Liver Transplantation for Hilar Cholangiocarcinoma: A German Survey

Kaiser, Gernot; Sotiropoulos, Georgios C.; Jauch, Karl Walter; Löhe, F.; Hirner, A.; Kalff, Joerg C.; Königsrainer, Alfred; Steurer, Wolfgang; Senninger, N.; Brockmann, J. G.; Schlitt, HJ; Zülke, C.; Büchler, Markus W.; Schemmer, Peter; Settmacher, Utz; Hauß, J.; Lippert, H.; Hopt, UT; Otto, Gerd; Heiss, M. M.; Bechstein, Wolf O.; Timm, S.; Klar, E.; Hölscher, A. H.; Rogiers, Xavier; Stangl, Manfred; Hohenberger, W.; Müller, V.; Molmenti, Ernesto P.; Fouzas, I.; Erhard, J; Malagó, Massimo; Paul, Andreas; Broelsch, Christoph E.; Lang, Hauke

doi:10.1016/j.transproceed.2008.08.039

Cited by 40 publications

(18 citation statements)

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“…Study and patient characteristics are summarized in Tables 1 and 2. Six studies were based in the United States,13, 17, 23, 25, 29, 31, 33 three in Germany22, 24, 32, 34, 35 and one each in Sweden,26 Spain,12 Canada,27 China28 and the United Kingdom 30. A total of 605 patients were included in this meta‐analysis, with an average age ranging from 43 to 55 years old, of which more than 60% were male.…”

Section: Resultsmentioning

confidence: 99%

“…A total of 605 patients were included in this meta‐analysis, with an average age ranging from 43 to 55 years old, of which more than 60% were male. All 14 observational studies enrolled patients with distinct types of bile duct cancer irrespective of intrahepatic cholangiocarcinoma (ICC),12, 25–27 hilar cholangiocarcinoma12, 17, 22–24, 26, 28, 30, 32–35 or extrahepatic cholangiocarcinoma (ECC) 25–27. A large proportion of selected studies (10/14) described concomitant diseases such as PSC,13, 17, 25–27, 29–31, 33 Carolis disease,28 ulcerative colitis17 and cirrhosis 35.…”

Section: Resultsmentioning

confidence: 99%

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Efficacy and safety of liver transplantation in patients with cholangiocarcinoma: A systematic review and meta‐analysis

Bai

Shi

et al. 2012

Intl Journal of Cancer

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The aim of our study was to evaluate the efficacy and safety of liver transplantation in patients with cholangiocarcinoma. According to the requirements of Cochrane systematic review, a thorough literature search was performed in PubMed/ Medline, Embase and Cochrane electronic databases between 1995 and 2009 in terms of the key words ''liver transplantation'' and ''cholangiocarcinoma,'' ''cholangiocellular carcinoma'' or ''bile duct cancer,'' with restricted articles for the English language. Data were processed for a meta-analysis by Stata 10 software. Altogether 14 clinical trials containing 605 transplanted patients of bile duct cancers were finally enrolled in our study. In addition, the overall pooled incidence of complications was 0.62 (95% CI 5 0.44-0.78), among which that of OLT-PAT group (0.58; 95% CI 5 0.20-0.92) was relatively acceptable compared to those of liver transplantation alone (0.61; 95% CI 5 0.33-0.85) and liver transplantation with extended bile duct resection (0.78; 95% CI 5 0.55-0.94). In comparison to curative resection of cholangiocarcinoma with the 5-year survival rate reported from 20 to 40%, the role of liver transplantation alone is so limited. In the future, attention will be focused on liver transplantation following neoadjuvant radiochemotherapy, which requires a well-designed, prospective randomized controlled study.Bile duct cancer or cholangiocarcinoma, which arises from the epithelium of bile ducts, is the second most common primary malignant tumor of the liver after hepatocellular carcinoma.1 Although hepatic resection represents the primary treatment for cholangiocarcinoma, extensive perineural and lymphatic invasion, bilateral liver involvement and vascular encasement frequently preclude potentially complete resection.2 In addition, extensive surgical resection is not tolerated in patients with primary sclerosing cholangitis (PSC) because of the underlying liver dysfunction.3 Even if curative resection is achieved, cholangiocarcinoma, to date, remains a devastating and challenging disease with 5-year survival rates reported from 20 to 40%. 4 As for palliative modalities including biliary drainage, irradiation or chemotherapy and photodynamic therapy, the median survival for unresectable individuals is less than 12 months. 1Since the late 1990s, orthotopic liver transplantation (OLT) has been established for end-stage liver disease as well as hepatocellular carcinoma.5 Total hepatectomy followed by subsequent OLT seems to offer a chance for significant prolongation of survival with wide tumor-free margins and without underlying liver disease.6 Taken into consideration, OLT was initially proposed as an optimal solution for patients with irresectable cholangiocarcinoma.7-10 Despite sound theoretical argument in favor of liver transplantation, the early experience with OLT alone for bile duct cancer was uniformly disappointing because of frequent tumor relapse. 11-13Reports from Hannover in 1996 described that 1-, 3-and 5-year survival rates for 25 liver transplants of proxima...

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Efficacy and safety of liver transplantation in patients with cholangiocarcinoma: A systematic review and meta‐analysis

Bai

Shi

et al. 2012

Intl Journal of Cancer

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“…Recent studies report 5-year survival following complete surgical resection of the perihilar cholangiocarcinoma combined with major hepatic resections in the range of 25–40 % 3 , 6. In addition to resection, liver transplantation may also offer a curative treatment option for selected patients suffering from hilar cholangiocarcinoma 7 – 9. The UICC TNM classification aims to reflect the outcome of patients with perihilar cholangiocarcinoma 3 , 10 – 12.…”

mentioning

confidence: 99%

Comparison of the Sixth and the Seventh Editions of the UICC Classification for Perihilar Cholangiocarcinoma

Juntermanns¹,

Sotiropoulos²,

Radünz³

et al. 2012

Ann Surg Oncol

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“…[129][130][131][132] There is retrospective evidence suggesting that neoadjuvant chemoradiation followed by liver transplantation is highly effective for selected patients with hilar cholangiocarcinoma. [133][134][135] Results from 2 studies suggest that the combination of liver transplantation and neoadjuvant and/or adjuvant chemoradiation is associated with higher RFS than a potentially curative resection.…”

Section: Management Of Extrahepatic Cholangiocarcinomamentioning

confidence: 99%