Skip to main content

Future Directions

  • Chapter
  • First Online:
Biliary Tract and Gallbladder Cancer

Part of the book series: Medical Radiology ((Med Radiol Radiat Oncol))

  • 1761 Accesses

Abstract

Improving the late detection and poor prognosis associated with gallbladder and biliary tract cancers remains a monumental task for physicians today. Recent developments in genome sequencing, pathology, functional imaging, and therapeutic approaches have resulted in enhanced diagnosis, staging, and management techniques of these cancers. However, to maximize the efficacy of these advancements, several considerations must be taken into account. Universal terminology should be defined because standard management guidelines cannot be established without uniform diagnosis and staging criteria. Multidisciplinary efforts among surgical oncology, medical oncology, radiation oncology, interventional radiology, pathology, and palliative care are fundamental to effective patient care as the collaboration of resources allows for more accurate treatment recommendations and favorable patient outcomes. Additional prospective clinical trials with large patient populations are needed to validate these findings and optimize full clinical potential in order to establish a standard of care for these patients.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 89.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Similar content being viewed by others

References

  1. Cleary S, Dawson L, Knox J, Gallinger S (2007) Cancer of the gallbladder and extrahepatic bile ducts. Curr Probl Surg 44(7):396–482

    Article  PubMed  Google Scholar 

  2. Ciombor K, Goff L (2013) Current therapy and future directions in biliary tract malignancies. Curr Treat Options Oncol 14(3):1–13

    Article  Google Scholar 

  3. Michaud D (2002) The epidemiology of pancreatic, gallbladder, and other biliary tract cancers. Gastrointest Endosc 56(6 Suppl):S195–S200

    Article  PubMed  Google Scholar 

  4. Voss J, Holtegaard L, Kerr S, Barr Fritcher E, Roberts L, Gores G et al (2013) Molecular profiling of cholangiocarcinoma shows potential for targeted therapy treatment decisions. Hum Pathol 44(7):1216–1222

    Article  PubMed  CAS  Google Scholar 

  5. Borger D, Iafrate A, Zhu A (2013) A new signature for bile duct cancer. Adv Mass Gen Cancer Cent 3(1):10–11

    Google Scholar 

  6. Xu Q, Zhang Y, Wang X (2013) HEPA and PARSE: systematic discovery of clinically relevant tumor-specific antigens. Oncoimmunology 2(3):0–1

    Article  Google Scholar 

  7. Geynisman D, Catenacci D (2012) Toward personalized treatment of advanced biliary tract cancers. Disc Med 14(74):41–57

    Google Scholar 

  8. Furuse J, Okusaka T (2011) Targeted therapy for biliary tract cancer. Cancers 3(2):2243–2254

    Article  PubMed Central  PubMed  Google Scholar 

  9. Tan Z, Zhang S, Li M, Wu X, Weng H, Ding Q et al (2013) Regulation of cell proliferation and migration in gallbladder cancer by zinc finger X-chromosomal protein. Gene 528(2):261–266

    Article  PubMed  CAS  Google Scholar 

  10. Chin L, Andersen J, Futreal P (2011) Cancer genomics: from discovery science to personalized medicine. Nat Med 17(3):297–303

    Article  PubMed  CAS  Google Scholar 

  11. Agarwal AK, Kalayarasan R, Javed A, Sakhuja P (2013) Role of routine 16b1 lymph node biopsy in the management of gallbladder cancer: an analysis. HPB (Oxford). doi:10.1111/hpb.12127. (in press)

  12. Oishi N, Kumar M, Roessler S, Ji J, Forgues M, Budhu A et al (2012) Transcriptomic profiling reveals hepatic stem-like gene signatures and interplay of miR-200c and epithelial-mesenchymal transition in intrahepatic cholangiocarcinoma. Hepatology 56(5):1792–1803

    Article  PubMed Central  PubMed  CAS  Google Scholar 

  13. Papaconstantinou I, Karakatsanis A, Gazouli M, Polymeneas G, Voros D (2012) The role of microRNAs in liver cancer. Eur J Gastroenterol Hepatol 24(3):223–229

    Article  PubMed  CAS  Google Scholar 

  14. Li M, Zhang S, Wang Z, Zhang B, Wu X, Weng H et al (2013) Prognostic significance of nemo-like kinase (NLK) expression in patients with gallbladder cancer. Tumor Biol 34(6):3995–4000

    Article  CAS  Google Scholar 

  15. Mulvenna J, Yonglitthipagon P, Sripa B, Brindley P, Loukas A, Bethony J (2012) Banking on the future: biobanking for “omics” approaches to biomarker discovery for opisthorchis-induced cholangiocarcinoma in Thailand. Parasitol Int 61(1):173–177

