const pptxgen = require("pptxgenjs");
const React = require("react");
const ReactDOMServer = require("react-dom/server");
const sharp = require("sharp");
const { execSync } = require("child_process");

// ─── Color Palette ───────────────────────────────────────────────────────────
const DARK_BG    = "0D1B2A";   // deep navy (dominant - title/section slides)
const MID_NAVY   = "1B3A5C";   // mid navy accent
const TEAL       = "1A7E8F";   // teal accent
const GOLD       = "D4A017";   // warm gold highlight
const WHITE      = "FFFFFF";
const LIGHT_BG   = "F0F4F8";   // light slides background
const TEXT_DARK  = "1A1A2E";   // headings on light slides
const TEXT_MED   = "2C3E50";   // body text
const SUBTEXT    = "5A6A7A";   // subtitles

// ─── Font faces ──────────────────────────────────────────────────────────────
const FONT_TITLE = "Calibri";
const FONT_BODY  = "Calibri";

// ─── Helper: draw top bar stripe on content slides ───────────────────────────
function addTopBar(slide, color) {
  slide.addShape("rect", { x: 0, y: 0, w: 10, h: 0.12, fill: { color: color || TEAL }, line: { type: "none" } });
}

// ─── Helper: slide number ────────────────────────────────────────────────────
function addSlideNum(slide, num, total) {
  slide.addText(`${num} / ${total}`, {
    x: 8.8, y: 5.35, w: 1, h: 0.2,
    fontSize: 9, color: SUBTEXT, align: "right", fontFace: FONT_BODY
  });
}

// ─── Helper: section divider slide ───────────────────────────────────────────
function addSectionDivider(pres, title, subtitle) {
  const slide = pres.addSlide();
  slide.addShape("rect", { x: 0, y: 0, w: 10, h: 5.625, fill: { color: DARK_BG }, line: { type: "none" } });
  slide.addShape("rect", { x: 0, y: 2.6, w: 10, h: 0.06, fill: { color: TEAL }, line: { type: "none" } });
  slide.addShape("rect", { x: 3.5, y: 1.2, w: 0.06, h: 2.0, fill: { color: GOLD }, line: { type: "none" } });
  slide.addText(title, {
    x: 4.0, y: 1.5, w: 5.5, h: 1.2,
    fontSize: 36, bold: true, color: WHITE, fontFace: FONT_TITLE, valign: "middle"
  });
  if (subtitle) {
    slide.addText(subtitle, {
      x: 4.0, y: 2.8, w: 5.5, h: 0.7,
      fontSize: 16, color: TEAL, fontFace: FONT_BODY, italic: true
    });
  }
  return slide;
}

// ─── Helper: content slide template ──────────────────────────────────────────
function addContentSlide(pres, heading, num, total, accentColor) {
  const slide = pres.addSlide();
  // Light background
  slide.addShape("rect", { x: 0, y: 0, w: 10, h: 5.625, fill: { color: LIGHT_BG }, line: { type: "none" } });
  // Top colored bar
  addTopBar(slide, accentColor || TEAL);
  // Heading band
  slide.addShape("rect", { x: 0, y: 0.12, w: 10, h: 0.75, fill: { color: MID_NAVY }, line: { type: "none" } });
  slide.addText(heading, {
    x: 0.3, y: 0.12, w: 9.4, h: 0.75,
    fontSize: 20, bold: true, color: WHITE, fontFace: FONT_TITLE, valign: "middle", margin: 0
  });
  addSlideNum(slide, num, total);
  return slide;
}

// ─── Helper: bullet items ────────────────────────────────────────────────────
function bullets(items, opts) {
  return items.map((item, i) => ({
    text: item,
    options: {
      bullet: { type: "bullet", characterCode: "2022" },
      fontSize: opts.fontSize || 15,
      color: opts.color || TEXT_DARK,
      fontFace: FONT_BODY,
      paraSpaceBefore: opts.paraSpace || 4,
      breakLine: i < items.length - 1
    }
  }));
}

// ─── Helper: sub-bullets ─────────────────────────────────────────────────────
function subbullets(items, opts) {
  return items.map((item, i) => ({
    text: item,
    options: {
      bullet: { type: "bullet", characterCode: "25B8", indent: 20 },
      fontSize: opts.fontSize || 13,
      color: opts.color || TEXT_MED,
      fontFace: FONT_BODY,
      indentLevel: 1,
      paraSpaceBefore: 2,
      breakLine: i < items.length - 1
    }
  }));
}

// ─── Helper: two-column layout ────────────────────────────────────────────────
function addTwoCols(slide, leftItems, rightItems, topY, colH, fontSize) {
  const leftTexts = bullets(leftItems, { fontSize: fontSize || 13, paraSpace: 5 });
  const rightTexts = bullets(rightItems, { fontSize: fontSize || 13, paraSpace: 5 });
  slide.addText(leftTexts, { x: 0.3, y: topY, w: 4.5, h: colH, valign: "top" });
  slide.addShape("rect", { x: 5.05, y: topY + 0.1, w: 0.04, h: colH - 0.2, fill: { color: TEAL }, line: { type: "none" } });
  slide.addText(rightTexts, { x: 5.2, y: topY, w: 4.5, h: colH, valign: "top" });
}

// ─── Fetch textbook images ────────────────────────────────────────────────────
function fetchImages(urls) {
  try {
    const result = execSync(
      `node /home/daytona/skills/shared/scripts/fetch_images.js ${urls.map(u => `"${u}"`).join(" ")}`
    ).toString();
    return JSON.parse(result);
  } catch (e) {
    return urls.map(() => ({ base64: null, error: e.message }));
  }
}

// ═════════════════════════════════════════════════════════════════════════════
async function buildPresentation() {
  const pres = new pptxgen();
  pres.layout = "LAYOUT_16x9";
  pres.title  = "Cholangiocarcinoma";
  pres.author = "Second-Year MBBS Student";

  const TOTAL = 18;

