Locoregional therapies in cholangiocarcinoma

Abstract

Cholangiocarcinoma is a rare and aggressive malignancy of the biliary tract. Complete surgical resection can be curative, but the majority of patients are diagnosed with advanced disease and usually die within a year of diagnosis. Most deaths are attributable to local disease progression rather than distant metastases, supporting the use of locoregional therapies. There is evidence that locoregional therapies can provide local tumor control resulting in increased survival while avoiding some of the side effects of systemic treatments, increasing potential treatment options for patients who may be unsuitable for systemic palliative treatments. This review considers the evidence for locoregional therapies in cholangiocarcinoma, which can be classified into endoscopic, vascular, percutaneous and radiation oncological therapies. Current guidelines do not recommend the routine use of locoregional therapies due to a lack of prospective data, but the results of ongoing trials are likely to increase the evidence base and impact on clinical practice.

Safety and efficacy of irreversible electroporation in the treatment of obstructive jaundice in advanced hilar cholangiocarcinoma

“…To address this issue, advanced HC palliation has been improved by combining biliary decompression with a range of locoregional therapies, such as photodynamic therapy (PDT), radiofrequency ablation (RFA), and chemo/radiotherapy (RT). [22][23][24][25][26] These therapies yield increased tumor decompression time, though, unlike IRE, the stent or catheter is never removed.…”

Evaluation of positive ductal margins of biliary tract cancer in intraoperative histological examination

“…Some report showed the radiotherapy for biliary tract cancer (38). However, the radiotherapy for biliary tract cancer is not established.…”

“…However, the radiotherapy for biliary tract cancer is not established. Some report showed the benefit of disease-free survival (39), but the evidence is insufficient due to the small number (<10) of 5-year survivors and retrospective study (38). Moreover, some reports have revealed the effectiveness of chemotherapy for biliary tract cancer (40).…”

Erfolgreiche intraduktale Radiofrequenzablation residuellen Adenomgewebes nach endoskopischer Papillektomie

“…ihre Reste im zentralen Papillenbereich könnte die intraduktale Radiofrequenzablation (RFA) darstellen. In der palliativen Therapie cholangiozellulärer Karzinome (CCC) hat die intraduktale RFA bereits einen gewissen Stellenwert [6,7]. Im Rahmen einer ERCP wird der die RFA-Sonde tragende Katheter transpapillär nach intraduktal über die tumorbedingte Engstelle vorgelegt.…”