Genetic Alterations and Clinical Practice
467 Original Article Page 1 of 12 Precision oncology for gallbladder cancer: insights from genetic alterations and clinical practice Jianzhen Lin1#, Kun Dong2#, Yi Bai1#, Songhui Zhao3, Yonghong Dong4, Junping Shi3, Weiwei Shi3, Junyu Long1, Xu Yang1, Dongxu Wang1, Xiaobo Yang1, Lin Zhao4, Ke Hu6, Jie Pan7, Xinting Sang1, Kai Wang3,8, Haitao Zhao1 1Department of Liver Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College (CAMS & PUMC), Beijing 100730, China; 2Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Pathology, Peking University Cancer Hospital & Institute, Beijing 100142, China; 3OrigiMed, Shanghai 201114, China; 4Department of General Surgery, Shanxi Provincial People’s Hospital, Taiyuan 710068, China; 5Department of Medical Oncology, 6Center for Radiotherapy, 7Department of Radiology, Peking Union Medical College Hospital, Beijing 100032, China; 8Zhejiang University International Hospital, Hangzhou 310030, China Contributions: (I) Conception and design: J Lin, L Zhao, K Hu, J Pan, X Sang, K Wang, H Zhao; (II) Administrative support: J Lin, X Sang, K Wang, H Zhao; (III) Provision of study materials or patients: J Lin, Y Bai, Y Dong, J Long, X Yang, D Wang, X Yang; (IV) Collection and assembly of data: J Lin, K Dong, Y Bai, J Long, X Yang, D Wang, X Yang; (V) Data analysis and interpretation: J Lin, K Dong, S Zhao, J Shi, W Shi, H Zhao; (VI) Manuscript writing: All authors; (VII) Final approval of manuscript: All authors. #These authors contributed equally to this work. Correspondence to: Haitao Zhao, MD. Department of Liver Surgery, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College (CAMS & PUMC), #1 Shuaifuyuan, Wangfujing, Beijing 100730, China.