Precarious Windows of Opportunity: Adverse Wait‐List Dropout for Cholangiocarcinoma Versus Hepatocellular Carcinoma Patients

Rizvi, Sumera; Gores, Gregory J.

doi:10.1002/lt.25854

Cited by 1 publication

(1 citation statement)

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“…Options to improve outcomes of patients that are potential LT candidates may include improved patient selection based on biology using enhanced staging techniques, including cell‐free DNA and effective neoadjuvant therapies. [ 87 ] Tumor biology will be a critical determinant of patient outcomes before and after LT. Within this context, certain histological growth patterns, like the tubular growth pattern of iCCA, have a higher association with metastatic disease than the papillary type.…”

Section: Summary: Ready For Prime Time?mentioning

confidence: 99%

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: Summary: Ready For Prime Time?mentioning

confidence: 99%