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Stage III Extrahepatic Bile Duct Cancer

MedGen UID:
218911
•Concept ID:
C1168220
•
Neoplastic Process

Definition

Stage III includes: T4, Any N, M0. T4: Tumor invades any of the following main portal vein or its branches bilaterally, common hepatic artery, or other adjacent structures, such as the colon, stomach, duodenum, or abdominal wall. N0: No regional lymph node metastasis. N1: Regional lymph node metastasis. M0: Distant metastasis. (AJCC 6th ed.) [from NCI]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVStage III Extrahepatic Bile Duct Cancer

Professional guidelines

PubMed

Surgical treatment and prognostic factors in perihilar tumors.
Polyakov AN, Patyutko YI, Kotelnikov AG, Frantsev DY, Korshak AV, Uzbekova AA, Egenov OA, Pokataev IA, Savchenko IV, Podluzhny DV
Khirurgiia (Mosk) 2024;(2):14-23. doi: 10.17116/hirurgia202402114. PMID: 38344956
Management and outcomes following pancreaticoduodenectomy for ampullary adenocarcinoma.
Chavez MT, Sharpe JP, O'Brien T, Patton KT, Portnoy DC, VanderWalde NA, Deneve JL, Shibata D, Behrman SW, Dickson PV
Am J Surg 2017 Nov;214(5):856-861. Epub 2017 Jan 30 doi: 10.1016/j.amjsurg.2017.01.029. PMID: 28285709
Management of hepatic vascular diseases.
Plessier A, Rautou PE, Valla DC
J Hepatol 2012;56 Suppl 1:S25-38. doi: 10.1016/S0168-8278(12)60004-X. PMID: 22300463

Recent clinical studies

Etiology

Pembrolizumab in combination with gemcitabine and cisplatin compared with gemcitabine and cisplatin alone for patients with advanced biliary tract cancer (KEYNOTE-966): a randomised, double-blind, placebo-controlled, phase 3 trial.
Kelley RK, Ueno M, Yoo C, Finn RS, Furuse J, Ren Z, Yau T, Klümpen HJ, Chan SL, Ozaka M, Verslype C, Bouattour M, Park JO, Barajas O, Pelzer U, Valle JW, Yu L, Malhotra U, Siegel AB, Edeline J, Vogel A; KEYNOTE-966 Investigators
Lancet 2023 Jun 3;401(10391):1853-1865. Epub 2023 Apr 16 doi: 10.1016/S0140-6736(23)00727-4. PMID: 37075781
Stereotactic body radiotherapy (SBRT) for locally advanced intrahepatic and extrahepatic cholangiocarcinoma.
Gkika E, Hallauer L, Kirste S, Adebahr S, Bartl N, Neeff HP, Fritsch R, Brass V, Nestle U, Grosu AL, Brunner TB
BMC Cancer 2017 Nov 21;17(1):781. doi: 10.1186/s12885-017-3788-1. PMID: 29162055Free PMC Article
Multi-Institutional Phase II Study of High-Dose Hypofractionated Proton Beam Therapy in Patients With Localized, Unresectable Hepatocellular Carcinoma and Intrahepatic Cholangiocarcinoma.
Hong TS, Wo JY, Yeap BY, Ben-Josef E, McDonnell EI, Blaszkowsky LS, Kwak EL, Allen JN, Clark JW, Goyal L, Murphy JE, Javle MM, Wolfgang JA, Drapek LC, Arellano RS, Mamon HJ, Mullen JT, Yoon SS, Tanabe KK, Ferrone CR, Ryan DP, DeLaney TF, Crane CH, Zhu AX
J Clin Oncol 2016 Feb 10;34(5):460-8. Epub 2015 Dec 14 doi: 10.1200/JCO.2015.64.2710. PMID: 26668346Free PMC Article
Prognostic score for recurrence after Whipple's pancreaticoduodenectomy for ampullary carcinomas; results of an AGEO retrospective multicenter cohort.
Colussi O, Voron T, Pozet A, Hammel P, Sauvanet A, Bachet JB, Vaillant JC, Rougier P, Nordlinger B, Berger A, Coriat R, Dousset B, Malka D, André T, Paye F, Aparicio T, Locher C, Cojean Zeleck D, Tchinou L, Bonnetain F, Taieb J
Eur J Surg Oncol 2015 Apr;41(4):520-6. Epub 2015 Jan 24 doi: 10.1016/j.ejso.2015.01.010. PMID: 25680954
Management of carcinoma of the gallbladder: a single-institution experience in 16 years.
Chan SY, Poon RT, Lo CM, Ng KK, Fan ST
J Surg Oncol 2008 Feb 1;97(2):156-64. doi: 10.1002/jso.20885. PMID: 18050290

