Yifan Wang1, Mario Strazzabosco2, David C Madoff3,4. 1. Department of Radiology and Biomedical Imaging, Section of Interventional Radiology, Yale School of Medicine, New Haven, CT, USA. 2. Department of Internal Medicine, Section of Digestive Diseases, Yale School of Medicine, New Haven, CT, USA. 3. Department of Radiology and Biomedical Imaging, Section of Interventional Radiology, Yale School of Medicine, New Haven, CT, USA. david.madoff@yale.edu. 4. Department of Internal Medicine, Section of Medical Oncology, Yale School of Medicine, New Haven, CT, USA. david.madoff@yale.edu.
Abstract
PURPOSE OF REVIEW: Intrahepatic cholangiocarcinoma (iCCA) carries a dismal prognosis and, despite increasing incidence, still lacks effective treatments. In this scenario, locoregional therapies (LRT) are gaining interest as they may be effective at local tumor control and complementary to surgical and non-surgical approaches. In this article, we will review the evolving role of LRT performed by interventional radiologists in the management of iCCA. RECENT FINDINGS: Accumulating retrospective evidence indicates that ablative therapies and transarterial embolizations are of benefit for iCCA with unresectable disease, demonstrating promising safety profiles and prolonged or comparable survival outcomes compared to systemic therapy and surgery. Additionally, for surgical candidates, portal ± hepatic venous embolization can improve the safety of hepatectomy by inducing preoperative hypertrophy of the non-involved liver lobe. LRTs are playing an increasingly important role in the multimodal treatment of iCCA from various perspectives with reduced toxicity relative to traditional treatments. To expand the scope of applications for LRTs in this setting, future prospective randomized studies are needed to confirm their efficacy and advantage.
PURPOSE OF REVIEW: Intrahepatic cholangiocarcinoma (iCCA) carries a dismal prognosis and, despite increasing incidence, still lacks effective treatments. In this scenario, locoregional therapies (LRT) are gaining interest as they may be effective at local tumor control and complementary to surgical and non-surgical approaches. In this article, we will review the evolving role of LRT performed by interventional radiologists in the management of iCCA. RECENT FINDINGS: Accumulating retrospective evidence indicates that ablative therapies and transarterial embolizations are of benefit for iCCA with unresectable disease, demonstrating promising safety profiles and prolonged or comparable survival outcomes compared to systemic therapy and surgery. Additionally, for surgical candidates, portal ± hepatic venous embolization can improve the safety of hepatectomy by inducing preoperative hypertrophy of the non-involved liver lobe. LRTs are playing an increasingly important role in the multimodal treatment of iCCA from various perspectives with reduced toxicity relative to traditional treatments. To expand the scope of applications for LRTs in this setting, future prospective randomized studies are needed to confirm their efficacy and advantage.
Authors: Juan Valle; Harpreet Wasan; Daniel H Palmer; David Cunningham; Alan Anthoney; Anthony Maraveyas; Srinivasan Madhusudan; Tim Iveson; Sharon Hughes; Stephen P Pereira; Michael Roughton; John Bridgewater Journal: N Engl J Med Date: 2010-04-08 Impact factor: 91.245
Authors: T Okusaka; K Nakachi; A Fukutomi; N Mizuno; S Ohkawa; A Funakoshi; M Nagino; S Kondo; S Nagaoka; J Funai; M Koshiji; Y Nambu; J Furuse; M Miyazaki; Y Nimura Journal: Br J Cancer Date: 2010-07-13 Impact factor: 7.640
Authors: Umberto Cillo; Constantino Fondevila; Matteo Donadon; Enrico Gringeri; Federico Mocchegiani; Hans J Schlitt; Jan N M Ijzermans; Marco Vivarelli; Krzysztof Zieniewicz; Steven W M Olde Damink; Bas Groot Koerkamp Journal: Liver Int Date: 2019-05 Impact factor: 5.828
Authors: Alphonse E Sirica; Gregory J Gores; John D Groopman; Florin M Selaru; Mario Strazzabosco; Xin Wei Wang; Andrew X Zhu Journal: Hepatology Date: 2019-03-25 Impact factor: 17.298