Topics:
Radiation Oncology • Gastrointestinal Cancers • Medical Oncology • Liver and Pancreas Tumors • Journal Club ft. NEJM publications
What is your approach to patients with unresectable, node-negative perihilar cholangiocarcinoma who have undergone biliary stenting and have no evidence of distant disease?
If borderline resectable, can the TOPAZ regimen be considered for downstaging effects?
Answer from: Medical Oncologist at Academic Institution
For perihilar cholangiocarcinoma that has been deemed unresectable by hepatobiliary surgeons, a good consideration is to have the patient evaluated for liver transplantation. The Mayo Clinic protocol allows tumor mass of <3cm, no nodal disease, and vascular involvement is allowed. Depending on th...
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Answer from: Radiation Oncologist at Community Practice
It's sad to me to see institutions such as the Mayo Clinic (when Len Gunderson was in charge---using intraoperative XRT and intrabiliary implants) and Johns Hopkins (when hepatobiliary surgeon John Cameron almost always had his patients receive postop XRT or primary XRT), pioneers in radiation thera...
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Radiation Oncologist at UNC SChool of Medicine
@Gene: we are showing our age here. The newer chem...
@Gene: we are showing our age here. The newer chem...
Medical Oncologist at Yuma Regional Medical Center Cancer Center
I would consider using chemo with RT with curative...
I would consider using chemo with RT with curative...
Radiation Oncologist at LJA
Dr. @Marks Thanks for remembering the early...
Dr. @Marks Thanks for remembering the early...
Answer from: Medical Oncologist at Academic Institution
I treat them as I would metastatic patients.The TOPAZ-1 regimen can be considered, as can gemcitabine, cisplatin, and abraxane based on phase II data, the latter especially if I think there is any hope of getting the patient downstaged and to surgery.
Answer from: Medical Oncologist at Community Practice
The treatment of peri-hilar (h-CCA) cholangiocarcinoma is an evolving field with continuous development of radiological and surgical techniques ranging from traditional hepatectomies to complex approaches involving preoperative portal vein embolization or associating liver partition and portal vein ...