Diagnosis

Stereotactic body radiotherapy (SBRT) for locally advanced intrahepatic and extrahepatic cholangiocarcinoma.
Gkika E, Hallauer L, Kirste S, Adebahr S, Bartl N, Neeff HP, Fritsch R, Brass V, Nestle U, Grosu AL, Brunner TB
BMC Cancer 2017 Nov 21;17(1):781. doi: 10.1186/s12885-017-3788-1. PMID: 29162055Free PMC Article
SWOG S0809: A Phase II Intergroup Trial of Adjuvant Capecitabine and Gemcitabine Followed by Radiotherapy and Concurrent Capecitabine in Extrahepatic Cholangiocarcinoma and Gallbladder Carcinoma.
Ben-Josef E, Guthrie KA, El-Khoueiry AB, Corless CL, Zalupski MM, Lowy AM, Thomas CR Jr, Alberts SR, Dawson LA, Micetich KC, Thomas MB, Siegel AB, Blanke CD
J Clin Oncol 2015 Aug 20;33(24):2617-22. Epub 2015 May 11 doi: 10.1200/JCO.2014.60.2219. PMID: 25964250Free PMC Article
Management of hepatic vascular diseases.
Plessier A, Rautou PE, Valla DC
J Hepatol 2012;56 Suppl 1:S25-38. doi: 10.1016/S0168-8278(12)60004-X. PMID: 22300463
Management of carcinoma of the gallbladder: a single-institution experience in 16 years.
Chan SY, Poon RT, Lo CM, Ng KK, Fan ST
J Surg Oncol 2008 Feb 1;97(2):156-64. doi: 10.1002/jso.20885. PMID: 18050290
Carcinoid of the ampulla of Vater.
Hartel M, Wente MN, Sido B, Friess H, Büchler MW
J Gastroenterol Hepatol 2005 May;20(5):676-81. doi: 10.1111/j.1440-1746.2005.03744.x. PMID: 15853978