  // ── Fetch the histopathology image from Robbins ─────────────────────────
  const imgUrls = [
    "https://cdn.orris.care/cdss_images/3e92f1397cc3ba1c353762cd045b612780c70a8dba8b8e2806f736bccbabe016.png"
  ];
  const imgs = fetchImages(imgUrls);
  const histoImg = imgs[0];

  // ─────────────────────────────────────────────────────────────────────────
  // SLIDE 1 – Title Slide
  // ─────────────────────────────────────────────────────────────────────────
  {
    const slide = pres.addSlide();
    // Full dark background
    slide.addShape("rect", { x: 0, y: 0, w: 10, h: 5.625, fill: { color: DARK_BG }, line: { type: "none" } });
    // Decorative diagonal accent
    slide.addShape("rect", { x: 0, y: 3.8, w: 10, h: 0.1, fill: { color: TEAL }, line: { type: "none" } });
    slide.addShape("rect", { x: 0, y: 3.95, w: 6, h: 0.05, fill: { color: GOLD }, line: { type: "none" } });
    // Title
    slide.addText("CHOLANGIOCARCINOMA", {
      x: 0.5, y: 0.8, w: 9, h: 1.4,
      fontSize: 44, bold: true, color: WHITE,
      fontFace: FONT_TITLE, align: "center", valign: "middle",
      charSpacing: 2
    });
    // Subtitle
    slide.addText("Bile Duct Cancer: A Comprehensive Overview", {
      x: 0.5, y: 2.4, w: 9, h: 0.6,
      fontSize: 18, color: TEAL, fontFace: FONT_BODY, align: "center", italic: true
    });
    // Presenter line
    slide.addText("Presented by: Second-Year MBBS Student", {
      x: 0.5, y: 4.2, w: 9, h: 0.4,
      fontSize: 14, color: GOLD, fontFace: FONT_BODY, align: "center"
    });
    slide.addText("Department of Pathology  |  MBBS 2nd Year  |  2026", {
      x: 0.5, y: 4.7, w: 9, h: 0.35,
      fontSize: 12, color: WHITE, fontFace: FONT_BODY, align: "center"
    });
  }

  // ─────────────────────────────────────────────────────────────────────────
  // SLIDE 2 – Table of Contents
  // ─────────────────────────────────────────────────────────────────────────
  {
    const slide = addContentSlide(pres, "Table of Contents", 2, TOTAL);
    const topics = [
      ["1. Introduction & Definition",       "2. Epidemiology"],
      ["3. Etiology & Risk Factors",          "4. Classification"],
      ["5. Pathogenesis",                     "6. Morphology & Histopathology"],
      ["7. Clinical Features",                "8. Diagnosis & Investigations"],
      ["9. Staging (TNM)",                    "10. Treatment"],
      ["11. Prognosis",                       "12. Summary & Key Points"],
    ];
    topics.forEach((row, i) => {
      const y = 1.1 + i * 0.65;
      slide.addShape("rect", { x: 0.3, y: y, w: 4.3, h: 0.55, fill: { color: MID_NAVY }, line: { type: "none" } });
      slide.addShape("rect", { x: 5.1, y: y, w: 4.3, h: 0.55, fill: { color: MID_NAVY }, line: { type: "none" } });
      slide.addText(row[0], { x: 0.5, y: y, w: 4.1, h: 0.55, fontSize: 13, color: WHITE, fontFace: FONT_BODY, valign: "middle" });
      slide.addText(row[1], { x: 5.3, y: y, w: 4.1, h: 0.55, fontSize: 13, color: WHITE, fontFace: FONT_BODY, valign: "middle" });
    });
  }

  // ─────────────────────────────────────────────────────────────────────────
  // SLIDE 3 – Introduction & Definition
  // ─────────────────────────────────────────────────────────────────────────
  {
    const slide = addContentSlide(pres, "Introduction & Definition", 3, TOTAL);
    slide.addText([
      { text: "What is Cholangiocarcinoma?", options: { bold: true, fontSize: 17, color: MID_NAVY, fontFace: FONT_TITLE, breakLine: true } },
    ], { x: 0.3, y: 1.1, w: 9.4, h: 0.45 });

    const defItems = bullets([
      "Malignant tumor arising from the epithelium of the bile ducts (cholangiocytes)",
      "Second most common primary malignant tumor of the liver, after Hepatocellular Carcinoma (HCC)",
      "Accounts for ~3% of all gastrointestinal cancers",
      "Often abbreviated as CCA",
      "Produces mucin — histologically a mucin-secreting adenocarcinoma",
      "Notorious for late presentation, dense desmoplasia, and poor prognosis"
    ], { fontSize: 14, paraSpace: 5 });
    slide.addText(defItems, { x: 0.3, y: 1.6, w: 9.2, h: 3.7, valign: "top" });
  }

  // ─────────────────────────────────────────────────────────────────────────
  // SLIDE 4 – Epidemiology
  // ─────────────────────────────────────────────────────────────────────────
  {
    const slide = addContentSlide(pres, "Epidemiology", 4, TOTAL, GOLD);
    // Left column: global stats
    slide.addText("Global Statistics", { x: 0.3, y: 1.0, w: 4.5, h: 0.4, fontSize: 14, bold: true, color: MID_NAVY, fontFace: FONT_TITLE });
    slide.addText(bullets([
      "~2,000–3,000 new cases/year in the US",
      "15% of primary liver malignancies worldwide",
      "More common in East Asia (SE Asia, Korea, Japan)",
      "Incidence rising globally over past 3 decades",
      "Peak age: 55–75 years",
      "Male > Female",
    ], { fontSize: 13, paraSpace: 4 }), { x: 0.3, y: 1.45, w: 4.5, h: 3.5, valign: "top" });

    slide.addShape("rect", { x: 5.05, y: 1.0, w: 0.04, h: 4.0, fill: { color: TEAL }, line: { type: "none" } });

