Past, Present, and Future Management of Localized Biliary Tract Malignancies

Li, Janet; Rocha, Flavio G.; Mayo, Skye C.

doi:10.1016/j.soc.2022.07.007

Cited by 3 publications

(1 citation statement)

References 42 publications

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“…As there are contrasting outcomes in low-risk patients, a study by Munir et al [ 35 ] examined the adherence to NCCN guidelines in low-risk resectable CCA, showing improved survival among this group of patients. This study demonstrated that following the evidence-based guidelines was associated with a reduced risk of about 15% of deaths, compared with non-compliance among CCA patients with R0 resection and negative regional lymph nodes [ 35 , 36 ].…”

Section: Adjuvant Therapymentioning

confidence: 99%

Current Perspectives in Liver Transplantation for Perihilar Cholangiocarcinoma

et al. 2023

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Cholangiocarcinoma (CCA) encompasses all malignant neoplasms arising from the epithelial cells of the biliary tree. About 40% of CCAs are perihilar, involving the bile ducts distal to the second-order biliary branches and proximal to the cystic duct implant. About two-thirds of pCCAs are considered unresectable at the time of diagnosis or exploration. When resective surgery is deemed unfeasible, liver transplantation (LT) could be an effective alternative. The overall survival rates after LT at 1 and 3 years are 91% and 81%, respectively. The overall five-year survival rate after transplantation is 73% (79% for patients with underlying PSC and 63% for de novo pCCA). Multicenter case series reported a 5-year disease-free survival rate of ~65%. However, different protocols, including neoadjuvant therapy, have been proposed. The scarcity of organ availability represents a crucial limiting factor in recommending LT preferentially in treating pCCA. Living donor transplantations and marginal cadaveric allografts have proven to be exciting options to overcome organ shortage. Management of jaundice and cholangitis is still challenging for these patients and could impact LT listing. Whether to adopt surgical resection or LT as standard-of-care in pCCA is still a matter of debate, and more prospective studies are needed.

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Section: Adjuvant Therapymentioning

confidence: 99%