Therapy

Pembrolizumab in combination with gemcitabine and cisplatin compared with gemcitabine and cisplatin alone for patients with advanced biliary tract cancer (KEYNOTE-966): a randomised, double-blind, placebo-controlled, phase 3 trial.
Kelley RK, Ueno M, Yoo C, Finn RS, Furuse J, Ren Z, Yau T, Klümpen HJ, Chan SL, Ozaka M, Verslype C, Bouattour M, Park JO, Barajas O, Pelzer U, Valle JW, Yu L, Malhotra U, Siegel AB, Edeline J, Vogel A; KEYNOTE-966 Investigators
Lancet 2023 Jun 3;401(10391):1853-1865. Epub 2023 Apr 16 doi: 10.1016/S0140-6736(23)00727-4. PMID: 37075781
Stereotactic body radiotherapy (SBRT) for locally advanced intrahepatic and extrahepatic cholangiocarcinoma.
Gkika E, Hallauer L, Kirste S, Adebahr S, Bartl N, Neeff HP, Fritsch R, Brass V, Nestle U, Grosu AL, Brunner TB
BMC Cancer 2017 Nov 21;17(1):781. doi: 10.1186/s12885-017-3788-1. PMID: 29162055Free PMC Article
Multi-Institutional Phase II Study of High-Dose Hypofractionated Proton Beam Therapy in Patients With Localized, Unresectable Hepatocellular Carcinoma and Intrahepatic Cholangiocarcinoma.
Hong TS, Wo JY, Yeap BY, Ben-Josef E, McDonnell EI, Blaszkowsky LS, Kwak EL, Allen JN, Clark JW, Goyal L, Murphy JE, Javle MM, Wolfgang JA, Drapek LC, Arellano RS, Mamon HJ, Mullen JT, Yoon SS, Tanabe KK, Ferrone CR, Ryan DP, DeLaney TF, Crane CH, Zhu AX
J Clin Oncol 2016 Feb 10;34(5):460-8. Epub 2015 Dec 14 doi: 10.1200/JCO.2015.64.2710. PMID: 26668346Free PMC Article
SWOG S0809: A Phase II Intergroup Trial of Adjuvant Capecitabine and Gemcitabine Followed by Radiotherapy and Concurrent Capecitabine in Extrahepatic Cholangiocarcinoma and Gallbladder Carcinoma.
Ben-Josef E, Guthrie KA, El-Khoueiry AB, Corless CL, Zalupski MM, Lowy AM, Thomas CR Jr, Alberts SR, Dawson LA, Micetich KC, Thomas MB, Siegel AB, Blanke CD
J Clin Oncol 2015 Aug 20;33(24):2617-22. Epub 2015 May 11 doi: 10.1200/JCO.2014.60.2219. PMID: 25964250Free PMC Article
Prognostic score for recurrence after Whipple's pancreaticoduodenectomy for ampullary carcinomas; results of an AGEO retrospective multicenter cohort.
Colussi O, Voron T, Pozet A, Hammel P, Sauvanet A, Bachet JB, Vaillant JC, Rougier P, Nordlinger B, Berger A, Coriat R, Dousset B, Malka D, André T, Paye F, Aparicio T, Locher C, Cojean Zeleck D, Tchinou L, Bonnetain F, Taieb J
Eur J Surg Oncol 2015 Apr;41(4):520-6. Epub 2015 Jan 24 doi: 10.1016/j.ejso.2015.01.010. PMID: 25680954

Prognosis

Pembrolizumab in combination with gemcitabine and cisplatin compared with gemcitabine and cisplatin alone for patients with advanced biliary tract cancer (KEYNOTE-966): a randomised, double-blind, placebo-controlled, phase 3 trial.
Kelley RK, Ueno M, Yoo C, Finn RS, Furuse J, Ren Z, Yau T, Klümpen HJ, Chan SL, Ozaka M, Verslype C, Bouattour M, Park JO, Barajas O, Pelzer U, Valle JW, Yu L, Malhotra U, Siegel AB, Edeline J, Vogel A; KEYNOTE-966 Investigators
Lancet 2023 Jun 3;401(10391):1853-1865. Epub 2023 Apr 16 doi: 10.1016/S0140-6736(23)00727-4. PMID: 37075781
Multi-Institutional Phase II Study of High-Dose Hypofractionated Proton Beam Therapy in Patients With Localized, Unresectable Hepatocellular Carcinoma and Intrahepatic Cholangiocarcinoma.
Hong TS, Wo JY, Yeap BY, Ben-Josef E, McDonnell EI, Blaszkowsky LS, Kwak EL, Allen JN, Clark JW, Goyal L, Murphy JE, Javle MM, Wolfgang JA, Drapek LC, Arellano RS, Mamon HJ, Mullen JT, Yoon SS, Tanabe KK, Ferrone CR, Ryan DP, DeLaney TF, Crane CH, Zhu AX
J Clin Oncol 2016 Feb 10;34(5):460-8. Epub 2015 Dec 14 doi: 10.1200/JCO.2015.64.2710. PMID: 26668346Free PMC Article
SWOG S0809: A Phase II Intergroup Trial of Adjuvant Capecitabine and Gemcitabine Followed by Radiotherapy and Concurrent Capecitabine in Extrahepatic Cholangiocarcinoma and Gallbladder Carcinoma.
Ben-Josef E, Guthrie KA, El-Khoueiry AB, Corless CL, Zalupski MM, Lowy AM, Thomas CR Jr, Alberts SR, Dawson LA, Micetich KC, Thomas MB, Siegel AB, Blanke CD
J Clin Oncol 2015 Aug 20;33(24):2617-22. Epub 2015 May 11 doi: 10.1200/JCO.2014.60.2219. PMID: 25964250Free PMC Article
Management of carcinoma of the gallbladder: a single-institution experience in 16 years.
Chan SY, Poon RT, Lo CM, Ng KK, Fan ST
J Surg Oncol 2008 Feb 1;97(2):156-64. doi: 10.1002/jso.20885. PMID: 18050290
Carcinoid of the ampulla of Vater.
Hartel M, Wente MN, Sido B, Friess H, Büchler MW
J Gastroenterol Hepatol 2005 May;20(5):676-81. doi: 10.1111/j.1440-1746.2005.03744.x. PMID: 15853978

