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Bile Duct and Gallbladder Cancer

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Intraoperative Irradiation

Part of the book series: Current Clinical Oncology ((CCO))

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Abstract

Many patients with gallbladder and extrahepatic biliary duct lesions have either technically ­unresectable lesions or gross or microscopic residual disease after attempts at resection because of anatomic location and technical limitations [1–3]. Surgical removal of a malignant gallbladder lesion often necessitates blunt dissection from the liver with narrow or nonexistent margins unless a wedge of liver is removed.

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References

  1. Adson MA, Farnell MD. Hepatobiliary cancer – surgery considerations. Mayo Clin Proc. 1981;56:686–99.

    PubMed  CAS  Google Scholar 

  2. Cameron JL, Pitt HA, Zinner MJ, et al. Management of proximal cholangiocarcinoma by surgical resection and radiotherapy. Am J Surg. 1990;159:91–7.

    Article  PubMed  CAS  Google Scholar 

  3. Kopelson G, Galdabini J, Warshaw A, Gunderson LL. Patterns of failure after curative surgery for extrahepatic biliary tract carcinoma. Int J Radiat Oncol Biol Phys. 1981;7:413–7.

    Article  PubMed  CAS  Google Scholar 

  4. Hadjis NS, Blenkhart JI, Alexander N, Benjamin IS, Blumgart LH. Outcome of radical surgery in hilar cholangiocarcinoma. Surgery. 1990;107:597–604.

    PubMed  CAS  Google Scholar 

  5. Lai ECS, Lo CM. Cholangiocarcinoma. GI Cancer. 1996;1:163–70.

    Google Scholar 

  6. Nagorney DM, Donohue JH, Farnell MB, Schleck CD, Ilstrup AM. Outcomes after curative resection of cholangiocarcinoma. Arch Surg. 1993;128:871–9.

    PubMed  CAS  Google Scholar 

  7. Goldstein RM, Stone M, Tillery W, et al. Is liver transplantation indicated for cholangiocarcinoma. Am J Surg. 1993;166:768–72.

    Article  PubMed  CAS  Google Scholar 

  8. Starzl TE, Todo S, Tzakis A, et al. Abdominal organ cluster transplantation for the treatment of upper abdominal malignancies. Ann Surg. 1989;210:374–86.

    Article  PubMed  CAS  Google Scholar 

  9. Kopelson G, Harisiadis L, Tretter P, Chang CH. The role of radiation therapy in cancer of the extra-hepatic biliary system: an analysis of thirteen patients and a review of the literature of the effectiveness of surgery, chemotherapy, and radiotherapy. Int J Radiat Oncol Biol Phys. 1977;2:883–94.

    Article  PubMed  CAS  Google Scholar 

  10. Willett C, Warshaw AL, Convery K, Compton CC. Pattern of failure after pancreatoduodenectomy for ampullary carcinoma. Surg Gynecol Obstet. 1993;176:33–8.

    PubMed  CAS  Google Scholar 

  11. Gunderson LL, Willett CG. Pancreas and hepatobiliary tract. In: Perez C, Brady L, editors. Principles and practice of radiation oncology. 3rd ed. Philadelphia: J. B. Lippincott; 1997. p. 1467–88.

    Google Scholar 

  12. Buskirk SJ, Gunderson LL, Schild SE, Bender CE, et al. Analysis of failure following curative irradiation of extrahepatic bile duct carcinoma. Ann Surg. 1992;215:125–31.

    Article  PubMed  CAS  Google Scholar 

  13. Fields JN, Emami B. Carcinoma of the extrahepatic biliary system: results of primary and adjuvant radiotherapy. Int J Radiat Oncol Biol Phys. 1987;13:331–8.

    Article  PubMed  CAS  Google Scholar 

  14. Hanna SS, Rider WD. Carcinoma of the gallbladder or extrahepatic bile ducts: the role of radiotherapy. Can Med Assoc J. 1978;118:59–61.

    PubMed  CAS  Google Scholar 

  15. Robertson JM, Marsh L, Tenhaken RK, Lawrence TS. The clinical application of a non-axial treatment plan for pancreatic and biliary malignancies. Radiother Oncol. 1992;24:198–200.