    // Right column: geographic
    slide.addText("High-Risk Regions", { x: 5.2, y: 1.0, w: 4.5, h: 0.4, fontSize: 14, bold: true, color: MID_NAVY, fontFace: FONT_TITLE });
    slide.addText(bullets([
      "NE Thailand, Laos, Cambodia — 30-40x higher rates",
      "Driven by endemic liver fluke (Opisthorchis viverrini)",
      "South Korea — Clonorchis sinensis infestation",
      "Increasing incidence in Western countries linked to NASH/NAFLD",
      "ICD-10: C22.1 (intrahepatic), C24 (extrahepatic)"
    ], { fontSize: 13, paraSpace: 4 }), { x: 5.2, y: 1.45, w: 4.5, h: 3.5, valign: "top" });
  }

  // ─────────────────────────────────────────────────────────────────────────
  // SLIDE 5 – Etiology & Risk Factors
  // ─────────────────────────────────────────────────────────────────────────
  {
    const slide = addContentSlide(pres, "Etiology & Risk Factors", 5, TOTAL);

    // Three card boxes
    const cards = [
      { title: "Parasitic / Infectious", color: TEAL, items: ["Liver flukes: Opisthorchis viverrini, Clonorchis sinensis", "Hepatitis B virus (HBV)", "Hepatitis C virus (HCV)", "HIV infection"] },
      { title: "Biliary Tract Disease",   color: MID_NAVY, items: ["Primary Sclerosing Cholangitis (PSC) — lifetime risk 5–20%", "Choledochal cysts", "Hepatolithiasis (intrahepatic stones)", "Caroli disease"] },
      { title: "Metabolic / Other",       color: GOLD, items: ["NAFLD / NASH", "Diabetes mellitus", "Obesity", "Inflammatory bowel disease (UC)", "Thorotrast exposure (historical)"] },
    ];

    cards.forEach((card, i) => {
      const x = 0.2 + i * 3.3;
      slide.addShape("rect", { x, y: 1.0, w: 3.1, h: 0.45, fill: { color: card.color }, line: { type: "none" } });
      slide.addText(card.title, { x, y: 1.0, w: 3.1, h: 0.45, fontSize: 13, bold: true, color: WHITE, fontFace: FONT_TITLE, align: "center", valign: "middle" });
      slide.addShape("rect", { x, y: 1.45, w: 3.1, h: 3.85, fill: { color: WHITE }, line: { color: card.color, pt: 1.5 } });
      const bItems = card.items.map((item, j) => ({
        text: item,
        options: { bullet: { type: "bullet", characterCode: "25BA" }, fontSize: 12, color: TEXT_DARK, fontFace: FONT_BODY, paraSpaceBefore: 5, breakLine: j < card.items.length - 1 }
      }));
      slide.addText(bItems, { x: x + 0.12, y: 1.5, w: 2.88, h: 3.75, valign: "top" });
    });

    // Bottom note
    slide.addText("Mnemonic: 'CHIPS' — Cholangitis, Hepatolithiasis, IBD, Parasites, Sclerosing cholangitis", {
      x: 0.3, y: 5.2, w: 9.4, h: 0.3, fontSize: 11, color: TEAL, italic: true, fontFace: FONT_BODY
    });
  }

  // ─────────────────────────────────────────────────────────────────────────
  // SLIDE 6 – Classification
  // ─────────────────────────────────────────────────────────────────────────
  {
    const slide = addContentSlide(pres, "Classification of Cholangiocarcinoma", 6, TOTAL, GOLD);

    slide.addText("By Anatomical Location (Most Clinically Used):", {
      x: 0.3, y: 1.0, w: 9.4, h: 0.4, fontSize: 15, bold: true, color: MID_NAVY, fontFace: FONT_TITLE
    });

    const typeCards = [
      { type: "Intrahepatic (iCCA)", pct: "~10%", desc: "Peripheral, within liver parenchyma. Often presents as a large mass. Shares risk factors with HCC. Difficult to detect early.", color: TEAL },
      { type: "Perihilar (pCCA)", pct: "50–60%", desc: "Also called Klatskin tumor. Located at the biliary confluence. Most common type. Causes early biliary obstruction.", color: MID_NAVY },
      { type: "Distal (dCCA)", pct: "20–30%", desc: "Arises from common bile duct posterior to duodenum. Earliest obstructive symptoms. Best surgical outcomes.", color: GOLD },
    ];

    typeCards.forEach((tc, i) => {
      const x = 0.2 + i * 3.27;
      slide.addShape("rect", { x, y: 1.5, w: 3.1, h: 3.8, fill: { color: WHITE }, line: { color: tc.color, pt: 2 } });
      slide.addShape("rect", { x, y: 1.5, w: 3.1, h: 0.6, fill: { color: tc.color }, line: { type: "none" } });
      slide.addText(tc.type, { x, y: 1.5, w: 3.1, h: 0.4, fontSize: 13, bold: true, color: WHITE, fontFace: FONT_TITLE, align: "center", valign: "middle" });
      slide.addText(tc.pct, { x, y: 1.9, w: 3.1, h: 0.25, fontSize: 16, bold: true, color: tc.color, fontFace: FONT_TITLE, align: "center" });
      slide.addText(tc.desc, { x: x + 0.1, y: 2.2, w: 2.9, h: 3.0, fontSize: 12, color: TEXT_DARK, fontFace: FONT_BODY, valign: "top", wrap: true });
    });

    slide.addText("Bismuth-Corlette Classification further subdivides perihilar CCA (Type I–IV) based on ductal involvement", {
      x: 0.3, y: 5.2, w: 9.4, h: 0.3, fontSize: 11, color: SUBTEXT, italic: true, fontFace: FONT_BODY
    });
  }

