Vascular Resection for Intrahepatic Cholangiocarcinoma: Current Considerations

Alikhanov, Ruslan; Dudareva, Anna; Trigo, Miguel Ángel; Serrablo, Alejandro

doi:10.3390/jcm10173829

Cited by 4 publications

(2 citation statements)

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“…[ 21 ] Moreover, some studies have pointed out that the postoperative margin of ICC and the macrovascular and microvascular invasion of ICC may also be important factors affecting patient prognosis. [ 22 ] There have been many studies on lymph gland metastases and ICC. Patients with a high probability of lymph node metastasis should undergo lymph node dissection with IHCC resection in order to obtain more than 4 lymph nodes.…”

Section: Discussionmentioning

confidence: 99%

Biomarkers for predicting the prognosis of intrahepatic cholangiocarcinoma: A retrospective single-center study

Sun

et al. 2023

Medicine

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The aim of this retrospective study was to investigate the association between preoperative serological and clinical indicators and postoperative recovery in patients who had undergone resection of intrahepatic cholangiocarcinoma (ICC). We collected data form the medical records of patients who underwent operations for the treatment of ICC at Qingdao University Affiliated Hospital from 2015 to 2021. We analyzed the data to explore the independent predictors of disease prognosis after surgery for ICC. By univariate analysis, we found that the following factors were significantly associated with overall survival and tumor-free survival in patients with ICC: TNM stage; degree of vascular invasion; levels of hemoglobin, carcinoembryonic antigen, carbohydrate antigen 125, direct bilirubin, alkaline phosphatase, and albumin; prothrombin time; neutrophil to lymphocyte ratio; prothrombin time to albumin ratio; albumin to alkaline phosphatase ratio; albumin to gamma-glutamyl transferase ratio; prognostic nutrition Index, and incisional margin. However, only carbohydrate antigen 24-2 and glutamyl transpeptidase were correlated with overall survival in patients with ICC. However, only a positive history of biliary surgery was significantly associated with tumor-free survival in patients with ICC. Preoperative prothrombin time, vascular invasion, N-stage, incisal edge, and carcinoembryonic antigen levels may be simple predictors of disease progression in ICC after hepatectomy.

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Section: Discussionmentioning

confidence: 99%

Biomarkers for predicting the prognosis of intrahepatic cholangiocarcinoma: A retrospective single-center study

Sun

et al. 2023

Medicine

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“…Venous reconstruction can be performed with similar perioperative morbidity to conventional resection, whilst long-term survival is equivalent in some series[ 11 ]. Arterial reconstruction is associated with higher perioperative morbidity and mortality and significantly lower long-term disease-free and OS compared to standard resection, however, outcomes remain significantly superior to palliative care[ 12 , 13 ].…”

Section: Introductionmentioning

confidence: 99%

Liver transplantation in the management of cholangiocarcinoma: Evolution and contemporary advances

Borakati¹,

Froghi²,

Bhogal³

et al. 2023

World J Gastroenterol

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Cholangiocarcinoma (CCA) is an aggressive malignancy arising from the biliary epithelium. It may occur at any location along the biliary tree with the perihilar area being the most common. Prognosis is poor with 5-year overall survival at less than 10%, typically due to unresectable disease at presentation. Radical surgical resection with clear margins offers a chance of cure in patients with resectable tumours, but is frequently not possible due to locally advanced disease. On the other hand, orthotopic liver transplantation (LT) allows for a radical and potentially curative resection for these patients, but has been historically controversial due to the limited supply of donor grafts and previously poor outcomes. In patients with perihilar CCA, within specific criteria and following the implementation of a protocol combining neoadjuvant chemoradiation and LT, excellent results have been achieved in the last decades, resulting in its increasing acceptance as an indication for LT and the standard of care in several centres with significant experience. However, in intrahepatic CCA, the role of LT remains controversial and owing to dismal previous results it is not an accepted indication. Nevertheless, more recent studies have demonstrated favourable results with LT in early intrahepatic CCA, indicating that, under defined criteria, its role may increase in the future. This review highlights the history and contemporary advances of LT in CCA, with particular focus on the improving outcomes of LT in intrahepatic and perihilar CCA and future perspectives.

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