    Article  PubMed  CAS  Google Scholar 

  16. Alden ME, Mohiudden M. The impact of radiation dose in combined external beam and intraluminal Ir-192 for bile duct cancer. Int J Radiat Oncol Biol Phys. 1994;28:945–51.

    Article  PubMed  CAS  Google Scholar 

  17. Minsky BD, Wessan MF, Armstrong JG, et al. Combined modality therapy of extrahepatic biliary system cancer. Int J Radiat Oncol Biol Phys. 1990;18:1157–63.

    Article  PubMed  CAS  Google Scholar 

  18. Weiss MC, Whittington R, Schultz D, Jardines L, et al. Extrahepatic biliary carcinoma: primary treatment and patterns of failure. Int J Radiat Oncol Biol Phys. 1992;24:213.

    Google Scholar 

  19. Gonzalez DG, Gerard JP, Maners AW, De La Lande-Guyauz B, et al. Results of radiation therapy in carcinoma of the proximal bile duct (Klatskin tumor). Semin Liver Dis. 1990;10:131–41.

    Article  Google Scholar 

  20. Pitt HA, Nakeeb A, Abrams RA, et al. Perihilar cholangiocarcinoma: Postoperative radiotherapy does not improve survival. Ann Surg. 1995;221:788–98.

    Article  PubMed  CAS  Google Scholar 

  21. Hayes JK, Sapozink MD, Miller JF. Definitive radiation therapy in bile duct carcinoma. Int J Radiat Oncol Biol Phys. 1988;15:735–44.

    Article  PubMed  Google Scholar 

  22. Johnson DW, Safai C, Goffinet DR. Malignant obstructive jaundice: treatment with external beam and intracavitary radiotherapy. Int J Radiat Oncol Biol Phys. 1985;11:411–6.

    Article  PubMed  CAS  Google Scholar 

  23. Foo M, Gunderson LL, Bender C, Busbirk S. External radiation therapy and transcatheter iridium in the treatment of extrahepatic bile duct cancer. Int J Radiat Oncol Biol Phys. 1997;39:929–35.

    Article  PubMed  CAS  Google Scholar 

  24. Fritz P, Brambs HJ, Schraube P, et al. Combined external beam radiotherapy and intraluminal high dose brachytherapy on bile duct carcinomas. Int J Radiat Oncol Biol Phys. 1994;29:855–61.

    Article  PubMed  CAS  Google Scholar 

  25. Veeze-Kuypers B, Meerwaldt JH, Lameris JS, et al. The role of radiotherapy in the treatment of bile duct carcinoma. Int J Radiat Oncol Biol Phys. 1990;18:63–7.

    Article  Google Scholar 

  26. Urego M, Flickenger JC, Carr BJ. Radiotherapy and multimodality management of cholangiocarcinoma. Int J Radiat Oncol Biol Phys. 1999;44:121–6.

    Article  PubMed  CAS  Google Scholar 

  27. De Vreede I, Steers JL, Burch PA, et al. Prolonged disease-free survival after orthotopic liver transplantation plus adjuvant chemoirradiation for cholangiocarcinoma. Liver Transplant. 2000;6:309–16.

    Article  Google Scholar 

  28. Rea DJ, Heimbach JK, Rosen CB, et al. Liver transplantation with neoadjuvant chemoradiation is more effective than resection for hilar cholangiocarcinoma. Ann Surg. 2005;242:451–62.

    PubMed  Google Scholar 

  29. Li J, Kuehl H, Grabellus F, et al. Preoperative assessment of hilar cholangiocarcinoma by dual-modality PET/CT. J Surg Oncol. 2008;98:438–43.

    Article  PubMed  Google Scholar 

  30. Gunderson LL, Martenson JA, Smalley SR, Garton GR. Upper gastrointestinal cancers: rationale, results and techniques of treatment. In: Meyer J, Vaeth J, editors. Lymphatics and cancer: controversies in oncology management. Basel: Karger; 1994. Front Rad Ther Oncol;28:121–39.

    Google Scholar 

  31. Buskirk SJ, Gunderson LL, Adson MA, et al. Analysis of failure following curative irradiation of gallbladder and extrahepatic bile duct carcinoma. Int J Radiat Oncol Biol Phys. 1984;10:2013–23.