Clinical prediction guides

Trends in Receipt of Adjuvant Chemotherapy and its Impact on Survival in Resected Biliary Tract Cancers.
Rhodin KE, Liu A, Bartholomew A, Kramer R, Parameswaran A, Uronis H, Strickler J, Hsu D, Morse MA, Shah KN, Herbert G, Zani S, Nussbaum DP, Allen PJ, Lidsky ME
Ann Surg Oncol 2023 Aug;30(8):4813-4821. Epub 2023 May 15 doi: 10.1245/s10434-023-13567-4. PMID: 37188803Free PMC Article
Cell-free DNA as a prognostic and predictive biomarker in resectable distal common bile duct cancer.
Shyr BS, Chen SC, Shyr YM, Wang SE, Shyr BU
J Chin Med Assoc 2023 Sep 1;86(9):835-841. Epub 2023 Mar 31 doi: 10.1097/JCMA.0000000000000923. PMID: 36998178
Multi-Institutional Phase II Study of High-Dose Hypofractionated Proton Beam Therapy in Patients With Localized, Unresectable Hepatocellular Carcinoma and Intrahepatic Cholangiocarcinoma.
Hong TS, Wo JY, Yeap BY, Ben-Josef E, McDonnell EI, Blaszkowsky LS, Kwak EL, Allen JN, Clark JW, Goyal L, Murphy JE, Javle MM, Wolfgang JA, Drapek LC, Arellano RS, Mamon HJ, Mullen JT, Yoon SS, Tanabe KK, Ferrone CR, Ryan DP, DeLaney TF, Crane CH, Zhu AX
J Clin Oncol 2016 Feb 10;34(5):460-8. Epub 2015 Dec 14 doi: 10.1200/JCO.2015.64.2710. PMID: 26668346Free PMC Article
SWOG S0809: A Phase II Intergroup Trial of Adjuvant Capecitabine and Gemcitabine Followed by Radiotherapy and Concurrent Capecitabine in Extrahepatic Cholangiocarcinoma and Gallbladder Carcinoma.
Ben-Josef E, Guthrie KA, El-Khoueiry AB, Corless CL, Zalupski MM, Lowy AM, Thomas CR Jr, Alberts SR, Dawson LA, Micetich KC, Thomas MB, Siegel AB, Blanke CD
J Clin Oncol 2015 Aug 20;33(24):2617-22. Epub 2015 May 11 doi: 10.1200/JCO.2014.60.2219. PMID: 25964250Free PMC Article
Prognostic score for recurrence after Whipple's pancreaticoduodenectomy for ampullary carcinomas; results of an AGEO retrospective multicenter cohort.
Colussi O, Voron T, Pozet A, Hammel P, Sauvanet A, Bachet JB, Vaillant JC, Rougier P, Nordlinger B, Berger A, Coriat R, Dousset B, Malka D, André T, Paye F, Aparicio T, Locher C, Cojean Zeleck D, Tchinou L, Bonnetain F, Taieb J
Eur J Surg Oncol 2015 Apr;41(4):520-6. Epub 2015 Jan 24 doi: 10.1016/j.ejso.2015.01.010. PMID: 25680954

Recent systematic reviews

Impact of histopathological type on the prognosis of ampullary carcinoma: A systematic review and meta-analysis.
Shin DW, Kim S, Jung K, Jung JH, Kim B, Ahn J, Kim J, Hwang JH, Lee JC
Eur J Surg Oncol 2023 Feb;49(2):306-315. Epub 2022 Oct 9 doi: 10.1016/j.ejso.2022.10.001. PMID: 36272870

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