Hepatic Resection in the Treatment of Hilar Cholangiocarcinoma

Nagorney, David M.; Kendrick, Michael L.

doi:10.1016/j.yasu.2006.05.009

Cited by 56 publications

(38 citation statements)

References 62 publications

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“…HCC can spread directly into the hepatic parenchyma and the hepatoduodenal ligament where the proper hepatic artery and the portal vein are in close proximity to the bile duct, while distal ECC may directly infiltrate into the pancreas or the duodenum [166] . Up to 80% of HCC have extension into the liver parenchyma [166,167] by direct infiltration or by longitudinal extension along the biliary ducts [168] . The latter mechanism explains the caudate lobe involvement by HCC and tumors involving the left hepatic duct [169] .…”

Section: Tumor Spreadmentioning

confidence: 99%

“…Hence, the practice of partial hepatectomy with caudate lobectomy for the surgical treatment of patients with hilar tumors is associated with improved survival [168] . Tumors at the biliary confluence involve the portal vein in 30% of cases and often result in hepatic lobar atrophy [166,167] . The significance of portal vein involvement in patients' survival is controversial.…”

Section: Tumor Spreadmentioning

confidence: 99%

See 1 more Smart Citation

Advances in diagnosis, treatment and palliation of cholangiocarcinoma: 1990-2009

Aljiffry¹,

Walsh²,

Molinari³

2009

WJG

254

190

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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.

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Section: Tumor Spreadmentioning

confidence: 99%

Section: Tumor Spreadmentioning

confidence: 99%

Advances in diagnosis, treatment and palliation of cholangiocarcinoma: 1990-2009

Aljiffry¹,

Walsh²,

Molinari³

2009

WJG

254

190

View full text Add to dashboard Cite

show abstract

“…Additional analysis evaluating post-transplant prognosis documented a survival rate of 46% for HCC-CC as compared with 78% survival for HCC (44). When reviewing these results with prior studies of survival results for HCC and CC, the survival percentiles of HCC-CC are more consistent with CC (41)(42)(43)(44)(45). For CC, the survival after transplantation has been estimated at 22-42% of CC and 0-18% for CC without transplantation.…”

Section: Discussionmentioning

confidence: 81%

A genetic database can be utilized to identify potential biomarkers for biphenotypic hepatocellular carcinoma-cholangiocarcinoma

Mok

Mohan

Grewal

et al. 2016

J. Gastrointest. Oncol.

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“…Therefore, a gross surgical margin of more than 1 cm in the in fi ltration type and more than 2 cm in the papillary and nodular types is required to achieve a R0 resection [ 29 ] . Furthermore, about 75 % of hilar cholangiocarcinoma is associated with perineural invasion (a prognostic factor for poor survival) [ 30,31 ] , 80 % has extended into the liver parenchyma [ 32,33 ] , 30 % involves the portal vein [ 32,33 ] and around 45 % has metastases to the lymph nodes [ 29 ] .…”

Section: Local Resection Of Hilar Cholangiocarcinomamentioning

confidence: 99%