Surgical management of intrahepatic cholangiocarcinoma: resection versus liver transplantation

  • Ilenia Bartolini Department of Clinical and Experimental Medicine, AOU Careggi
  • Matteo Risaliti
  • Laura Fortuna
  • Carlotta Agostini
  • Maria Novella Ringressi
  • Antonio Taddei
  • Paolo Muiesan

Abstract

Intrahepatic cholangiocarcinoma (ICC) is the second most common liver primary tumour after hepatocellular carcinoma and represents 20% of all the cholangiocarcinomas. Its incidence is increasing and mortality rates are rising. Surgical resection is the only option to cure the disease, despite the high recurrence rates reported to be up to 80%. Intrahepatic recurrences may be still treated with curative intent in a small percentage of the patients. Unfortunately, due to lack of specific symptoms, most patients are diagnosed in a late stage of disease and often unsuitable for resection. Liver transplantation for ICC is still controversial. After the first published poor results, improving outcomes have been reported in highly selected cases, including locally advanced ICC treated with neoadjuvant chemotherapy, when successful in controlling tumour progression. Thus, liver transplantation should be considered a possible option within study protocols. When surgical management is not possible, palliative treatments include chemotherapy, radiotherapy and loco-regional treatments such as radiofrequency ablation, trans-arterial chemoembolization or radio embolization.

This update on the management of ICC focusses on surgical treatments. Known and potential prognostic factors are highlighted in order to assist in treatment selection.

Published
2020-09-02
How to Cite
Bartolini, I., Risaliti, M., Fortuna, L., Agostini, C., Ringressi, M. N., Taddei, A., & Muiesan, P. (2020). Surgical management of intrahepatic cholangiocarcinoma: resection versus liver transplantation. Radiology and Oncology, 54(3), 263-271. Retrieved from https://radioloncol.com/index.php/ro/article/view/3457
Section
Review