Katherine E Poruk1, Timothy M Pawlik1, Matthew J Weiss2. 1. Department of Surgery, The Johns Hopkins University School of Medicine, Halsted 614 600 N. Wolfe Street, Baltimore, MD, 21287, USA. 2. Department of Surgery, The Johns Hopkins University School of Medicine, Halsted 614 600 N. Wolfe Street, Baltimore, MD, 21287, USA. mweiss5@jhmi.edu.
Abstract
BACKGROUND: Cholangiocarcinoma is the most common primary tumor of the biliary tract although it accounts for only 2 % of all human malignancies. We herein review hilar cholangiocarcinoma including its risk factors, the main classification systems for tumors, current surgical management of the disease, and the role chemotherapy and liver transplantation may play in selected patients. METHODS: We performed a comprehensive literature search using PubMed, Medline, and the Cochrane library for the period 1980-2015 using the following MeSH terms: "hilar cholangiocarcinoma", "biliary cancer", and "cholangiocarcinoma". Only recent studies that were published in English and in peer reviewed journals were included. FINDINGS: Hilar cholangiocarcinoma is a disease of advanced age with an unclear etiology, most frequently found in Southeast Asia and relatively rare in Western countries. The best chance of long-term survival and potential cure is surgical resection with negative surgical margins, but many patients are unresectable due to locally advanced or metastatic disease at diagnosis. As a result of recent efforts, new methods of management have been identified for these patients, including preoperative portal vein embolism and biliary drainage, neoadjuvant chemotherapy with subsequent transplantation, and chemoradiation therapy. CONCLUSION: Current management of hilar cholangiocarcinoma depends on extent of the tumor at presentation and includes surgical resection, liver transplantation, portal vein embolization, and chemoradiation therapy. Our understanding of hilar cholangiocarcinoma has improved in recent years and further research offers hope to improve the outcome in patients with these rare tumors.
BACKGROUND:Cholangiocarcinoma is the most common primary tumor of the biliary tract although it accounts for only 2 % of all humanmalignancies. We herein review hilar cholangiocarcinoma including its risk factors, the main classification systems for tumors, current surgical management of the disease, and the role chemotherapy and liver transplantation may play in selected patients. METHODS: We performed a comprehensive literature search using PubMed, Medline, and the Cochrane library for the period 1980-2015 using the following MeSH terms: "hilar cholangiocarcinoma", "biliary cancer", and "cholangiocarcinoma". Only recent studies that were published in English and in peer reviewed journals were included. FINDINGS:Hilar cholangiocarcinoma is a disease of advanced age with an unclear etiology, most frequently found in Southeast Asia and relatively rare in Western countries. The best chance of long-term survival and potential cure is surgical resection with negative surgical margins, but many patients are unresectable due to locally advanced or metastatic disease at diagnosis. As a result of recent efforts, new methods of management have been identified for these patients, including preoperative portal vein embolism and biliary drainage, neoadjuvant chemotherapy with subsequent transplantation, and chemoradiation therapy. CONCLUSION: Current management of hilar cholangiocarcinoma depends on extent of the tumor at presentation and includes surgical resection, liver transplantation, portal vein embolization, and chemoradiation therapy. Our understanding of hilar cholangiocarcinoma has improved in recent years and further research offers hope to improve the outcome in patients with these rare tumors.
Authors: K M Boberg; A Bergquist; S Mitchell; A Pares; F Rosina; U Broomé; R Chapman; O Fausa; T Egeland; G Rocca; E Schrumpf Journal: Scand J Gastroenterol Date: 2002-10 Impact factor: 2.423
Authors: Emmanuel E Zervos; Dana Osborne; Steven B Goldin; Desiree V Villadolid; Donald P Thometz; Alan Durkin; Larry C Carey; Alexander S Rosemurgy Journal: Am J Surg Date: 2005-11 Impact factor: 2.565
Authors: Hashem B El-Serag; Eric A Engels; Ola Landgren; Elizabeth Chiao; Louise Henderson; Harshinie C Amaratunge; Thomas P Giordano Journal: Hepatology Date: 2009-01 Impact factor: 17.425
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 O'Brien; N Bhutiani; M E Egger; A N Brown; K H Weaver; D Kline; L R Kelly; C R Scoggins; R C G Martin; G C Vitale Journal: Surg Endosc Date: 2019-05-28 Impact factor: 4.584
Authors: Gaya Spolverato; Fabio Bagante; Cecilia G Ethun; George Poultsides; Thuy Tran; Kamran Idrees; Chelsea A Isom; Ryan C Fields; Bradley Krasnick; Emily Winslow; Clifford Cho; Robert C G Martin; Charles R Scoggins; Perry Shen; Harveshp D Mogal; Carl Schmidt; Eliza Beal; Ioannis Hatzaras; Rivfka Shenoy; Shishir K Maithel; Timothy M Pawlik Journal: World J Surg Date: 2017-01 Impact factor: 3.352
Authors: Sven H Loosen; Christoph Roderburg; Katja L Kauertz; Alexander Koch; Mihael Vucur; Anne T Schneider; Marcel Binnebösel; Tom F Ulmer; Georg Lurje; Wenzel Schoening; Frank Tacke; Christian Trautwein; Thomas Longerich; Cornelis H Dejong; Ulf P Neumann; Tom Luedde Journal: Sci Rep Date: 2017-12-05 Impact factor: 4.379