Advances in diagnosis, treatment and palliation of cholangiocarcinoma: 1990-2009
Open Access
- 1 January 2009
- journal article
- review article
- Published by Baishideng Publishing Group Inc. in World Journal of Gastroenterology
- Vol. 15 (34), 4240-4262
- https://doi.org/10.3748/wjg.15.4240
Abstract
Several advances in diagnosis, treatment and palliation of cholangiocarcinoma (CC) have occurred in the last decades. A multidisciplinary approach to this disease is therefore recommended. CC is a relatively rare tumor and the main risk factors are: chronic inflammation, genetic predisposition and congenital abnormalities of the biliary tree. While the incidence of intra-hepatic CC is increasing, the incidence of extra-hepatic CC is trending down. The only curative treatment for CC is surgical resection with negative margins. Liver transplantation has been proposed only for selected patients with hilar CC that cannot be resected who have no metastatic disease after a period of neoadjuvant chemo-radiation therapy. Magnetic resonance imaging/magnetic resonance cholangiopancreatography, positron emission tomography scan, endoscopic ultrasound and computed tomography scans are the most frequently used modalities for diagnosis and tumor staging. Adjuvant therapy, palliative chemotherapy and radiotherapy have been relatively ineffective for inoperable CC. For most of these patients biliary stenting provides effective palliation. Photodynamic therapy is an emerging palliative treatment that seems to provide pain relief, improve biliary patency and increase survival. The clinical utility of other emerging therapies such as transarterial chemoembolization, hepatic arterial chemoinfusion and high intensity intraductal ultrasound needs further study.Keywords
This publication has 167 references indexed in Scilit:
- Risk of hepatobiliary and pancreatic cancers after hepatitis C virus infection: A population-based study of U.S. veteransJournal of Hepatology, 2008
- Utility of serum tumor markers, imaging, and biliary cytology for detecting cholangiocarcinoma in primary sclerosing cholangitisJournal of Hepatology, 2008
- 18F-fluorodeoxyglucose Positron Emission Tomography Influences Management Decisions in Patients with Biliary CancerJournal of the American College of Surgeons, 2008
- Adjuvant Concurrent Chemoradiation for Adenocarcinoma of the Distal Common Bile DuctInternational Journal of Radiation Oncology*Biology*Physics, 2007
- Impact of integrated positron emission tomography and computed tomography on staging and management of gallbladder cancer and cholangiocarcinomaJournal of Hepatology, 2006
- Significance of fluorodeoxyglucose PET imaging in the diagnosis of malignancies in patients with biliary strictureEuropean Journal of Surgical Oncology, 2005
- Effects of 5-Fluorouracil and Leucovorin in the Treatment of Pancreatic–Biliary Tract AdenocarcinomasAmerican Journal of Clinical Oncology, 2000
- Outcome of treatment for distal bile duct cancerBritish Journal of Surgery, 1996
- Palliation of irresectable hilar cholangiocarcinoma with biliary drainage and radiotherapyBritish Journal of Surgery, 1995
- A reappraisal of cholangiocarcinoma in patient with hepatolithiasisCancer, 1993