  // ─────────────────────────────────────────────────────────────────────────
  // SLIDE 7 – Pathogenesis
  // ─────────────────────────────────────────────────────────────────────────
  {
    const slide = addContentSlide(pres, "Pathogenesis", 7, TOTAL);

    slide.addText("Core Mechanism: Chronic Inflammation → Genetic Damage → Malignant Transformation", {
      x: 0.3, y: 1.0, w: 9.4, h: 0.45,
      fontSize: 13, color: TEAL, italic: true, fontFace: FONT_BODY, bold: true
    });

    // Flow boxes
    const steps = [
      { label: "Chronic\nInflammation", desc: "PSC, flukes, stones" },
      { label: "Cholestasis\n& Bile Stasis", desc: "Toxic bile acids accumulate" },
      { label: "Oxidative DNA\nDamage", desc: "ROS, cytokines (IL-6, TNF-α)" },
      { label: "Somatic\nMutations", desc: "KRAS, IDH1/2, FGFR2, TP53, SMAD4" },
      { label: "Malignant\nTransformation", desc: "Adenocarcinoma" },
    ];
    const arrowW = 0.3;
    const boxW = 1.6;
    const totalW = steps.length * boxW + (steps.length - 1) * arrowW;
    const startX = (10 - totalW) / 2;

    steps.forEach((step, i) => {
      const x = startX + i * (boxW + arrowW);
      const boxColor = i === 4 ? TEAL : MID_NAVY;
      slide.addShape("rect", { x, y: 1.65, w: boxW, h: 0.8, fill: { color: boxColor }, line: { type: "none" } });
      slide.addText(step.label, { x, y: 1.65, w: boxW, h: 0.8, fontSize: 11, bold: true, color: WHITE, fontFace: FONT_TITLE, align: "center", valign: "middle" });
      slide.addText(step.desc, { x: x - 0.05, y: 2.5, w: boxW + 0.1, h: 0.55, fontSize: 9.5, color: TEXT_MED, fontFace: FONT_BODY, align: "center", italic: true });
      if (i < steps.length - 1) {
        slide.addText("→", { x: x + boxW, y: 1.68, w: arrowW, h: 0.7, fontSize: 22, color: GOLD, align: "center", valign: "middle" });
      }
    });

    slide.addText("Molecular Drivers:", {
      x: 0.3, y: 3.2, w: 9.4, h: 0.4, fontSize: 14, bold: true, color: MID_NAVY, fontFace: FONT_TITLE
    });

    const molItems = bullets([
      "IDH1 / IDH2 mutations — most common in intrahepatic CCA (~15–25%)",
      "FGFR2 fusions — targetable driver in ~15% of intrahepatic CCA (new therapies available)",
      "KRAS mutations — common in extrahepatic CCA",
      "TP53 inactivation, SMAD4 loss, CDKN2A deletion",
      "Epigenetic changes: promoter hypermethylation, histone modifications"
    ], { fontSize: 13, paraSpace: 4 });
    slide.addText(molItems, { x: 0.3, y: 3.6, w: 9.4, h: 1.9, valign: "top" });
  }

  // ─────────────────────────────────────────────────────────────────────────
  // SLIDE 8 – Morphology & Histopathology
  // ─────────────────────────────────────────────────────────────────────────
  {
    const slide = addContentSlide(pres, "Morphology & Histopathology", 8, TOTAL, GOLD);

    // Left text
    slide.addText("Gross Morphology:", {
      x: 0.3, y: 1.0, w: 5.2, h: 0.35, fontSize: 14, bold: true, color: MID_NAVY, fontFace: FONT_TITLE
    });
    slide.addText(bullets([
      "Extrahepatic CCA: Firm, gray nodules within bile duct wall; may be diffusely infiltrative",
      "Intrahepatic CCA: Occurs in non-cirrhotic liver; may track along portal tracts or form large tumors",
      "Growth patterns: Mass-forming | Periductal-infiltrating | Intraductal"
    ], { fontSize: 12.5, paraSpace: 5 }), { x: 0.3, y: 1.4, w: 5.0, h: 1.5, valign: "top" });

    slide.addText("Histopathology (Microscopy):", {
      x: 0.3, y: 3.0, w: 5.2, h: 0.35, fontSize: 14, bold: true, color: MID_NAVY, fontFace: FONT_TITLE
    });
    slide.addText(bullets([
      "Mucin-producing adenocarcinoma (well to moderately differentiated)",
      "Glandular / tubular structures lined by malignant epithelium",
      "Marked desmoplastic stroma (dense fibrous reaction) — KEY FEATURE",
      "Lymphovascular invasion and perineural invasion — common",
      "IHC: CK7+, CK19+, MOC31+; Hepatocyte markers negative"
    ], { fontSize: 12.5, paraSpace: 4 }), { x: 0.3, y: 3.38, w: 5.0, h: 2.1, valign: "top" });

    // Histology image from Robbins
    if (histoImg && histoImg.base64 && !histoImg.error) {
      slide.addImage({ data: histoImg.base64, x: 5.55, y: 1.0, w: 4.15, h: 3.2, sizing: { type: "contain", w: 4.15, h: 3.2 } });
      slide.addText("Fig: Cholangiocarcinoma — invasive malignant glands in sclerotic stroma (Robbins Pathology)", {
        x: 5.55, y: 4.3, w: 4.15, h: 0.5, fontSize: 9, color: SUBTEXT, italic: true, fontFace: FONT_BODY, align: "center"
      });
    } else {
      slide.addShape("rect", { x: 5.55, y: 1.0, w: 4.15, h: 3.2, fill: { color: MID_NAVY }, line: { type: "none" } });
      slide.addText("Histopathology Image\n(Invasive glands in desmoplastic stroma)", {
        x: 5.55, y: 1.0, w: 4.15, h: 3.2, fontSize: 13, color: WHITE, align: "center", valign: "middle", fontFace: FONT_BODY
      });
    }
  }

