Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Radiation, chemotherapy with liver transplant improves cancer survival

12.09.2005


Mayo Clinic study details treatment for bile duct cancer patients



A new treatment for patients with a type of bile duct cancer promises a greater chance at survival by combining radiation, chemotherapy and liver transplantation, Mayo Clinic physicians report in the September issue of the Annals of Surgery.

The five-year survival rate for patients who received a liver transplant after radiation and chemotherapy was 82 percent, significantly higher than for those who had a conventional operation. "With the combined benefits of radiation, chemotherapy and liver transplantation, our patients with bile duct cancer now have a much better chance to live longer and enjoy a good quality of life," says Charles Rosen, M.D., a Mayo Clinic transplant surgeon and co-author of the study.


Conventional therapy for hilar cholangiocarcinoma, a type of bile duct cancer, is to remove (resect) the tumor, which may require removing part of the liver. Survival for patients with this type of operation is only 25 to 35 percent, and many patients cannot be treated this way because the tumors can involve both sides of the liver. Combination therapy with liver transplantation is possible for more patients. Transplantation enables surgeons to remove the entire liver and obtain better tumor clearance. Patients treated with transplantation have enjoyed a higher likelihood of prolonged survival than those treated with the conventional operation.

To improve results of liver transplantation for unresectable hilar cholangiocarcinoma, Mayo Clinic physicians developed a treatment protocol combining radiation therapy, chemotherapy and liver transplantation. Patients receive high dose external beam radiation therapy, followed by high dose irradiation with iridium administered through a catheter passing through the bile duct and tumor. Chemotherapy starts during radiation treatment and continues until transplantation. Prior to transplantation, patients undergo a staging abdominal operation so surgeons can look for any spread of the tumor to lymph nodes or the abdomen that would prevent complete tumor removal.

Mayo Clinic’s liver transplant team has treated over 90 patients with hilar cholangiocarcinoma. Approximately one-third of the patients have findings at the staging operation that preclude subsequent transplantation, but this number may be decreasing with earlier diagnosis and referral for treatment. Sixty patients have undergone liver transplantation -- many recently with living donors -- and results remain superb, says Dr. Rosen.

Cholangiocarcinoma is a relatively uncommon malignant tumor that is often found in the lining of the bile duct. In the United States, the most common risk factor is sclerosing cholangitis, a chronic liver disease characterized by inflammation, destruction and fibrosis of the bile ducts, often leading to cirrhosis of the liver. The cancer also is seen in patients with congenital bile duct cysts and bile duct stones. Most frequently, these tumors are located near the liver. Cholangiocarcinomas in this location are difficult to treat because the tumor often extends deep into the liver in a way that it cannot be completely removed with a conventional operation.

The incidence of bile duct cancer is increasing in the United States, according to Gregory Gores, M.D., Mayo Clinic liver transplant specialist and co-author of the study. Mayo Clinic has ongoing research into new tests to diagnose the tumor earlier, which could lead to even better results.

"The major problem is that we still don’t have enough livers for everyone who needs one," says Dr. Rosen. "We feel that patients with cholangiocarcinoma should have equal access to donor organs, because the results are comparable to those achieved for other patients who undergo transplantation. Without a transplant, the outlook for these patients is fairly poor."

Other Mayo Clinic physician researchers involved with this study include: David Rea, M.D., Julie Heimbach, M.D., Michael Haddock, M.D., Steven Alberts, M.D., Walter Kremers, Ph.D., and David Nagorney, M.D.

John Murphy | EurekAlert!
Further information:
http://www.mayo.edu

More articles from Health and Medicine:

nachricht Hot cars can hit deadly temperatures in as little as one hour
24.05.2018 | Arizona State University

nachricht 3D images of cancer cells in the body: Medical physicists from Halle present new method
16.05.2018 | Martin-Luther-Universität Halle-Wittenberg

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Powerful IT security for the car of the future – research alliance develops new approaches

The more electronics steer, accelerate and brake cars, the more important it is to protect them against cyber-attacks. That is why 15 partners from industry and academia will work together over the next three years on new approaches to IT security in self-driving cars. The joint project goes by the name Security For Connected, Autonomous Cars (SecForCARs) and has funding of €7.2 million from the German Federal Ministry of Education and Research. Infineon is leading the project.

Vehicles already offer diverse communication interfaces and more and more automated functions, such as distance and lane-keeping assist systems. At the same...

Im Focus: Molecular switch will facilitate the development of pioneering electro-optical devices

A research team led by physicists at the Technical University of Munich (TUM) has developed molecular nanoswitches that can be toggled between two structurally different states using an applied voltage. They can serve as the basis for a pioneering class of devices that could replace silicon-based components with organic molecules.

The development of new electronic technologies drives the incessant reduction of functional component sizes. In the context of an international collaborative...

Im Focus: LZH showcases laser material processing of tomorrow at the LASYS 2018

At the LASYS 2018, from June 5th to 7th, the Laser Zentrum Hannover e.V. (LZH) will be showcasing processes for the laser material processing of tomorrow in hall 4 at stand 4E75. With blown bomb shells the LZH will present first results of a research project on civil security.

At this year's LASYS, the LZH will exhibit light-based processes such as cutting, welding, ablation and structuring as well as additive manufacturing for...

Im Focus: Self-illuminating pixels for a new display generation

There are videos on the internet that can make one marvel at technology. For example, a smartphone is casually bent around the arm or a thin-film display is rolled in all directions and with almost every diameter. From the user's point of view, this looks fantastic. From a professional point of view, however, the question arises: Is that already possible?

At Display Week 2018, scientists from the Fraunhofer Institute for Applied Polymer Research IAP will be demonstrating today’s technological possibilities and...

Im Focus: Explanation for puzzling quantum oscillations has been found

So-called quantum many-body scars allow quantum systems to stay out of equilibrium much longer, explaining experiment | Study published in Nature Physics

Recently, researchers from Harvard and MIT succeeded in trapping a record 53 atoms and individually controlling their quantum state, realizing what is called a...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

VideoLinks
Industry & Economy
Event News

In focus: Climate adapted plants

25.05.2018 | Event News

Save the date: Forum European Neuroscience – 07-11 July 2018 in Berlin, Germany

02.05.2018 | Event News

Invitation to the upcoming "Current Topics in Bioinformatics: Big Data in Genomics and Medicine"

13.04.2018 | Event News

 
Latest News

In focus: Climate adapted plants

25.05.2018 | Event News

Flow probes from the 3D printer

25.05.2018 | Machine Engineering

Less is more? Gene switch for healthy aging found

25.05.2018 | Life Sciences

VideoLinks
Science & Research
Overview of more VideoLinks >>>