TY - JOUR
T1 - Clinical Target Volume in Biliary Carcinoma: A Systematic Review of Pathological Studies
AU - Marinelli, Ilaria
AU - Guido, Alessandra
AU - Fuccio, Lorenzo
AU - Farioli, Andrea
AU - Panni, Valeria
AU - Giaccherini, Lucia
AU - Arcelli, Alessandra
AU - Ercolani, Giorgio
AU - Brandi, Giovanni
AU - Cammelli, Silvia
AU - Galuppi, Andrea
AU - Macchia, Gabriella
AU - Frakulli, Rezarta
AU - Mattiucci, Gian Carlo
AU - Cellini, Francesco
AU - Buwenge, Milly
AU - Renzulli, Matteo
AU - Deodato, Francesco
AU - Cilla, Savino
AU - Valentini, Vincenzo
AU - Tombolini, Vincenzo
AU - Golfieri, Rita
AU - Morganti, Alessio G.
AU - Morganti, Alessio Giuseppe
PY - 2017
Y1 - 2017
N2 - Background/Aim: Radiotherapy is a treatment option for both adjuvant and neo-adjuvant settings for biliary tract cancer. Guidelines on the delineation of the target volume of lymph nodes are lacking; only generic indications are available, without specific recommendations for different primary tumour locations (e.g. intrahepatic, extrahepatic biliary tract or gallbladder cancer). The aim of this study was to systematically review available literature to provide recommendations on lymph node target volume delineation in patients with unresectable biliary tumour. Materials and Methods: A systematic search of electronic databases was performed up to July 2016. The primary outcome measure was the rate of lymph node involvement according to the location of primary biliary tumour. Sites with = 5% of nodal metastases were considered in the clinical target volume for radiotherapy planning. Results: Twelve studies (1075 patients) were included. The most frequent site of lymph node metastasis in intrahepatic biliary tree carcinoma was retroportal (61.1%, 95% confidence interval (CI)= 50.7-706%). Other frequently involved lymph nodes were along the hepatoduodenal ligament [ frequency=38.7%, 95% CI=31.0-47.0%], those along the common hepatic artery (17.0%, 95% CI=8.2-31.9%) and the hilar nodes (16.9%, 95% CI=13.2-21.4%). In extrahepatic biliary tree cancer, the most frequently involved lymph nodes were the pericholedochal (42.7%, 95% CI=33.8-52.1%) and those along the hepatoduodenal ligament (40.3%, 95% CI=32.4-48.8%). Other commonly involved nodal regions included retroportal lymph nodes (30.9%, 95% CI=23.0-40.1%), pancreaticoduodenal anterior and posterior nodes (30.1%, 95% CI=12.2-57.1%), those along the common hepatic artery (19.7%, 95% CI=11.8-31.0%) and para_aortic nodes (15.2%, 95% CI=8.0-27.0%). The most common site of metastases in gallbladder cancer were the pericholedochal nodes (25.2%, 95% CI=18.6-33.2%), those along the cystic duct (23%, 95% CI=16.6-30.8%), and retroportal nodes (17.1%, 95% CI=11.6-24.5%). Conclusion: Biliary tract cancer has a high propensity for regional lymphatic metastases. An evidencebased nodal target definition of biliary tract cancer based on primary tumour location was proposed.
AB - Background/Aim: Radiotherapy is a treatment option for both adjuvant and neo-adjuvant settings for biliary tract cancer. Guidelines on the delineation of the target volume of lymph nodes are lacking; only generic indications are available, without specific recommendations for different primary tumour locations (e.g. intrahepatic, extrahepatic biliary tract or gallbladder cancer). The aim of this study was to systematically review available literature to provide recommendations on lymph node target volume delineation in patients with unresectable biliary tumour. Materials and Methods: A systematic search of electronic databases was performed up to July 2016. The primary outcome measure was the rate of lymph node involvement according to the location of primary biliary tumour. Sites with = 5% of nodal metastases were considered in the clinical target volume for radiotherapy planning. Results: Twelve studies (1075 patients) were included. The most frequent site of lymph node metastasis in intrahepatic biliary tree carcinoma was retroportal (61.1%, 95% confidence interval (CI)= 50.7-706%). Other frequently involved lymph nodes were along the hepatoduodenal ligament [ frequency=38.7%, 95% CI=31.0-47.0%], those along the common hepatic artery (17.0%, 95% CI=8.2-31.9%) and the hilar nodes (16.9%, 95% CI=13.2-21.4%). In extrahepatic biliary tree cancer, the most frequently involved lymph nodes were the pericholedochal (42.7%, 95% CI=33.8-52.1%) and those along the hepatoduodenal ligament (40.3%, 95% CI=32.4-48.8%). Other commonly involved nodal regions included retroportal lymph nodes (30.9%, 95% CI=23.0-40.1%), pancreaticoduodenal anterior and posterior nodes (30.1%, 95% CI=12.2-57.1%), those along the common hepatic artery (19.7%, 95% CI=11.8-31.0%) and para_aortic nodes (15.2%, 95% CI=8.0-27.0%). The most common site of metastases in gallbladder cancer were the pericholedochal nodes (25.2%, 95% CI=18.6-33.2%), those along the cystic duct (23%, 95% CI=16.6-30.8%), and retroportal nodes (17.1%, 95% CI=11.6-24.5%). Conclusion: Biliary tract cancer has a high propensity for regional lymphatic metastases. An evidencebased nodal target definition of biliary tract cancer based on primary tumour location was proposed.
KW - Biliary Tract Neoplasms
KW - Carcinoma
KW - Evidence-Based Medicine
KW - Hepatic Artery
KW - Humans
KW - Lymph Nodes
KW - Lymph node metastasis
KW - Lymphatic Metastasis
KW - Neoadjuvant Therapy
KW - Neoplasm Metastasis
KW - Radiotherapy Planning, Computer-Assisted
KW - Research Design
KW - Treatment Outcome
KW - biliary tract cancer
KW - clinical target volume
KW - review
KW - Biliary Tract Neoplasms
KW - Carcinoma
KW - Evidence-Based Medicine
KW - Hepatic Artery
KW - Humans
KW - Lymph Nodes
KW - Lymph node metastasis
KW - Lymphatic Metastasis
KW - Neoadjuvant Therapy
KW - Neoplasm Metastasis
KW - Radiotherapy Planning, Computer-Assisted
KW - Research Design
KW - Treatment Outcome
KW - biliary tract cancer
KW - clinical target volume
KW - review
UR - http://hdl.handle.net/10807/149102
U2 - 10.21873/anticanres.11404
DO - 10.21873/anticanres.11404
M3 - Article
SN - 0250-7005
VL - 37
SP - 955
EP - 961
JO - Anticancer Research
JF - Anticancer Research
ER -