  // ─────────────────────────────────────────────────────────────────────────
  // SLIDE 9 – Clinical Features
  // ─────────────────────────────────────────────────────────────────────────
  {
    const slide = addContentSlide(pres, "Clinical Features", 9, TOTAL);

    slide.addText("Clinical Presentation varies by location:", {
      x: 0.3, y: 1.0, w: 9.4, h: 0.35, fontSize: 14, bold: true, color: MID_NAVY, fontFace: FONT_TITLE
    });

    const clCols = [
      {
        title: "Intrahepatic CCA",
        color: TEAL,
        items: ["Often SILENT until late stage", "Vague right upper quadrant pain", "Weight loss, fatigue", "Hepatomegaly", "Elevated liver enzymes", "Incidental imaging finding"]
      },
      {
        title: "Perihilar (Klatskin)",
        color: MID_NAVY,
        items: ["Progressive obstructive JAUNDICE (painless)", "Pruritus (bile salt deposition)", "Dark urine, pale stools (clay-colored)", "Weight loss", "Cholangitis (fever, RUQ pain)", "Courvoisier sign may be absent"]
      },
      {
        title: "Distal CCA",
        color: GOLD,
        items: ["Painless progressive jaundice", "Palpable gallbladder (Courvoisier sign +ve)", "Pale stools, dark urine", "Steatorrhea", "Earlier presentation than perihilar CCA"]
      }
    ];

    clCols.forEach((col, i) => {
      const x = 0.2 + i * 3.27;
      slide.addShape("rect", { x, y: 1.45, w: 3.1, h: 0.42, fill: { color: col.color }, line: { type: "none" } });
      slide.addText(col.title, { x, y: 1.45, w: 3.1, h: 0.42, fontSize: 12, bold: true, color: WHITE, fontFace: FONT_TITLE, align: "center", valign: "middle" });
      slide.addShape("rect", { x, y: 1.87, w: 3.1, h: 3.5, fill: { color: WHITE }, line: { color: col.color, pt: 1.5 } });
      const bItems = col.items.map((it, j) => ({
        text: it,
        options: { bullet: { type: "bullet", characterCode: "2022" }, fontSize: 12, color: TEXT_DARK, fontFace: FONT_BODY, paraSpaceBefore: 5, breakLine: j < col.items.length - 1 }
      }));
      slide.addText(bItems, { x: x + 0.1, y: 1.95, w: 2.9, h: 3.35, valign: "top" });
    });
  }

  // ─────────────────────────────────────────────────────────────────────────
  // SLIDE 10 – Diagnosis & Investigations
  // ─────────────────────────────────────────────────────────────────────────
  {
    const slide = addContentSlide(pres, "Diagnosis & Investigations", 10, TOTAL, TEAL);

    const diagCols = [
      {
        label: "Laboratory Tests",
        color: MID_NAVY,
        items: [
          "LFTs: ↑Bilirubin (conjugated), ↑ALP, ↑GGT",
          "CA 19-9 — most used tumor marker; sensitivity 60–70%",
          "CEA — less specific",
          "AFP — elevated in HCC, not CCA",
          "IgG4 — rule out autoimmune cholangiopathy",
          "LDH, CBC"
        ]
      },
      {
        label: "Imaging",
        color: TEAL,
        items: [
          "Ultrasound: First-line — dilated bile ducts",
          "MRCP: Gold standard for biliary anatomy (non-invasive)",
          "CT Abdomen (triple phase): Mass, vascular invasion, metastases",
          "PET-CT: Staging and distant metastases",
          "ERCP: Diagnostic + therapeutic (stenting)",
          "EUS: Lymph node sampling"
        ]
      },
      {
        label: "Tissue Diagnosis",
        color: GOLD,
        items: [
          "Biliary brushings (ERCP) — sensitivity ~30–50%",
          "Fluorescence in situ hybridization (FISH) improves yield",
          "EUS-guided biopsy for nodes / mass",
          "Percutaneous biopsy (unresectable disease)",
          "Cholangoscopy + directed biopsy",
          "Next-gen sequencing for IDH1/2, FGFR2 mutations"
        ]
      }
    ];

    diagCols.forEach((col, i) => {
      const x = 0.2 + i * 3.27;
      slide.addShape("rect", { x, y: 1.0, w: 3.1, h: 0.42, fill: { color: col.color }, line: { type: "none" } });
      slide.addText(col.label, { x, y: 1.0, w: 3.1, h: 0.42, fontSize: 12.5, bold: true, color: WHITE, fontFace: FONT_TITLE, align: "center", valign: "middle" });
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    });
  }

  // ─────────────────────────────────────────────────────────────────────────
  // SLIDE 11 – TNM Staging
  // ─────────────────────────────────────────────────────────────────────────
  {
    const slide = addContentSlide(pres, "TNM Staging (Distal CCA — AJCC 8th Ed.)", 11, TOTAL);

    slide.addText("T – Primary Tumor:", {
      x: 0.3, y: 1.0, w: 4.5, h: 0.3, fontSize: 13, bold: true, color: MID_NAVY, fontFace: FONT_TITLE
    });

    const tRows = [
      ["T1", "Invades bile duct wall, depth < 5 mm"],
      ["T2", "Invades bile duct wall, depth 5–12 mm"],
      ["T3", "Invades bile duct wall, depth > 12 mm"],
      ["T4", "Involves celiac axis / SMA / common hepatic artery"],
    ];
    const nRows = [
      ["N0", "No regional lymph node metastasis"],
      ["N1", "Metastasis in 1–3 regional nodes"],
      ["N2", "Metastasis in ≥4 regional nodes"],
    ];
    const mRows = [
      ["M0", "No distant metastasis"],
      ["M1", "Distant metastasis"],
    ];

