EASL-ILCA Clinical Practice Guidelines on the management of intrahepatic cholangiocarcinoma

Chemotherapy with or without selective internal radiation therapy for intrahepatic cholangiocarcinoma: Data from clinical trials

“…This analysis provides novel evidence regarding the potential role of SIRT in liver-only iCCA. Indeed, current guidelines diverge regarding the role of SIRT: the European Association for the Study of the Liver-International Liver Cancer Association guidelines state that intra-arterial therapies may be a reasonable alternative in selected patients with unresectable disease; [11] the European Society for Medical Oncology guidelines place them only after providing standard of care systemic treatment [10] and finally the AASLD guidelines consider the current data insufficient to make a recommendation. [12] This might be due to the current absence of comparative data and the heterogeneity of results presented in retrospective series.…”

“…The BINGO trial was a randomized phase 2 trial comparing gemcitabineoxaliplatin (GEMOX regimen: gemcitabine 1000 mg/m 2 and oxaliplatin 100 mg/m 2 given every 2 weeks) with or without cetuximab (an EGFR-targeting monoclonal antibody) and included 150 patients. [11] The trial was negative, with no improvement of the primary end point, 4-month PFS rate, and no difference in PFS, OS, or RR. The PRODIGE 38 AMEBICA trial was a planned randomized phase 2/3 trial that compared CISGEM with FOLFIRINOX (oxaliplatin 85 mg/m 2 , irinotecan 180 mg/m 2 , folinic acid 400 mg/m 2 , and fluorouracil 2400 mg/m 2 over 46 h, every 2 wk) and included 190 patients.…”

“…Probably due to the limitations of the current data, recommendations currently diverge regarding the role of SIRT, or more generally loco-regional treatments, for liver-only iCCA, with the European Society for Medical Oncology and European Association for the Study of the Liver-International Liver Cancer Association guidelines recently suggesting that loco-regional treatments might be considered an option, while the recent AASLD guidelines stating that data are insufficient to recommend loco-regional treatment as a standard therapy for locally advanced unresectable iCCA. [10][11][12] We thus planned to compare individual-patient level data of patients treated within MISPHEC with those of patients treated with first-line chemotherapy alone within prospective clinical trials, focusing on the population with liver-only iCCA, using robust methods for matching of population.…”

Preoperative Endoscopic Ultrasound-Guided Hepaticogastrostomy for Definite Biliary Drainage in Hilar Cholangiocarcinoma Laparoscopic Resection: A Hybrid Minimal-Invasive Technique

“…Perihilar cholangiocarcinoma (PHC) is a rare but aggressive biliary duct cancer of either the extrahepatic main biliary confluence or intrahepatic small bile ducts adjacent to the biliary confluence and invading the hepatic hilum. 1 Radical resection is the only intent to cure treatment but is characterized by a complex surgical management requiring major liver resections with biliary reconstructions. 1,2 It is thus generally admitted that open surgery is the standard of care and the postoperative course is consequently often complicated, with severe morbidity (27.5%-54%) and mortality rates (18%).…”

“…1 Radical resection is the only intent to cure treatment but is characterized by a complex surgical management requiring major liver resections with biliary reconstructions. 1,2 It is thus generally admitted that open surgery is the standard of care and the postoperative course is consequently often complicated, with severe morbidity (27.5%-54%) and mortality rates (18%). 2 Moreover, 5-year patient survival rarely exceeds 35%.…”