    Article  PubMed  CAS  Google Scholar 

  32. Gunderson LL, Nagorney DM, Garton GR, et al. Pancreas and bile duct cancer results of IORT. In: Abe M, Takahashi M, editors. Intraoperative radiation therapy. New York: Pergamon Press, Inc.; 1991. p. 212–4.

    Google Scholar 

  33. Monson JRT, Donohue JH, Gunderson LL, et al. Intraoperative radiotherapy for unresectable cholangiocarcinoma: the Mayo Clinic experience. Surg Oncol. 1992;1:283–90.

    Article  PubMed  CAS  Google Scholar 

  34. Todoroki T, Kawamoto T, Otsuka M, et al. IORT combined with resection for stage IV gallbladder carcinoma. In: Vaeth JM, editor. Intraoperative radiation therapy in the treatment of cancer. Basel: Karger; 1997. Radiat Ther Oncol;31:165–72.

    Google Scholar 

  35. Todoroki T, Takahashi H, Koike N, et al. Outcomes of aggressive treatment of stage IV gallbladder cancer and predictors of survival. Hepatogastroenterology. 1999;46:2114–21.

    PubMed  CAS  Google Scholar 

  36. Moon Y, Todoroki T, Ohno T, et al. Enhanced radiation killing by 5-fluorouracil of biliary tract cancer cell lines. Int J Oncol. 2000;16:987–94.

    PubMed  CAS  Google Scholar 

  37. Deziel DJ, Kiel KD, Kramer TS, Doolas A, Roseman DL. Intraoperative radiation therapy in biliary tract cancer. Am Surg. 1988;54:402–7.

    PubMed  CAS  Google Scholar 

  38. Busse PM, Stone MD, Sheldon TA, Chaffey JT. Intraoperative radiation therapy for biliary tract carcinoma: results of a five-year experience. Surgery. 1989;105:724–33.

    PubMed  CAS  Google Scholar 

  39. Todoroki T, Iwasaki Y, Okamura T, et al. Intraoperative radiotherapy for advanced carcinoma of the biliary system. Cancer. 1980;46:2179–84.

    Article  PubMed  CAS  Google Scholar 

  40. Iwasaki Y, Todoroki T, Fukao K, et al. The role of intraoperative radiation therapy in the treatment of bile duct cancer. World J Surg. 1988;12:91–8.

    Article  PubMed  CAS  Google Scholar 

  41. Todoroki T, Ohara K, Kawamoto T, et al. Benefits of adjuvant radiotherapy after radical resection of locally advanced main hepatic duct carcinoma. Int J Radiat Oncol Biol Phys. 2000;46:581–7.

    Article  PubMed  CAS  Google Scholar 

  42. Todoroki T, Kawamoto T, Koike N, et al. Radical resection of hilar bile duct carcinoma and predictors of survival. Br J Surg. 2000;87:306–13.

    Article  PubMed  CAS  Google Scholar 

  43. Todoroki T. Radiotherapy as a component of multidisciplinary treatment of bile duct cancer: a surgeon’s perspective. J Hepatobiliary Pancreat Surg. 2001;8:130–6.

    Article  PubMed  CAS  Google Scholar 

  44. Todoroki T. IORT is the effective component in combination with radical surgery and PORT for locally advanced hilar bile duct carcinoma. Madrid: ISIORT; 2008, personal communication.

    Google Scholar 

  45. Willborn K, Sauerwein W, Erhard J, et al. IORT of carcinoma of the extrahepatic bile ducts. In: Vaeth JM, editor. Intraoperative radiation therapy in the treatment of cancer. Basel: Karger; 1997. Front Radiat Ther Oncol;31:173–6.

    Google Scholar 

  46. Kaiser GM, Oldhafer KJ, Zhang HW, et al. Treatment of nonresectable proximal bile duct carcinoma using intraoperative radiotherapy combined with hepatojejunostomy. J Surg Oncol. 2002;81:55–7.

    Article  PubMed  Google Scholar 

  47. Kaiser GM, Frühauf NR, Lang H, et al. Impact of intraoperative radiotherapy (IORT) on survival of patients with unresectable hilar cholangiocarcinoma. Hepatogastroenterology. 2008;55:1951–5.