    Article  PubMed Central  PubMed  Google Scholar 

  16. Mou Y, Xing R, Liu C (2012) Diagnosis of gallbladder cancer using matrix-assisted laser desorption/ionization time-of-flight profiling. Am J Med Sci 343(2):119–123

    Article  PubMed  Google Scholar 

  17. Matsuda A, Kuno A, Matsuzaki H, Kawamoto T, Shikanai T, Nakanuma Y et al (2013) Glycoproteomics-based cancer marker discovery adopting dual enrichment with Wisteria floribunda agglutinin for high specific glyco-diagnosis of cholangiocarcinoma. J Proteomics 85:1–11

    Article  PubMed  CAS  Google Scholar 

  18. Wu L, Jiang X, Gu H, Xu X, Zhang W, Lin L et al (2011) Endoscopic ultrasound-guided fine-needle aspiration biopsy in the evaluation of bile duct strictures and gallbladder masses: a systematic review and meta-analysis. Eur J Gastroenterol Hepatol 23(2):113–120

    Article  PubMed  Google Scholar 

  19. Anderson M, Appalaneni V, Ben-Menachem T, Decker G, Early D, Evans J et al (2013) The role of endoscopy in the evaluation and treatment of patients with biliary neoplasia. Gastrointest Endosc 77(2):167–174

    Article  PubMed  Google Scholar 

  20. Liu L, Xu H, Lu M, Xie X, Wang W, Hu B et al (2012) Contrast-enhanced ultrasound in the diagnosis of gallbladder diseases: a multi-center experience. PloS One 7(10):1–13

    Google Scholar 

  21. Faingold R, Albuquerque P, Carpineta L (2011) Hepatobiliary tumors. Radiol Clin North Am 49:679–687

    Article  PubMed  Google Scholar 

  22. Barretta M, Catalano O, Setola S, Granata V, Marone U, Gallipoli A (2011) Gallbladder metastasis: spectrum of imaging findings. Abdom Imaging 36(6):729–734

    Article  PubMed  Google Scholar 

  23. Konstantinidis I, Bajpai S, Kambadakone A, Tanabe K, Berger D, Zheng H et al (2012) Gallbladder lesions identified on ultrasound. Lessons from the last 10 years. J Gastrointest Surg 16(3):549–553

    Article  PubMed  Google Scholar 

  24. Dutta U (2012) Gallbladder cancer: can newer insights improve the outcome? J Gastroenterol Hepatol 27(4):642–653

    Article  PubMed  Google Scholar 

  25. Takuma K, Kamisawa T, Tabata T, Hara S, Kuruma S, Inaba Y et al (2012) Importance of early diagnosis of pancreaticobiliary maljunction without biliary dilatation. World J Gastroenterol 18(26):3409–3414

    Article  PubMed Central  PubMed  Google Scholar 

  26. Inui K, Yoshino J, Miyoshi H (2011) Diagnosis of gallbladder tumors. Intern Med 50(11):1133–1136

    Article  PubMed  Google Scholar 

  27. Stelter L, Grieser C, Perez Fernandes C, Rothe J, Streitparth F, Seehofer D et al (2012) Flip angle modulations in late phase of gd-EOB-DTPA MRI improve the identification of the biliary system. Eur J Radiol 81(11):e991–e995

    Article  PubMed  Google Scholar 

  28. Kim J, Lee J, Kang K, Lee H, Han S, Kim T et al (2012) Whole-body distribution and radiation dosimetry of 68 Ga-NOTA-RGD, a positron emission tomography agent for angiogenesis imaging. Cancer Biother Radiopharm 27(1):65–71

    Article  PubMed  CAS  Google Scholar 

  29. Leibfarth S, Monnich D, Welz S, Siegel C, Schwenzer N, Schmidt H et al (2013) A strategy for multimodal deformable image registration to integrate PET/MR into radiotherapy treatment planning. Acta Oncol 52(7):1353–1359

    Article  PubMed  Google Scholar 

  30. Jadvar H, Colletti P (2013) Competitive advantage of PET/MRI. Eur J Radiol 83(1):84–94

    Google Scholar 

  31. Eltawil K, Berry R, Abdolell M, Molinari M (2012) Quality of life and survival analysis of patients undergoing transarterial chemoembolization for primary hepatic malignancies: a prospective cohort study. HPB 14(5):341–350 (Oxford)

    Article  PubMed Central  PubMed  Google Scholar 

  32. Kuhlmann J, Euringer W, Spangenberg H, Breidert M, Blum H, Harder J et al (2012) Treatment of unresectable cholangiocarcinoma: conventional transarterial chemoembolization compared with drug eluting bead-transarterial chemoembolization and systemic chemotherapy. Eur J Gastroenterol Hepatol 24(4):437–443

