The Role of Surgical Resection and Liver Transplantation for the Treatment of Intrahepatic Cholangiocarcinoma
| Autor: | James V. Guarrera, Jarot J. Guerra, Guergana Panayotova, Keri E Lunsford |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Surgical resection
medicine.medical_specialty medicine.medical_treatment Locally advanced Review Liver transplantation Malignancy Extent of resection 03 medical and health sciences Liver disease 0302 clinical medicine intrahepatic cholangiocarcinoma medicine biliary tract malignancy Intrahepatic Cholangiocarcinoma liver transplantation Tumor biology business.industry General Medicine medicine.disease Surgery 030220 oncology & carcinogenesis liver resection Medicine 030211 gastroenterology & hepatology transplant oncology business cholangiocarcinoma |
| Zdroj: | Journal of Clinical Medicine, Vol 10, Iss 2428, p 2428 (2021) Journal of Clinical Medicine |
| ISSN: | 2077-0383 |
| Popis: | Intrahepatic cholangiocarcinoma (iCCA) is a rare and complex malignancy of the biliary epithelium. Due to its silent presentation, patients are frequently diagnosed late in their disease course, resulting in poor overall survival. Advances in molecular profiling and targeted therapies have improved medical management, but long-term survival is rarely seen with medical therapy alone. Surgical resection offers a survival advantage, but negative oncologic margins are difficult to achieve, recurrence rates are high, and the need for adequate future liver remnant limits the extent of resection. Advances in neoadjuvant and adjuvant treatments have broadened patient treatment options, and these agents are undergoing active investigation, especially in the setting of advanced, initially unresectable disease. For those who are not able to undergo resection, liver transplantation is emerging as a potential curative therapy in certain cases. Patient selection, favorable tumor biology, and a protocolized, multidisciplinary approach are ultimately necessary for best patient outcomes. This review will discuss the current surgical management of locally advanced, liver-limited intrahepatic cholangiocarcinoma as well as the role of liver transplantation for select patients with background liver disease. |
| Databáze: | OpenAIRE |
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