    const drawTable = (rows, x, y, w, headerColor) => {
      rows.forEach((row, i) => {
        const rowY = y + i * 0.48;
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        slide.addShape("rect", { x, y: rowY, w: 1.0, h: 0.44, fill: { color: headerColor }, line: { type: "none" } });
        slide.addShape("rect", { x: x + 1.0, y: rowY, w: w - 1.0, h: 0.44, fill: { color: bg }, line: { color: "CCCCCC", pt: 0.5 } });
        slide.addText(row[0], { x, y: rowY, w: 1.0, h: 0.44, fontSize: 12, bold: true, color: WHITE, fontFace: FONT_BODY, align: "center", valign: "middle" });
        slide.addText(row[1], { x: x + 1.05, y: rowY, w: w - 1.1, h: 0.44, fontSize: 11.5, color: TEXT_DARK, fontFace: FONT_BODY, valign: "middle" });
      });
    };

    drawTable(tRows, 0.3, 1.38, 4.3, MID_NAVY);

    slide.addText("N – Lymph Nodes:", {
      x: 0.3, y: 3.4, w: 4.3, h: 0.3, fontSize: 13, bold: true, color: TEAL, fontFace: FONT_TITLE
    });
    drawTable(nRows, 0.3, 3.74, 4.3, TEAL);

    slide.addText("M – Distant Metastasis:", {
      x: 5.1, y: 1.0, w: 4.5, h: 0.3, fontSize: 13, bold: true, color: GOLD, fontFace: FONT_TITLE
    });
    drawTable(mRows, 5.1, 1.38, 4.5, GOLD);

    slide.addText("Overall Staging:", { x: 5.1, y: 2.4, w: 4.5, h: 0.3, fontSize: 13, bold: true, color: MID_NAVY, fontFace: FONT_TITLE });
    const stageRows = [
      ["Stage I",   "T1–T2, N0, M0"],
      ["Stage II",  "T3, N0, M0"],
      ["Stage III", "T1–T3, N1, M0  OR  T4, any N, M0"],
      ["Stage IVA", "T4, N2, M0"],
      ["Stage IVB", "Any T, Any N, M1"],
    ];
    stageRows.forEach((row, i) => {
      const y = 2.75 + i * 0.47;
      const bg = i % 2 === 0 ? "EDF4FB" : WHITE;
      slide.addShape("rect", { x: 5.1, y, w: 1.5, h: 0.43, fill: { color: MID_NAVY }, line: { type: "none" } });
      slide.addShape("rect", { x: 6.6, y, w: 3.0, h: 0.43, fill: { color: bg }, line: { color: "CCCCCC", pt: 0.5 } });
      slide.addText(row[0], { x: 5.1, y, w: 1.5, h: 0.43, fontSize: 12, bold: true, color: WHITE, fontFace: FONT_BODY, align: "center", valign: "middle" });
      slide.addText(row[1], { x: 6.65, y, w: 2.9, h: 0.43, fontSize: 11.5, color: TEXT_DARK, fontFace: FONT_BODY, valign: "middle" });
    });
  }

  // ─────────────────────────────────────────────────────────────────────────
  // SLIDE 12 – Treatment Overview
  // ─────────────────────────────────────────────────────────────────────────
  {
    const slide = addContentSlide(pres, "Treatment", 12, TOTAL, GOLD);

    slide.addText("Treatment depends on location, stage, and resectability:", {
      x: 0.3, y: 1.0, w: 9.4, h: 0.35, fontSize: 13, color: TEAL, italic: true, fontFace: FONT_BODY, bold: true
    });

    const txCols = [
      {
        label: "Surgical (Curative)",
        color: TEAL,
        items: [
          "Hepatic resection with clear margins (R0) — only cure",
          "Bile duct resection for extrahepatic CCA",
          "Whipple procedure (pancreaticoduodenectomy) for distal CCA",
          "Liver transplantation: selected perihilar CCA + Mayo Protocol",
          "Only ~20–30% of patients are resectable at diagnosis"
        ]
      },
      {
        label: "Palliative Interventions",
        color: MID_NAVY,
        items: [
          "Biliary stenting (ERCP or PTC) — relieve obstruction",
          "Photodynamic therapy (PDT)",
          "Transarterial chemoembolization (TACE) for intrahepatic CCA",
          "Radiofrequency ablation (RFA)",
          "Radiation therapy (stereotactic body radiotherapy)"
        ]
      },
      {
        label: "Systemic Therapy",
        color: GOLD,
        items: [
          "First-line: Gemcitabine + Cisplatin (standard of care)",
          "Added durvalumab (anti-PD-L1) — improves survival (TOPAZ-1 trial)",
          "IDH1 inhibitor: Ivosidenib (approved for IDH1-mutant iCCA)",
          "FGFR2 inhibitors: Pemigatinib, Infigratinib",
          "Second-line: FOLFOX, FOLFIRI"
        ]
      }
    ];

    txCols.forEach((col, i) => {
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      slide.addShape("rect", { x, y: 1.45, w: 3.1, h: 0.42, fill: { color: col.color }, line: { type: "none" } });
      slide.addText(col.label, { x, y: 1.45, w: 3.1, h: 0.42, fontSize: 11.5, bold: true, color: WHITE, fontFace: FONT_TITLE, align: "center", valign: "middle" });
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      const bItems = col.items.map((it, j) => ({
        text: it,
        options: { bullet: { type: "bullet", characterCode: "2022" }, fontSize: 12, color: TEXT_DARK, fontFace: FONT_BODY, paraSpaceBefore: 5, breakLine: j < col.items.length - 1 }
      }));
      slide.addText(bItems, { x: x + 0.1, y: 1.95, w: 2.9, h: 3.42, valign: "top" });
    });
  }

  // ─────────────────────────────────────────────────────────────────────────
  // SLIDE 13 – Prognosis
  // ─────────────────────────────────────────────────────────────────────────
  {
    const slide = addContentSlide(pres, "Prognosis", 13, TOTAL);

    slide.addText("Overall prognosis is poor — late presentation, early metastasis, desmoplastic barrier.", {
      x: 0.3, y: 1.0, w: 9.4, h: 0.38, fontSize: 13, color: TEAL, italic: true, fontFace: FONT_BODY, bold: true
    });

