Evaluation and management of intrahepatic and extrahepatic cholangiocarcinoma

Esnaola, Nestor F.; Meyer, Joshua E.; Karachristos, Andreas; Maranki, Jennifer; Camp, E. Ramsay; Denlinger, Crystal S.

doi:10.1002/cncr.29692

Cited by 228 publications

(185 citation statements)

References 248 publications

(623 reference statements)

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“…29 In this circumstance, liver abscesses can develop manifesting as peripheral enhancing lesions in the liver, which resembles the appearances of intrahepatic metastases. Even though some previous work suggested imaging features on MR imaging differentiating hepatic abscesses from metastases, 30 it is challenging to distinguish these two conditions particularly when the lesions are small.…”

Section: 김소연 수술 전 영상학적 평가mentioning

confidence: 99%

Preoperative Radiologic Evaluation of Cholangiocarcinoma

Kim

2017

Korean J Gastroenterol

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In patients with cholangiocarcinoma, surgical resection with curative intent is the only way to achieve cure. Since surgical resection of cholangiocarcinomas is technically demanding, determination of resectability and accurate preoperative staging are crucial. For these purposes, high quality imaging including multidetector computed tomography and magnetic resonance imaging with magnetic resonance cholangiopancreaticography, is mandatory. This article will present recent advances in imaging techniques for cholangiocarginomas, potential pitfalls in imaging evaluation, and a checklist for preoperative radiologic assessment of resectability in these patients with an emphasis on perihilar cholangiocarinoma. (Korean J Gastroenterol 2017;69:159-163)

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Section: 김소연 수술 전 영상학적 평가mentioning

confidence: 99%

Preoperative Radiologic Evaluation of Cholangiocarcinoma

Kim

2017

Korean J Gastroenterol

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“…There is common consensus that preoperative biliary drainage is not required unless additional liver resection or neoadjuvant therapy is planned [7]. …”

Section: Extrahepatic Distal Cholangiocarcinomamentioning

confidence: 99%

“…In this regard, distal cholangiocarcinoma has the highest resectability and the most favorable outcome due to its anatomical properties when compared with the other tumor localizations [7]. Thus, anatomical localization and special growth pattern are essential for planning surgery.…”

Section: Introductionmentioning

confidence: 99%

Surgical Therapy of Cholangiocarcinoma

Radtke

Königsrainer

2016

Visc Med

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Background: The majority of patients with cholangiocarcinoma present with advanced disease that is often challenging to diagnose and to treat. The optimal preoperative evaluation requires a coordinated multidisciplinary approach. Surgical resection is the mainstay of therapy. Methods: This systematic review delineates surgical treatment strategies for cholangiocarcinoma in general as well as special considerations concerning the particular tumor localization. A literature search (see keywords) was conducted using PubMed and publications between 1990 and 2016 regarding resectable and advanced cholangiocarcinoma were reviewed. Selected studies were utilized based on their significance and innovation. Results: The type and extent of resection performed depends on the location of the cholangiocarcinoma within the liver or biliary tree and the extent of local tumor invasion. The common surgical strategy contains: (i) for intrahepatic tumors: tailored partial hepatectomy combined with extended hilar, suprapancreatic, celiac axis lymphadenectomy, (ii) for hilar tumors: complete resection of the extrahepatic biliary tree combined with extended hepatectomy inclusive of segment I, resection of portal vein bifurcation, and systematic N1/N2 lymphadenectomy, and (iii) for distal tumors: en bloc pancreatoduodenectomy combined with complete resection of the extrahepatic bile duct below the hepatic confluence and systematic N1/N2 lymphadenectomy. Pathologic confirmation is not required prior to resection. Preoperative biliary drainage and remnant liver volume augmentation are necessary in selected patients with intrahepatic or hilar cholangiocarcinoma considered for extensive liver resection. Conclusion: Cure for cholangiocarcinoma requires complete surgical resection with histologically negative margins. R0 resection provides a satisfactory long-term outcome in patients with lymph node-negative stage. Neoadjuvant treatment followed by liver transplantation provides long-term survival in highly selected cases with localized, unresectable, lymph node-negative hilar cholangiocarcinoma.

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“…(1, 2) The American Cancer Society estimated 11,420 new cases of, and 3,710 deaths, from gallbladder cancer and extrahepatic cholangiocarcinoma in 2016. (3) Cure for both requires complete surgical resection with histologically negative margins.…”

Section: Introductionmentioning

confidence: 99%

Evaluating the American College of Surgeons National Surgical Quality Improvement project risk calculator: results from the U.S. Extrahepatic Biliary Malignancy Consortium

Beal

Lyon

Kearney

et al. 2017

HPB

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Background The objective of this study is to evaluate use of the American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP) online risk calculator for estimating common outcomes after operations for gallbladder cancer and extrahepatic cholangiocarcinoma. Methods Subjects from the United States Extrahepatic Biliary Malignancy Consortium (USE-BMC) who underwent operation between January 1, 2000 and December 31, 2014 at 10 academic medical centers were included in this study. Calculator estimates of risk were compared to actual outcomes. Results The majority of patients underwent partial or major hepatectomy, Whipple procedures or extrahepatic bile duct resection. For the entire cohort, c-statistics for surgical site infection (0.635), reoperation (0.680) and readmission (0.565) were less than 0.7. The c-statistic for death was 0.740. For all outcomes the actual proportion of patients experiencing an event was much higher than the median predicted risk of that event. Similarly, the group of patients who experienced an outcome did have higher median predicted risk than those who did not. Conclusions The ACS NSQIP risk calculator is easy to use butrequires further modifications to more accurately estimate outcomes for some patient populations and operations for which validation studies show suboptimal performance.

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Evaluation and management of intrahepatic and extrahepatic cholangiocarcinoma

Cited by 228 publications

References 248 publications

Preoperative Radiologic Evaluation of Cholangiocarcinoma

Preoperative Radiologic Evaluation of Cholangiocarcinoma

Surgical Therapy of Cholangiocarcinoma

Evaluating the American College of Surgeons National Surgical Quality Improvement project risk calculator: results from the U.S. Extrahepatic Biliary Malignancy Consortium

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