Is liver transplantation a viable option for the treatment of intrahepatic cholangiocarcinoma?

Prakash, Gagan S.; Amin, Arpit; Paterno, Flavio; Brown, Lloyd; Guarrera, James V.; Lunsford, Keri E.

doi:10.1002/jso.26573

Cited by 3 publications

(3 citation statements)

References 9 publications

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“…[ 48 ] Moreover, the high rate of neoadjuvant chemotherapy (61.4% of LT patients) and neoadjuvant radiation (42.1% of LT patients) has raised some skepticism, especially given that iCCA does not represent an accepted LT indication in the USA and hence receiving such treatments would be unlikely, given that most would presumably only be identified incidentally on the liver explant. [ 49 ] Though smaller case series have evaluated outcomes of LT in iCCA patients who received previous neoadjuvant therapy, these numbers are significantly lower than those presented. [ 22,48,50 ] This may be related to issues inherent to large registries, such as misclassification.…”

Section: Lr Versus Ltmentioning

confidence: 99%

“…However, as further evidence accumulates either in support of LT in iCCA or for settings where LT should not be considered for iCCA, revision of the NLRB guidance document to include such guidance may be needed. [ 49 ] The use of living donor liver transplant (LDLT) is another option that would secure a graft for the patients enrolled in the trials, though not all patients have a suitable living donor, and not all centers offer LDLT. Certain countries such as Norway, with a less pronounced organ scarcity, may be instrumental in further accelerating trial results and exploring the limits of patient selection, as has been observed with the previous SECA trials with LT for patients with colorectal liver metastases.…”

Section: Mmajccc Prospective Case Seriesmentioning

confidence: 99%

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Liver Transplantation for Intrahepatic Cholangiocarcinoma: Ready for Prime Time?

Ivanics

Heimbach

2022

Hepatology

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Cholangiocarcinoma (CCA) represents the second-most common primary liver malignancy after HCC and has risen in incidence globally in the past decades. Intrahepatic cholangiocarcinoma (iCCA) comprises 20% of all CCAs, with the rest being extrahepatic (including perihilar [pCCA] and distal CCA). Though long representing an absolute contraindication for liver transplantation (LT), recent analyses of outcomes of LT for iCCA have suggested that iCCA may be a potentially feasible option for highly selected patients.This has been motivated both by successes noted in outcomes of LT for other malignancies, such as HCC and pCCA, and by several retrospective reviews demonstrating favorable results with LT for a selected group of iCCA patients with small lesions. LT for iCCA is primarily relevant within two clinical scenarios. The first includes patients with very early disease (single tumor, ≤2 cm) with cirrhosis and are not candidates for liver resection (LR). The second scenario is patients with locally advanced iCCA, but where the extent of LR would be too extensive to be feasible. Preliminary single-center reports have described LT in a selected group of patients with locally advanced tumors who have responded to neoadjuvant therapy and have a period of disease stability. Currently, there are three prospective trials underway that will help clarify the role of LT in iCCA. This review seeks to explore the available studies involving LT for iCCA, the challenges of ongoing trials, and opportunities for the future.

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Section: Lr Versus Ltmentioning

confidence: 99%

Section: Mmajccc Prospective Case Seriesmentioning

confidence: 99%

Liver Transplantation for Intrahepatic Cholangiocarcinoma: Ready for Prime Time?

Ivanics

Heimbach

2022

Hepatology

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“…The 5-year OS rate in patients with ICC after LT was 52.8%, which was significantly higher than that in patients with ICC following LR (HR = 0.62, p = 0.009). The results of our study are encouraging because it is generally accepted in the transplant community that a 5-year OS rate of at least 50–60% is required for a transplant indication to be considered acceptable 20 .…”

Section: Discussionmentioning

confidence: 56%

Liver transplantation for intrahepatic cholangiocarcinoma: a propensity score-matched analysis

Huang

Song

Zhang

et al. 2023

Sci Rep

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Liver resection (LR) is the only recommended effective curative treatment for patients with intrahepatic cholangiocarcinoma (ICC), but the prognosis of patients with ICC is still poor even after curative resection. Recently, many researchers focused on the therapeutic value of LT for patients with ICC. This study aimed to identify the role of liver transplantation in patients with ICC by internally comparing with LR in ICC and externally comparing with LT in HCC. We obtained patient data from SEER database. Propensity score methods were applied to control confounders. Survival outcome was estimated using Kaplan–Meier survival curves and compared using the log-rank test. A total of 2538 patients with ICC after surgery and 5048 patients with HCC after LT between 2000 and 2019 were included in this study. The prognosis of patients with ICC after LT were better than patients with ICC after LR in both unmatched (HR 0.65, P = 0.002) and matched cohorts (HR 0.62, P = 0.009). The 5-year OS rate after LT could be improved to 61.7% in patients with local advanced ICC after neoadjuvant chemotherapy. In conclusion, our study demonstrated that the prognosis of patients with ICC after LT was better than patients with ICC after LR, but was still worse than patients with HCC after LT. LT with neoadjuvant chemotherapy should be considered as a treatment option for patients with locally advanced ICC, but more prospective multicenter clinical trials are needed to further confirm these results.

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Contemporary trends and outcomes after liver transplantation and resection for intrahepatic cholangiocarcinoma

Howell,

Rhodin,

Shaw

et al. 2024

Journal of Gastrointestinal Surgery

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Is liver transplantation a viable option for the treatment of intrahepatic cholangiocarcinoma?

Cited by 3 publications

References 9 publications

Liver Transplantation for Intrahepatic Cholangiocarcinoma: Ready for Prime Time?

Liver Transplantation for Intrahepatic Cholangiocarcinoma: Ready for Prime Time?

Liver transplantation for intrahepatic cholangiocarcinoma: a propensity score-matched analysis

Contemporary trends and outcomes after liver transplantation and resection for intrahepatic cholangiocarcinoma

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