    // Prognosis table
    const progRows = [
      ["Tumor Type",                 "Median Survival",    "5-Year Survival",   "Key Factor"],
      ["Resected distal CCA",        "24–36 months",       "20–35%",            "R0 resection margin"],
      ["Resected perihilar CCA",     "18–24 months",       "10–20%",            "Bismuth type, margins"],
      ["Intrahepatic CCA (resected)","12–24 months",       "15–35%",            "Tumor size, vascular invasion"],
      ["Unresectable / Metastatic",  "6–12 months",        "< 5%",              "Systemic chemo response"],
    ];

    progRows.forEach((row, i) => {
      const y = 1.5 + i * 0.63;
      const isHeader = i === 0;
      const bg = isHeader ? MID_NAVY : (i % 2 === 1 ? "EDF4FB" : WHITE);
      const textColor = isHeader ? WHITE : TEXT_DARK;
      const widths = [3.0, 1.9, 1.8, 2.95];
      const xs = [0.25, 3.25, 5.15, 6.95];
      row.forEach((cell, j) => {
        slide.addShape("rect", { x: xs[j], y, w: widths[j], h: 0.58, fill: { color: bg }, line: { color: "CCCCCC", pt: 0.5 } });
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      });
    });

    // Poor prognostic factors
    slide.addText("Poor Prognostic Factors:", { x: 0.3, y: 4.72, w: 4.5, h: 0.3, fontSize: 12, bold: true, color: MID_NAVY, fontFace: FONT_TITLE });
    slide.addText("Positive margins (R1/R2) • Lymph node involvement • Vascular invasion • Perineural invasion • Advanced T stage • Intrahepatic CCA type", {
      x: 0.3, y: 5.05, w: 9.4, h: 0.35, fontSize: 11, color: TEXT_MED, fontFace: FONT_BODY
    });
  }

  // ─────────────────────────────────────────────────────────────────────────
  // SLIDE 14 – Differential Diagnosis
  // ─────────────────────────────────────────────────────────────────────────
  {
    const slide = addContentSlide(pres, "Differential Diagnosis", 14, TOTAL, TEAL);

    slide.addText("Important conditions to distinguish from Cholangiocarcinoma:", {
      x: 0.3, y: 1.0, w: 9.4, h: 0.35, fontSize: 13, color: TEAL, italic: true, fontFace: FONT_BODY
    });

    const ddx = [
      { dx: "Hepatocellular Carcinoma (HCC)", clue: "Cirrhosis background, AFP elevated, hepatocyte markers +ve on IHC" },
      { dx: "Gallbladder Carcinoma",          clue: "Arises from GB wall; may invade liver bed; often presents as thickened GB wall" },
      { dx: "Pancreatic Adenocarcinoma",      clue: "Similar jaundice pattern; CA19-9 elevated; ERCP shows pancreatic duct involvement" },
      { dx: "Primary Sclerosing Cholangitis", clue: "Inflammatory, non-malignant biliary strictures; bead-and-pruned appearance on MRCP" },
      { dx: "Metastatic Adenocarcinoma",      clue: "History of primary tumor (colon, breast, lung); IHC panel, clinical history key" },
      { dx: "IgG4-related Cholangiopathy",    clue: "Elevated serum IgG4, responds to steroids; mimics perihilar CCA clinically" },
    ];

    ddx.forEach((d, i) => {
      const y = 1.44 + i * 0.65;
      const bg = i % 2 === 0 ? "EDF4FB" : WHITE;
      slide.addShape("rect", { x: 0.25, y, w: 3.5, h: 0.6, fill: { color: MID_NAVY }, line: { type: "none" } });
      slide.addShape("rect", { x: 3.75, y, w: 5.9, h: 0.6, fill: { color: bg }, line: { color: "DDDDDD", pt: 0.5 } });
      slide.addText(d.dx, { x: 0.3, y, w: 3.45, h: 0.6, fontSize: 12, bold: true, color: WHITE, fontFace: FONT_BODY, valign: "middle" });
      slide.addText(d.clue, { x: 3.85, y, w: 5.75, h: 0.6, fontSize: 11.5, color: TEXT_DARK, fontFace: FONT_BODY, valign: "middle" });
    });
  }

  // ─────────────────────────────────────────────────────────────────────────
  // SLIDE 15 – Recent Advances
  // ─────────────────────────────────────────────────────────────────────────
  {
    const slide = addContentSlide(pres, "Recent Advances & Targeted Therapies", 15, TOTAL, GOLD);

    slide.addText("Molecular profiling has revolutionized CCA treatment in the last decade:", {
      x: 0.3, y: 1.0, w: 9.4, h: 0.35, fontSize: 13, color: MID_NAVY, italic: true, fontFace: FONT_BODY, bold: true
    });

    const advances = [
      { target: "FGFR2 Fusions", drug: "Pemigatinib, Infigratinib, Futibatinib", note: "~15% iCCA; FDA-approved 2nd line" },
      { target: "IDH1 Mutations", drug: "Ivosidenib", note: "~15–25% iCCA; FDA-approved 2021" },
      { target: "BRAF V600E", drug: "Dabrafenib + Trametinib", note: "Rare, ~5%; off-label use" },
      { target: "HER2 Amplification", drug: "Trastuzumab + Pertuzumab", note: "Emerging target; trials ongoing" },
      { target: "PD-L1 / PD-1", drug: "Durvalumab, Pembrolizumab", note: "TOPAZ-1 (durvalumab): improved OS; FDA-approved" },
      { target: "NTRK Fusions", drug: "Larotrectinib, Entrectinib", note: "Rare; tumor-agnostic approval" },
    ];

    advances.forEach((a, i) => {
      const y = 1.45 + i * 0.62;
      const bg = i % 2 === 0 ? "EDF4FB" : WHITE;
      slide.addShape("rect", { x: 0.25, y, w: 2.5, h: 0.57, fill: { color: TEAL }, line: { type: "none" } });
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      slide.addText(a.drug,    { x: 2.8,  y, w: 3.4, h: 0.57, fontSize: 11.5, color: TEXT_DARK, fontFace: FONT_BODY, valign: "middle" });
      slide.addText(a.note,    { x: 6.3,  y, w: 3.3, h: 0.57, fontSize: 11.5, color: SUBTEXT,   fontFace: FONT_BODY, valign: "middle", italic: true });
    });
  }

