my dad was diagnosed klatskins tumour
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Amr….I am sorry to hear about your Dad and I would like to follow Lainy in welcoming you to our board. And, I agree with Lainy in that you should have another opinion especially, since Klatskin tumor (occurring at the confluence of the right and left hepatic duct) is quite uncommon in your country.
Do you have all medical records on hand? Is it possible for you to forward all to a physician in France?Michel Ducreux, MD, PhD
Institut Gustave Roussy
Villejuif, FranceIn England you might want to contact the following surgeons:
J Peter A Lodge MD FRCS
Professor of Surgery
Clinical Director of Surgery
HPB and Transplant Unit
St James’s University Hospital
Leeds LS9 7TFTel +44 (0) 113 2064890
Fax +44 (0) 113 2448182Prof. Brian Davidson
University Department of Surgery,
The Royal Free Hospital, Pond Street, London, NW3 2QGE mail: b.davidson[at]medsch.ucl.ac.uk
Other members may want to forward additional physicians names to you.
If you would like to contact a physician in the U.S. please, let us know.
Capcitabine500/ Eluxatin = Gemzar/Oxiliplatin has been used frequently by members on this board and some with impressive results. However, I would also like to inform you about the following: the largest (multinational) study ever had been conducted in England with a combination of Capcitabine and Cisplatin. (Gemzar/Cisplatin.)
Gemcitabine with or without cisplatin in patients (pts) with advanced or metastatic biliary tract cancer (ABC): Results of a multicenter, randomized phase III trial (the UK ABC-02 trial).
Author(s):
J. W. Valle, H. S. Wasan, D. D. Palmer, D. Cunningham, D. A. Anthoney, A. Maraveyas, S. K. Hughes, M. Roughton, J. A. Bridgewater; Christie Hospital NHS Trust, Manchester, United Kingdom; Imperial College Healthcare Trust, London, United Kingdom; University of Birmingham , Birmingham, United Kingdom; Royal Marsden Hospital, London, United Kingdom; St. James’ University Hospital, Leeds, United Kingdom; Castle Hill Hospital, Hull, United Kingdom; University College London, London, United Kingdom
Abstract:“Background: There is no established standard chemotherapy for pts with inoperable ABC. We previously reported an improvement in progression-free survival (PFS) in a randomised phase II trial of 86 pts (ABC-01) using gemcitabine/cisplatin (GemCis) vs. gemcitabine (Gem) (Valle ASCO-GI 2006, abstr. 98). This study was extended into ABC-02, a phase III trial, to recruit a further 314 pts with overall survival (OS) as the primary end-point. Methods: Consenting pts with histologically/cytologically-confirmed ABC, aged ≥18 years, ECOG performance status 0 – 2, and adequate haematological, hepatic and renal function were randomised to receive either Cis (25 mg/m2) followed by Gem (1000 mg/m2 D1, 8 q21d) for 8 cycles, or Gem alone (1000 mg/m2 on D1, 8, 15 q28d) for 6 cycles, stratified by extent of disease, site of primary tumour, ECOG score and centre. The trial had an 80% power to detect an OS hazard ratio of 0.73. Results: From May 2005 to October 2008, 324 pts were randomised to ABC- 02 from 34 UK centres. We report the pre-planned combined analysis of ABC-01 and ABC-02 based on 410 pts (GemCis=206/Gem=204). Patient characteristics: median age 64 yrs (range 23-85); male (47%); metastatic disease (75%), locally advanced (25%); gallbladder (36%), bile duct (59%), ampulla (5%); and ECOG 0-1 (87%), 2 (12%). With a median follow-up of 6.1 months and 263 deaths, the median OS was greater with GemCis than Gem, 11.7 vs. 8.2 months (log rank p=0.002), with hazard ratio 0.68 (95%-CI 0.53, 0.86). The median PFS was greater with GemCis than Gem, 8.5 vs. 6.5 months (log rank p=0.003), with hazard ratio 0.70 (95%-CI 0.56, 0.88).Toxicity was similar between the arms (by week 12, 57% had a grade 3/4 toxicity in each arm), though there was a slight excess of neutropenia using GemCis. Conclusions: This is the largest ever study in ABC and demonstrates a clear survival advantage for GemCis without added clinically significant toxicity, setting a new international standard of care.”
I hope this helped and please, continue to put out your questions because the members on this board are extremely helpful and supportive.
All my best wishes,
MarionHello, Dr. Amr. I can really only advise about what my husband has and the Whipple. They cannot do chemo on him as 5 doctors said it would not work with his kind of CC. Last year when the CC first returned he did have radiation to decrease the size followed by cyber knife. It was fabulous! A Miracle. Now 2 tumors have returned, one near the liver and one near the kidney. But, they seem to be shrinking…on their own…another Miracle. We do not know why, it is just happening. While the tumors seem to be shrinking his CA19 is rising and we do not know why. He is scheduled for another PET Scan in March. He just had one this month.
Unfortunately during the holidays we do not normally have that many posts but I can guarantee that you will very soon hear from others who may be able to help you more on photo dynamic therapy. In fact at the top of the page if you type those words in the Search space you will get lots of posts relating to the subject you type in. Ask all the questions you want that is why we are all here.thx Lainy for reply
klatskin tumour in Egypt is very very rare.the common here is distal CC
our profs here can do whipple easily.
but they tell me they cant do anything for Hilar CC.palliative ttt only by stent or chemo.i wanna to communicat with u specially those who live in the states and having the same condition .does the photo dynamic therapy effective in this case?
i wanna ask more &more
plz keep going with meWelcome Dr. Amr to our Family but sad you had to find us. Absolutely, we always recommend 2nd and 3rd opinions if needed. If the stent was just put in, perhaps the bilirubin will come down more in the next week so that chemo can begin. In the meantime unless you are absolutely convinced that everything is being done you have every right to another opinion. Your father has some good things going for him, it has not spread, billirubin coming down,
otherwise healthy. And he has you in his corner. I am not a medical person but
I have to tell you after 4 years of caring for my husband (He had a Whipple Surgery) I have learned to go with a lot of my gut feelings. I am sure you will get some good advise from others, in the meantime please keep us posted about your father and his progress.Hello everybody
i am Dr. Amr 26 yo from Egypt.
this is the 1st time with you.my father was diagnosed the last month with klatskin tuomur .on 18 nov 2009
by MRCP.
previusly it was diagnosed stones obsructing CBD.on 24 Nov 2009 the doctor take the decision to make the operation
unfortunately the mass was irresectabe.it was retroportal hoding 2 branches of portal vein and making mercedes benz sign in Rt Lt branches of CHD. Y shape.the LN biopsy revealed no malignant cells. triphasic CT before operation revealed no spread.after one week we put a stent transmitting bile to duodenum.
he goes will after the stent. now total bilirubin 4 mg/dlyesterday the oncologist tell me that he will not able to stat chemotherapy
until bilirubin goes below 2 mg/dl
he said my dad at the second stage of the diseasehe will start chemo with Capcitabine500 + Eluxatin 200
is this chemo can shrinks this mass or control it?
i read alot about this cancer but unfortunately ……….
i am a doctor and i know everything about this malignant pernicious cancer
but i hope every thing goes will.can i take another option from another dr? or this doctor enough?
god can do every thing
waiting ur replies… Thx
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