Cholangiocarcinoma and Gallbladder cancer 2023
ฝัง
- เผยแพร่เมื่อ 11 มิ.ย. 2024
- Cholangiocarcinoma and gallbladder cancer are not common. But the incidence of intrahepatic cholangiocarcinoma increasing rapidly.
For the past 2 years, tremendous progress in diagnosis and treatment has been made, especially with targeted therapy and immunotherapy, improving the prognosis.
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Thank-you doctor !! I am so happy I found you ...
As a rad onc I have found your videos to be the most informative and comprehensive regarding systemic therapy on youtube, thank you Dr. Kim and god bless
Thank you!
Excellent, not just good for medical students but also great lecture for practicing physicians.
Thank you, Dr. Rodriguez!
Thank you, Dr. Kim Learning new things every day.
One video on gastric carcinoma pls sir!!
Nyc class
excellent lecture Doctor Kim.
Hoping the noble work continues ...
God bless you Dr. Kim
Thank you!
Hello doctor - I was wondering how to find the reference paper you mentioned at 42.14 (Intrahepatic CCA, 5 yrs survival 63%). Appreciate your help and this video has been fantastic. My wife recently has a liver resection with zero margins and as I've been looking at 5 yr survival data, there is so much variation from website to website and doctor to doctor. Thank you.
Thank you Dr. Kim for this detailed lecture......excellent for the surgery residents. Your highlighting on white platform is very helpful for demonstration. However, highlighting persistently on the images instead prevent us from appreciating what you are explaining......may be just one circle will do. Thank you for taking my criticism with a pinch of salt.
Thank you for the suggestion. I will try to not highlight on images.
@@stanleykim1924 thanks for your prompt response Dr. Kim.....I am sure the other videos I plan to watch are also as interesting
Thank you, Doctor Kim. I have binge-watched your lectures on oncology. Thank you for elucidating these topics so well.
You’re welcome!
@@stanleykim1924à
Dr is there any merit to Dr Thomas Seyfried approach to starving cancer by depriving it of glucose and glutamine.
2023 new NCCN Guidelines
Molecular testing
The NCCN recommends comprehensive molecular profiling for those with unresectable or metastatic BTCs, such as NTRK gene fusion, microsatellite instability-high/mismatch repair deficient (MSI-H/dMMR) status, tumor mutational burden-high (TMB-H) status, BRAF V600E mutation, FGFR2 fusion or rearrangement, IDH1 mutation, HER2 (ERBB2) overexpression and/or amplification, and/or RET gene fusion.
Consider cell-free DNA (cfDNA) to identify gene mutations.
Germline testing in hepatobiliary cancers
Insufficient evidence exists for definitive recommendations about specific criteria to guide genetic risk assessment in hepatobiliary cancers or for universal germline testing in these tumors.
Systemic Therapy
Primary treatment for unresectable and metastatic disease
Preferred regimen: Durvalumab plus gemcitabine plus cisplatin. This regimen is also recommended as an option for those with recurrent disease that develops longer than 6 months postoperatively with curative intent as well as longer than 6 months post adjuvant therapy completion.
Subsequent-line therapy for BTCs that progress
Preferred regimen: Folinic acid plus fluorouracil plus oxaliplatin (FOLFOX)
The NCCN guidelines above are published in July 2023, which is almost a year after my recommendation shown in my lecture!
김일철교수님 안녕하셨어요 ^^ 일전에 림사랑카페(림프종)에서 좋은정보주시고 자세하게 설명해주셔서 많은 도움이되었습니다 .
아내는 소포성림프종4기였는데 b.r치료 3차이후 불응해서 구제항암후 자가이식했습니다 이식한지 벌써2년6개월이 되었습니다
4개월전 심한독감이후
목에 멍울이 만져서 펫씨티찍고 씨티상 목에만 두곳재발소견있어서 조직검사후 임상(2중항체)하려는데
조직검사결과 재발이
아니라고 나와서 2달에한번 추적검사 하고있습니다. 현재목에있는 멍울싸이즈는 더작아진 상태입니다
항상 불안에 떨며 지내고 있습니다
교수님 항상건강하세요~~
다행이에요. 그러나 소포성 림프종은 grade 3B 가 아닌이상 천천히 자라는 암이므로 장기적으로 예후가 좋은 림프종입니다.
@@stanleykim1924 깜짝놀랐습니다(다변없을줄알았거든요^^;;)
바쁘실텐데 댓글주셔서
너무 감사드립니다
항상 좋은정보 구독해서 유튜브로 잘보고있습니다
저는
교수님이 계셔서 너무감사합니다
교수님앞날에 행운이. 깃들길. 기원하겠습니다
교수님 그리고 하도안타까운 어느 소녀이야기입니다 들어주세요. 어머니가 거대미만성 림프종인데 4년전 발병해서 항암후 자가이식했는데 재발하여
임상하였습니다
(아칼라브루티닙
리툭시맙
레날리도마이드)
이후 불응으로 ice구제항암을 5차례. 한후 자매와 반일치 동종이식
했다고 합니다 그런데
5개월후 새로운 호치킨암이 생겼다고 합니다 그래서 호치킨 항맘치료 4차후 관해되었고
항암부작용으로 힘들어하다 다시 가슴에암이생겼고 커지는속도가 빠르다고 합니다
병원에서 치료를포기했다고. 기대여명이
3달이라고 합니다
소녀가 너무 가슴아파합니다
환자나이는 49세입니다 정말 포기해야 하나요? 다른약은 없을까요?
마음이 아프시겠어요. 호지킨스 림포마는 재발시 면역치료를 해 보실 수 있어요. 키투루다 혹은 옵디보. 또한브렌퉄시맵-베도틴 이라는 약도 효과가 있습니다
@@stanleykim1924 아이고 교수님 바쁘신가운데
이렇게. 답벽을주시고
너무감사합니다
구독자로써 가끔올려주시는영상 잘보고있습니다
지금말씀해주신
내용은 소녀에게 전하겠습니다 감사드립니다
항상건강하시길 작은힘이나마 기도드리겠습니다
Doc can cholangiocarcinoma be consider as differential diagnosis for Gallbladder cancer?
Cholangiocarcinoma is different from gallbladder cancer.
What are the goals of cholangiocarcinoma?
For early stages, the goal is ‘cure’. For advanced and metastatic diseases, new therapy can prolong the lifespan and hopefully improve the quality life.
@@stanleykim1924 Thank you sir