  // ─────────────────────────────────────────────────────────────────────────
  // SLIDE 16 – Key Points / Summary
  // ─────────────────────────────────────────────────────────────────────────
  {
    const slide = addContentSlide(pres, "Key Points to Remember", 16, TOTAL);

    const keyPoints = [
      "CCA = malignant tumor of bile duct epithelium; 2nd most common primary liver cancer",
      "Perihilar (Klatskin tumor) is the MOST COMMON type (~50–60%)",
      "Hallmark histology: mucin-producing adenocarcinoma with DESMOPLASTIC stroma",
      "Painless progressive jaundice is the classic presentation of extrahepatic CCA",
      "MRCP is the gold standard for imaging the biliary tree",
      "CA 19-9 is the most used tumor marker (but not specific)",
      "ONLY surgical resection (R0) offers a curative chance",
      "First-line palliative chemo: Gemcitabine + Cisplatin ± Durvalumab",
      "Targetable mutations: FGFR2 fusions and IDH1 mutations are most important",
      "Prognosis is poor — median survival < 1 year for unresectable disease"
    ];

    keyPoints.forEach((kp, i) => {
      const y = 1.05 + i * 0.44;
      const color = i % 2 === 0 ? TEAL : MID_NAVY;
      slide.addShape("rect", { x: 0.25, y, w: 0.35, h: 0.36, fill: { color }, line: { type: "none" } });
      slide.addText(`${i + 1}`, { x: 0.25, y, w: 0.35, h: 0.36, fontSize: 12, bold: true, color: WHITE, fontFace: FONT_BODY, align: "center", valign: "middle" });
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    });
  }

  // ─────────────────────────────────────────────────────────────────────────
  // SLIDE 17 – References
  // ─────────────────────────────────────────────────────────────────────────
  {
    const slide = addContentSlide(pres, "References", 17, TOTAL, TEAL);

    const refs = [
      "Kumar V, Abbas A, Aster J. Robbins & Kumar Basic Pathology, 10th ed. Elsevier; 2023.",
      "Feldman M, Friedman L, Brandt L. Sleisenger and Fordtran's Gastrointestinal and Liver Disease, 11th ed. Elsevier; 2021.",
      "Banales JM, et al. Cholangiocarcinoma 2020: the next horizon in mechanisms and management. Nat Rev Gastroenterol Hepatol. 2020;17:557–588.",
      "Oh DY, et al. Durvalumab plus Gemcitabine/Cisplatin in advanced biliary tract cancer (TOPAZ-1 trial). NEJM Evid. 2022.",
      "NCI PDQ: Bile Duct Cancer (Cholangiocarcinoma) Treatment. cancer.gov. Accessed June 2026.",
      "Abou-Alfa GK, et al. Ivosidenib in IDH1-mutant, chemotherapy-refractory cholangiocarcinoma. NEJM. 2020;382:2219–2227.",
      "Abou-Alfa GK, et al. Pemigatinib for previously treated CCA with FGFR2 rearrangements. NEJM. 2020;383:1442–1454.",
      "AJCC Cancer Staging Manual, 8th ed. Springer; 2017."
    ];

    refs.forEach((ref, i) => {
      const y = 1.05 + i * 0.53;
      slide.addText(`${i + 1}. ${ref}`, {
        x: 0.35, y, w: 9.3, h: 0.5, fontSize: 11, color: TEXT_DARK, fontFace: FONT_BODY, valign: "top", wrap: true
      });
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    });
  }

  // ─────────────────────────────────────────────────────────────────────────
  // SLIDE 18 – Thank You
  // ─────────────────────────────────────────────────────────────────────────
  {
    const slide = pres.addSlide();
    slide.addShape("rect", { x: 0, y: 0, w: 10, h: 5.625, fill: { color: DARK_BG }, line: { type: "none" } });
    slide.addShape("rect", { x: 0, y: 2.5, w: 10, h: 0.08, fill: { color: TEAL }, line: { type: "none" } });
    slide.addShape("rect", { x: 3.5, y: 1.0, w: 3.0, h: 0.06, fill: { color: GOLD }, line: { type: "none" } });
    slide.addText("Thank You", {
      x: 0.5, y: 1.2, w: 9, h: 1.0,
      fontSize: 52, bold: true, color: WHITE, fontFace: FONT_TITLE, align: "center", valign: "middle"
    });
    slide.addText("For Your Attention", {
      x: 0.5, y: 2.3, w: 9, h: 0.55,
      fontSize: 20, color: TEAL, fontFace: FONT_BODY, align: "center", italic: true
    });
    slide.addText("Questions & Discussion Welcome", {
      x: 0.5, y: 3.0, w: 9, h: 0.45,
      fontSize: 16, color: GOLD, fontFace: FONT_BODY, align: "center"
    });
    slide.addText("Cholangiocarcinoma | 2nd Year MBBS | Department of Pathology | 2026", {
      x: 0.5, y: 4.9, w: 9, h: 0.35,
      fontSize: 11, color: SUBTEXT, fontFace: FONT_BODY, align: "center"
    });
  }

  // ─── Save ────────────────────────────────────────────────────────────────
  const outPath = "/home/daytona/workspace/cholangiocarcinoma-ppt/Cholangiocarcinoma_MBBS.pptx";
  await pres.writeFile({ fileName: outPath });
  console.log("Saved:", outPath);
}

buildPresentation().catch(err => { console.error(err); process.exit(1); });

Successfully replaced 1 instance(s) of the string in '/home/daytona/workspace/cholangiocarcinoma-ppt/build.js'