Thermal Ablation Versus Repeated Hepatic Resection for Recurrent Intrahepatic Cholangiocarcinoma

Zhang, Shaojun; Hu, Peng; Wang, Neng; Shen, Qiang; Sun, Aixue; Kuang, Ming; Gao, Qian

doi:10.1245/s10434-013-3035-1

Cited by 93 publications

(102 citation statements)

References 25 publications

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“…However, for patients with recurrent ICC after surgery, it has been reported that ablation therapy (RFA or microwave ablation) have been reported to have an overall efficacy similar to that of repeated hepatic resection especially in patients with tumors up to 3 cm in diameter (24). This observation is consistent with previous reports examining the use of ablation therapies for ICC, and suggests that although ablation therapy might be effective in selected patients with recurrent ICC, its indication should be limited according to tumor size (14,16).…”

Section: Prognostic Impact and Role Of Rfa In Multidisciplinary Treatmentioning

confidence: 99%

“…In the largest series comparing ablation therapies with repeated resection for recurrent ICC, the major complication rate was 3.9% after ablation therapies, while it was 46.9% after repeated resection (24). Therefore, in a selected population with small recurrent tumors, ablation therapies could be a firstline treatment comparable with surgical resection.…”

Section: Prognostic Impact and Role Of Rfa In Multidisciplinary Treatmentioning

confidence: 99%

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Ablative therapies for intrahepatic cholangiocarcinoma

Shindoh¹

2017

Hepatobiliary Surg. Nutr.

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Intrahepatic cholangiocarcinoma (ICC) is the second most common primary hepatic malignancy.Although surgical resection has been a cornerstone in the management of ICC, the efficacies of several nonsurgical management strategies have been actively investigated and somewhat preferable outcomes have been reported for ablation therapies in selected cases. Nevertheless, because of the rarity of these tumors and the small number of studies, the clinical significance and actual role of ablation therapies in a multidisciplinary approach for ICC remain unclear. In this article, the reported outcomes of ablation therapies for ICC will be summarized and their potential indications will be discussed.

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Section: Prognostic Impact and Role Of Rfa In Multidisciplinary Treatmentioning

confidence: 99%

Section: Prognostic Impact and Role Of Rfa In Multidisciplinary Treatmentioning

confidence: 99%

Ablative therapies for intrahepatic cholangiocarcinoma

Shindoh¹

2017

Hepatobiliary Surg. Nutr.

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“…Considerable interest has been paid to various treatment options against ICC recurrence such as surgical treatment,6, 7, 8 chemotherapy,9 radiation therapy,7 radiofrequency ablation (RFA),10, 11 and transarterial chemotherapy 12, 13 with various degrees of success. In recent reports, aggressive surgical treatment for ICC recurrence led to good patient survival after recurrence, with a 3‐year overall survival (OS) rate of 25%,14 40%,6 and 100% 7.…”

Section: Introductionmentioning

confidence: 99%

Surgical management of recurrent intrahepatic cholangiocarcinoma: predictors, adjuvant chemotherapy, and surgical therapy for recurrence: A multi‐institutional study by the Kyushu Study Group of Liver Surgery

Yamashita

Shirabe²,

Beppu³

et al. 2017

Annals of Gastroent Surgery

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Objectives of the present study were to identify predictors of the recurrence of intrahepatic cholangiocarcinoma (ICC), and to evaluate the survival benefit of adjuvant chemotherapy and surgical treatment for ICC recurrence. A multi‐institutional retrospective study was carried out in 356 patients with ICC who underwent curative surgery at one of 14 institutions belonging to the Kyushu Study Group of Liver Surgery. A total of 214 patients (60%) had recurrence. Predictors of ICC recurrence were as follows: positive for pathological intrahepatic metastasis (im), positive for lymph node metastasis (n), positive for pathological lymphatic infiltration (ly), pathological bile duct invasion (b), and tumor size ≥4.4 cm. Adjuvant chemotherapy was given to 120 patients (34%) and, in the patients with im or tumor size ≥4.4 cm, adjuvant chemotherapy showed a survival benefit. Only 37 patients (17%) underwent surgical treatment for ICC recurrence. The surgical treatment resulted in a good 5‐year survival rate (44%), which is similar to the rate obtained by the first operation for primary ICC. Prognosis of patients with primary im after the second operation was significantly worse (5‐year survival 18%) compared to patients without primary im. Primary im+ should be considered a contraindication for surgical treatment for ICC recurrence.

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“…The postoperative recurrence rate of ICC remains high, and occurs in 50-80 % of cases even after curative resection [11,21,[38][39][40]72]. No effective treatments have been established for unresectable or recurrent ICC, and the prognosis of patients with these advanced ICCs is extremely poor.…”

Section: Treatments For Recurrent Iccmentioning

confidence: 99%

“…The development of effective adjuvant chemotherapy regimens can help to improve the postoperative outcomes of patients with ICC as many of them have advanced disease. Recently, aggressive treatments, including repeated hepatic resection and radiofrequency ablation (RFA) therapy are increasingly being used to treat recurrent ICC, which may prolong patient survival [21,[36][37][38][39][40][41][42]. Despite the many advances in ICC treatment, no standard strategy has been established.…”

Section: Introductionmentioning

confidence: 99%

Surgical treatment for intrahepatic cholangiocarcinoma

Uenishi

Yamamoto

Takemura

et al. 2014

Clin J Gastroenterol

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Despite surgical treatment for intrahepatic cholangiocarcinoma (ICC) becoming more widely available, the prognosis after hepatic resection for ICC remains poor. Because ICC is relatively rare, the TNM staging system for ICC was finally established in the 2000s. Resection margin status and lymph node metastases are important prognostic factors after surgery for ICC; however, the true impact of wide resection margins or lymph node dissection on postoperative survival is unclear. Although adjuvant chemotherapy can improve the postoperative prognosis of patients with various types of cancer, no standard regimen has been developed for ICC. Over 50 % of patients suffer postoperative recurrence, even after curative resection, and no effective treatment for recurrent ICC has been established. Therefore, despite advances in imaging studies and hepatobiliary surgery, significant challenges remain in improving the prognosis of patients with ICC.

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Thermal Ablation Versus Repeated Hepatic Resection for Recurrent Intrahepatic Cholangiocarcinoma

Abstract: Repeated HR and TAT are both effective treatments for RICC with similar overall efficacies. TAT should be preferred in any cases when the RICC is ≤3 cm in diameter and technically feasible. However, for large tumors (>3 cm), repeated HR may be a better choice.

Cited by 93 publications

References 25 publications

Ablative therapies for intrahepatic cholangiocarcinoma

Ablative therapies for intrahepatic cholangiocarcinoma

Surgical management of recurrent intrahepatic cholangiocarcinoma: predictors, adjuvant chemotherapy, and surgical therapy for recurrence: A multi‐institutional study by the Kyushu Study Group of Liver Surgery

Surgical treatment for intrahepatic cholangiocarcinoma

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