Resection for intrahepatic cholangiocellular cancer: new advances

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dc.contributorSistema FMUSP-HC: Faculdade de Medicina da Universidade de São Paulo (FMUSP) e Hospital das Clínicas da FMUSP
dc.contributor.authorWAISBERG, Daniel R.
dc.contributor.authorPINHEIRO, Rafael S.
dc.contributor.authorNACIF, Lucas S.
dc.contributor.authorROCHA-SANTOS, Vinicius
dc.contributor.authorMARTINO, Rodrigo B.
dc.contributor.authorARANTES, Rubens M.
dc.contributor.authorDUCATTI, Liliana
dc.contributor.authorLAI, Quirino
dc.contributor.authorANDRAUS, Wellington
dc.contributor.authorD'ALBUQUERQUE, Luiz C.
dc.date.accessioned2018-11-21T17:01:29Z
dc.date.available2018-11-21T17:01:29Z
dc.date.issued2018
dc.description.abstractIntrahepatic cholangiocarcinoma (ICC) is the second most prevalent primary liver neoplasm after hepatocellular carcinoma (HCC), corresponding to 10% to 15% of cases. Pathologies that cause chronic biliary inflammation and bile stasis are known predisposing factors for development of ICC. The incidence and cancer-related mortality of ICC is increasing worldwide. Most patients remain asymptomatic until advance stage, commonly presenting with a liver mass incidentally diagnosed. The only potentially curative treatment available for ICC is surgical resection. The prognosis is dismal for unresectable cases. The principle of the surgical approach is a margin negative hepatic resection with preservation of adequate liver remnant. Regional lymphadenectomy is recommended at time of hepatectomy due to the massive impact on outcomes caused by lymph node (LN) metastasis. Multicentric disease, tumor size, margin status and tumor differentiation are also important prognostic factors. Staging laparoscopy is warranted in high-risk patients to avoid unnecessary laparotomy. Exceedingly complex surgical procedures, such as major vascular, extrahepatic bile ducts and visceral resections, ex vivo hepatectomy and autotransplantation, should be implemented in properly selected patients to achieve negative margins. Neoadjuvant therapy may be used in initially unresectable lesions in order to downstage and allow resection. Despite optimal surgical management, recurrence is frustratingly high. Adjuvant chemotherapy with radiation associated with locoregional treatments should be considered in cases with unfavorable prognostic factors. Selected patients may undergo re-resection of tumor recurrence. Despite the historically poor outcomes of liver transplantation for ICC, highly selected patients with unresectable disease, especially those with adequate response to neoadjuvant therapy, may be offered transplant. In this article, we reviewed the current literature in order to highlight the most recent advances and recommendations for the surgical treatment of this aggressive malignancy.
dc.description.indexPubMed
dc.identifier.citationTRANSLATIONAL GASTROENTEROLOGY AND HEPATOLOGY, v.3, article ID 60, 13p, 2018
dc.identifier.doi10.21037/tgh.2018.08.03
dc.identifier.eissn2415-1289
dc.identifier.issn2224-476X
dc.identifier.urihttps://observatorio.fm.usp.br/handle/OPI/29469
dc.language.isoeng
dc.publisherAME PUBL CO
dc.relation.ispartofTranslational Gastroenterology and Hepatology
dc.rightsrestrictedAccess
dc.rights.holderCopyright AME PUBL CO
dc.subjectCholangiocarcinoma
dc.subjectbiliary tract cancer
dc.subjectintrahepatic
dc.subjectsurgery
dc.subjectresection
dc.subjectliver transplantation
dc.subject.otherportal-vein ligation
dc.subject.otherassociating liver partition
dc.subject.otherprimary sclerosing cholangitis
dc.subject.otherlong-term survival
dc.subject.otherhepatic resection
dc.subject.othermultiinstitutional analysis
dc.subject.otherhepatocellular-carcinoma
dc.subject.otherhepatobiliary malignancy
dc.subject.othergallbladder carcinoma
dc.subject.otherstaging laparoscopy
dc.subject.wosGastroenterology & Hepatology
dc.titleResection for intrahepatic cholangiocellular cancer: new advances
dc.typearticle
dc.type.categoryreview
dc.type.versionpublishedVersion
dspace.entity.typePublication
hcfmusp.affiliation.countryItália
hcfmusp.affiliation.countryisoit
hcfmusp.author.externalLAI, Quirino:Univ Aquila, San Salvatore Hosp, Dept Surg, Transplant Unit, Laquila, Italy
hcfmusp.citation.scopus33
hcfmusp.contributor.author-fmusphcDANIEL REIS WAISBERG
hcfmusp.contributor.author-fmusphcRAFAEL SOARES NUNES PINHEIRO
hcfmusp.contributor.author-fmusphcLUCAS SOUTO NACIF
hcfmusp.contributor.author-fmusphcVINICIUS ROCHA SANTOS
hcfmusp.contributor.author-fmusphcRODRIGO BRONZE DE MARTINO
hcfmusp.contributor.author-fmusphcRUBENS MACEDO ARANTES JUNIOR
hcfmusp.contributor.author-fmusphcLILIANA DUCATTI LOPES
hcfmusp.contributor.author-fmusphcWELLINGTON ANDRAUS
hcfmusp.contributor.author-fmusphcLUIZ AUGUSTO CARNEIRO D ALBUQUERQUE
hcfmusp.description.articlenumber60
hcfmusp.description.volume3
hcfmusp.origemWOS
hcfmusp.origem.pubmed30363713
hcfmusp.origem.scopus2-s2.0-85053677729
hcfmusp.origem.wosWOS:000446568500003
hcfmusp.publisher.citySHATIN
hcfmusp.publisher.countryPEOPLES R CHINA
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