    PubMed  Google Scholar 

  48. Lang H, Kaiser GM, Zöpf T, et al. Surgical treatment of hilar cholangiocarcinoma. Chirurg. 2006;77:325–34.

    Article  PubMed  CAS  Google Scholar 

  49. Kaiser GM, Frühauf NR, Oldhafer KJ, et al. Intraoperative radiotherapy in Germany. Zentralbl Chir. 2003;128:506–10.

    Article  PubMed  CAS  Google Scholar 

  50. Todoroki T. The late effects of single massive irradiation with electrons of the liver hilum of rabbits. Jpn J Gastroenterol Surg. 1978;11:169.

    Google Scholar 

  51. Sindelar WF, Tepper J, Travis EL. Tolerance of bile duct to inoperative irradiation. Surgery. 1982;92:533–40.

    PubMed  CAS  Google Scholar 

  52. Kaiser GM, Mueller AB, Sauerwein W, et al. Biliodigestive anastomosis after intraoperative irradiation in swine. J Invest Surg. 2005;18:305–13.

    Article  PubMed  CAS  Google Scholar 

  53. Kinsella TJ, Sindelar WF. Normal tissue tolerance to intraoperative radiation therapy. Experimental and clinical studies. Front Radiat Ther Oncol. 1989;23:202–14.

    PubMed  CAS  Google Scholar 

  54. Lygidakis NJ, Singh G, Bardaxoglou E, et al. Changing trends in the management of Klatskin tumor. Hepatogastroenterology. 2004;51:689–96.

    PubMed  CAS  Google Scholar 

  55. Kurosaki H, Katsuyuki K, Kaiza T, et al. Intraoperative radiotherapy for resectable extrahepatic bile duct cancer. Int J Radiat Oncol Biol Phys. 1999;45:635–8.

    Article  PubMed  CAS  Google Scholar 

  56. Willett CG, Del Castillo CF, Shih HA, et al. Long-term results of intraoperative electron beam irradiation (IOERT) for patients with unresectable pancreatic cancer. Ann Surg. 2005;241:295–9.

    Article  PubMed  Google Scholar 

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Author information

Authors and Affiliations

  1. Department of Surgery, Kitai-baraki Municipal General Hospital, Kitai-baraki, 319-1704, Japan

    Takeshi Todoroki

  2. Department of General, Visceral and Transplantation Surgery, University Hospital Essen, Hufelandstrasse 55, Essen, DE-45122, Germany

    Gernot M. Kaiser

  3. Department of Radiation Oncology, University Hospital Essen, Hufelandstrasse 55, Essen, DE-45122, Germany

    Wolfgang Sauerwein

  4. Department of Radiation Oncology, Mayo Clinic College of Medicine and Mayo Clinic Arizona, Scottsdale, AZ, USA

    Leonard L. Gunderson

Authors
  1. Takeshi Todoroki
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  2. Gernot M. Kaiser
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  3. Wolfgang Sauerwein
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  4. Leonard L. Gunderson
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Corresponding author

Correspondence to Takeshi Todoroki .

Editor information

Editors and Affiliations

  1. Department of Radiation Oncology, Mayo Clinic, East Shea Blvd 13400, Scottsdale, 85259, Arizona, USA

    Leonard L. Gunderson

  2. Dept. Radiation Oncology, Duke University Medical Center, Durham, North Carolina, USA

    Christopher G. Willett

  3. Gregorio Marañón, Depto. Radiación de Oncología, Hospital General Universitario, C/ Dr. Esquerdo 46, Madrid, 28007, Spain

    Felipe A. Calvo

  4. Albert Einstein College of Medicine, Radiation Oncology, Beth Israel Medical Center, Union Square East 10, New York, 10003, New York, USA

    Louis B. Harrison

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Todoroki, T., Kaiser, G.M., Sauerwein, W., Gunderson, L.L. (2011). Bile Duct and Gallbladder Cancer. In: Gunderson, L., Willett, C., Calvo, F., Harrison, L. (eds) Intraoperative Irradiation. Current Clinical Oncology. Humana Press. https://doi.org/10.1007/978-1-61779-015-7_14

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  • DOI: https://doi.org/10.1007/978-1-61779-015-7_14

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  • Print ISBN: 978-1-61779-014-0

  • Online ISBN: 978-1-61779-015-7

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