Improvement of biliary tract cancer treatment outcomes
Surgery is the only treatment modality, which is promising the long survival for biliary tract cancer. However among the biliary tract cancer patients the number of the patients who can underwent curative resection is relatively low and the long-term outcome of surgery for biliary tract cancer is still unsatisfactory. Biliary tract cancer, especially hilar cholangiocarcinoma is difficult to treat, and special knowledge or surgical techniques are needed to perform curative resection. We have been performing radical resection for biliary tract cancer patients without distant metastasis as much as possible even for patients with locally advanced cancer.
On the other hand, surgery of the biliary tract cancer is usually highly invasive, and morbidity and mortality rate are relatively high. So we investigate about safety (that is to reduce postoperative morbidity and mortality) and efficacy (that is to improve the prognosis) of surgery from various aspects.
Owing to the recent advance in chemotherapy, immunotherapy and gene therapy, multidisciplinary treatment promises to improve the outcome of biliary tract cancer.
In order to develop the novel treatment for biliary tract cancer, the biliary tract research group have been performed basic research related to the diagnosis of lymph node metastasis, invasion or metastasis of cancer.
Recently, the concept of EMT (epithelial-mesenchymal transition) is proposed in the mechanisms of cancer progression or invasion.
The concept of EMT is that cancer cells arose in epithelial cell infiltrate to the stroma and will get the ability to invade by which the nature of epithelial cell are generated transition on the nature of the mesenchymal cell.
We have been analyzed the EMT-associated protein using a large number of resected specimens to reveal its significance. Postoperative liver failure is thorny issue for perioperative management of biliary tract surgery. Liver failure is one of the mortal complications after surgery. In order to prevent postoperative liver failure, we perform portal vein embolization to reduce the volume of resected liver and enlarge the remnant liver prior to surgery, but it is insufficient. We are promoting the basic research aimed at effective hypertrophy of remnant liver by injecting stem cells (undifferentiated biological cells that can differentiate into specialized cells and can divide (through mitosis) to produce more stem cells) as a new approach to overcome the postoperative liver failure.