    PubMed  CAS  Google Scholar 

  33. Hoffman R, Paprottka P, Schon A, Bamberg F, Haug A, Durr E et al (2012) Transarterial hepatic yttrium-90 radioembolization in patients with unresectable intrahepatic cholangiocarcinoma: factors associated with prolonged survival. Cardiovasc Intervent Radiol 35(1):105–116

    Article  Google Scholar 

  34. Lee W, Chan C, Wang B (2013) Recent advances in laparoscopic surgery. Asian J Endosc Surg 6(1):1–8

    Article  PubMed  Google Scholar 

  35. Zhuang P, Tang Z, Liu Y, Quan Z, Zhang Y (2012) Diagnostic and prognostic role of laparoscopic staging for gallbladder carcinoma. Dig Surg 29(5):367–373

    Article  PubMed  Google Scholar 

  36. Buchs N, Addeo P, Bianco F, Elli E, Ayloo S, Giulianotti P (2011) Robotic palliation for unresectable pancreatic cancer and distal cholangiocarcinoma. Int J Med Robot 7(1):60–65

    Article  PubMed  Google Scholar 

  37. Pilgrim C, Groeschl R, Quebbeman E, Gamblin T (2013) Recent advances in systemic therapies and radiotherapy for gallbladder cancer. Surg Oncol 22(1):61–67

    Article  Google Scholar 

  38. Iwase R, Haruki K, Fujiwara Y, Furukawa K, Shiba H, Uwagawa T et al (2013) Combination chemotherapy of nafamostat mesylate with gemcitabine for gallbladder cancer targeting nuclearfactor-kB activation. J Surg Res 184(1):605–612

    Google Scholar 

  39. Lim J, Ryu J, Choi Y, Kwon J, Kim J, Lee Y et al (2013) A case of common bile duct cancer that completely responded to combination chemotherapy of gemcitabine and TS-1. Gut Liver 7(3):371–376

    Article  PubMed Central  PubMed  Google Scholar 

  40. Kobayashi M, Sakabe T, Abe H, Tanii M, Takahashi H, Chiba A et al (2013) Dendritic cell-based immunotherapy targeting synthesized peptides for advanced biliary tract cancer. J Gastrointest Surg 17(9):1609–1617

    Article  PubMed  Google Scholar 

  41. Takahashi R, Yoshitomi M, Yutani S et al (2013) Current status of immunotherapy for the treatment of biliary tract cancer. Hum Vacc Immunother 9(5):1069–1072

    Google Scholar 

  42. Chung K, Jeong Y, Chung C, Kim D, Kang D (2012) Anti-tumor activity of all-trans retinoic acid-incorporated glycol chitosan nanoparticles against HuCC-T1 human cholangiocarcinoma cells. Int J Pharm 422(1–2):454–461

    Article  PubMed  CAS  Google Scholar 

  43. Eriguchi T, Takeda A, Sanuki N et al (2013) Acceptable toxicity after stereotactic body radiation therapy for liver tumors adjacent to the central biliary system. Int J Radiat Oncol Biol Phys 85(4):1006–1011

    Google Scholar 

  44. Proton Beam Irradiation for the Treatment of Unresectable Hepatocellular Cancer and Cholangiocarcinoma (2013). Available from: ClinicalTrials.gov [Internet]

    Google Scholar 

  45. Valero V, Cosgrove D, Herman J, Pawlik T (2012) Management of perihilar cholangiocarcinoma in the era of multimodal therapy. Expert Rev Gastroenterol Hepatol 6(4):481–495

    Article  PubMed Central  PubMed  CAS  Google Scholar 

  46. Plengsuriyakarn T, Viyanant V, Eursitthichai V, Tesana S, Chaijaroenkul W, Itharat A et al (2012) Cytotoxicity, toxicity, and anticancer activity of Zingiber officinale Roscoe against cholangiocarcinoma. Asian Pacific J Cancer Prev 13(9):4597–4606

    Article  Google Scholar 

  47. Plengsuriyakarn T, Viyanant V, Eursitthichai V et al (2012) Anticancer activities against cholangiocarcinoma, toxicity and pharmacological activities of thai medicinal plants in animal models. BMC Complement Alt Med 12(23). doi: 10.1186/1472-6882-12-23

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Joseph M. Herman .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2014 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Herman, J.M., Rosati, L.M., Pawlik, T.M., Thomas, C.R. (2014). Future Directions. In: Herman, J., Pawlik, T., Thomas, Jr., C. (eds) Biliary Tract and Gallbladder Cancer. Medical Radiology(). Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-40558-7_23

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-40558-7_23

  • Published:

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-642-40557-0

  • Online ISBN: 978-3-642-40558-7

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics