[Intra and extra hepatic cholangiocarcinomas radiation therapy]. / Place de la radiothérapie des cholangiocarcinomes intra- et extrahépatiques.

Cholangiocarcinomas are digestive tumors whose incidence remains low and have poor prognosis. The benefits of adjuvant radiochemotherapy and radiotherapy have never been demonstrated in any phase III randomized controlled trial. Chemotherapy with capecitabine 6 months is the standard of care in adjuvant setting. Radiochemotherapy is validated in R1 patients. It is not recommended in neoadjuvant situations given the lack of evidence. Chemotherapy and radiochemotherapy are validated in adjuvant or locally advanced diseases. Stereotactic radiation therapy offers an interesting perspective, at the cost of significant digestive toxicities, requiring evaluation in randomized trials.

Liver cancer oncogenomics: opportunities and dilemmas for clinical applications.

Primary liver cancers are among the most rapidly evolving malignant tumors worldwide. An underlying chronic inflammatory liver disease, which precedes liver cancer development for several decades and frequently creates a pro-oncogenic microenvironment, impairs progress in therapeutic approaches. Molecular heterogeneity of liver cancer is potentiated by a crosstalk between epithelial tumor and stromal cells that complicate translational efforts to unravel molecular mechanisms of hepatocarcinogenesis with a drugable intend. Next-generation sequencing has greatly advanced our understanding of cancer development. With regards to liver cancer, the unprecedented coverage of next-generation sequencing has created a detailed map of genetic alterations and identified key somatic changes such as CTNNB1 and TP53 as well as several previously unrecognized recurrent disease-causing alterations that could contribute to new therapeutic approaches. Importantly, these investigations indicate that a classical oncogene addiction cannot be assumed for primary liver cancer. Therefore, hepatocarcinogenesis can be considered a paradigm suitable for individualized medicine.

A study on the chromosomal aberrations in Korean intrahepatic cholangiocarcinomas with comparative genomic hybridization / 한국간담췌외과학회지

AIMS AND METHOD: Comparative genomic hybridization serves as a screening test for regions of copy number changes in tumor genomes. I have applied the technique to map DNA losses and gains in 13 cases of frozen cholangiocarcinomas. RESULTS: All of the 13 cases showed genetic alterations. Loss of short arm of chromosome 19 (92%) was the most common changes observed. 22q(62%), 1p(54%), 17p(54%) and 19q(54%) also showed nonrandom patterns of genomic losses with high frequencies. Among the genomic gains, 13q was revealed as the most common site (69%), and 8q (46%) and 12q (46%) also showed relatively high frequencies of genomic gains. Genomic amplifications were detected on 5p13, 10q21.1 and 18q11.3 in 3 different cases, respectively. CONCLUSION: This study represents the first analysis of intrahepatic cholangiocarcinomas by CGH, and it confirms the presence of nonrandom genetic changes occur in the pathogenesis of cholangiocarcinomas. These findings should lead to the characterization of new loci involved in cholangiocarcinoma pathogenesis.