BACKGROUND: The majority of patients with cholangiocarcinoma present with advanced, irresectable tumours associated with poor prognosis. The incidence and mortality rates associated with cholangiocarcinoma continue to rise, mandating the development of novel strategies for early detection, improved resection and treatment of residual lesions. AIM: To review the current evidence base for surgical, adjuvant and neo-adjuvant techniques in the management of cholangiocarcinoma. METHODS: A search strategy incorporating PubMed/Medline search engines and utilising the key words biliary tract carcinoma; cholangiocarcinoma; management; surgery; chemotherapy; radiotherapy; photodynamic therapy; and radiofrequency ablation, in various combinations, was employed. RESULTS: Data on neo-adjuvant and adjuvant techniques remain limited, and much of the literature concerns palliation of inoperable disease. The only opportunity for long-term survival remains surgical resection with negative pathological margins or liver transplantation, both of which remain possible in only a minority of selected patients. Neo-adjuvant and adjuvant techniques currently provide only limited success in improving survival. CONCLUSIONS: The development of novel strategies and treatment techniques is crucial. However, the shortage of randomised controlled trials is compounded by the low feasibility of conducting adequately powered trials in liver surgery, due to the large sample sizes that are required.
BACKGROUND: The majority of patients with cholangiocarcinoma present with advanced, irresectable tumours associated with poor prognosis. The incidence and mortality rates associated with cholangiocarcinoma continue to rise, mandating the development of novel strategies for early detection, improved resection and treatment of residual lesions. AIM: To review the current evidence base for surgical, adjuvant and neo-adjuvant techniques in the management of cholangiocarcinoma. METHODS: A search strategy incorporating PubMed/Medline search engines and utilising the key words biliary tract carcinoma; cholangiocarcinoma; management; surgery; chemotherapy; radiotherapy; photodynamic therapy; and radiofrequency ablation, in various combinations, was employed. RESULTS: Data on neo-adjuvant and adjuvant techniques remain limited, and much of the literature concerns palliation of inoperable disease. The only opportunity for long-term survival remains surgical resection with negative pathological margins or liver transplantation, both of which remain possible in only a minority of selected patients. Neo-adjuvant and adjuvant techniques currently provide only limited success in improving survival. CONCLUSIONS: The development of novel strategies and treatment techniques is crucial. However, the shortage of randomised controlled trials is compounded by the low feasibility of conducting adequately powered trials in liver surgery, due to the large sample sizes that are required.
Authors: Helmut Witzigmann; Frieder Berr; Ulrike Ringel; Karel Caca; Dirk Uhlmann; Konrad Schoppmeyer; Andrea Tannapfel; Christian Wittekind; Joachim Mossner; Johann Hauss; Marcus Wiedmann Journal: Ann Surg Date: 2006-08 Impact factor: 12.969
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Authors: H A Pitt; A Nakeeb; R A Abrams; J Coleman; S Piantadosi; C J Yeo; K D Lillemore; J L Cameron Journal: Ann Surg Date: 1995-06 Impact factor: 12.969
Authors: S Kongpetch; A Puapairoj; C K Ong; L Senggunprai; A Prawan; U Kukongviriyapan; W Chan-On; E Y Siew; N Khuntikeo; B T Teh; V Kukongviriyapan Journal: Cell Prolif Date: 2016-01-04 Impact factor: 6.831
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Authors: Werner Dolak; Florian Schreiber; Hubert Schwaighofer; Michael Gschwantler; Wolfgang Plieschnegger; Alexander Ziachehabi; Andreas Mayer; Ludwig Kramer; Andreas Kopecky; Christiane Schrutka-Kölbl; Gernot Wolkersdörfer; Christian Madl; Frieder Berr; Michael Trauner; Andreas Püspök Journal: Surg Endosc Date: 2013-10-03 Impact factor: 4.584