Extending resectability of hilar cholangiocarcinomas: how can it be assessed and improved?
| Autor: | Gregor A. Stavrou, Marcello Donati, Francesco Basile, Karl J. Oldhafer, Axel Stang |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
0301 basic medicine
Cancer Research medicine.medical_specialty Standard of care medicine.medical_treatment Klatskin tumors Portal vein Portal vein ligation Resection 03 medical and health sciences Hepatic Artery 0302 clinical medicine Preoperative Care medicine Hepatectomy Humans Caudate lobe extended liver resections Tomography Portal Vein business.industry Patient Selection En bloc resection General Medicine Neoadjuvant Therapy Liver Transplantation X-Ray Computed Treatment Outcome 030104 developmental biology Bile Duct Neoplasms Liver Oncology 030220 oncology & carcinogenesis ALPPS Bile Ducts Radiology Hilar Cholangiocarcinomas hilar cholangiocarcinomas Tomography X-Ray Computed business Cholangiography extended hepatectomies neoadjuvant chemotherapy Klatskin Tumor |
| Zdroj: | Future Oncology. 15:193-205 |
| ISSN: | 1744-8301 1479-6694 |
| Popis: | Until the 1980's, Klatskin tumors were considered ‘desperate cases’ and most of them were not resected; almost no oncologic concept was available. After many improvements, today, extended hepatectomy, including caudate lobe resection and lymphoadenectomy, have become a standard of care for oncologicaly radical resection of Klatskin tumors. Portal vein en bloc resection, if necessary, is a diffused standard assuring R0-resection without any improvement of survival in most series. Arterial resection remains episodical and controversial in its oncologic impact. Arterial resection-reconstruction was demonstrated to be feasible with many different technical possibilities. Neoadjuvant chemotherapy, refinement of associating liver partition and portal vein ligation for staged hepatectomy and liver transplantations are some possible future resources for treatment of those aggressive tumors that could be able to expand the pool of treatable patients. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|