Advances in diagnosis, treatment and palliation of cholangiocarcinoma: 1990-2009.

Full Abstract

Several advances in diagnosis, treatment and palliation of cholangiocarcinoma (CC) have occurred in the last decades. A multidisciplinary approach to this disease is therefore recommended. CC is a relatively rare tumor and the main risk factors are: chronic inflammation, genetic predisposition and congenital abnormalities of the biliary tree. While the incidence of intra-hepatic CC is increasing, the incidence of extra-hepatic CC is trending down. The only curative treatment for CC is surgical resection with negative margins. Liver transplantation has been proposed only for selected patients with hilar CC that cannot be resected who have no metastatic disease after a period of neoadjuvant chemo-radiation therapy. Magnetic resonance imaging/magnetic resonance cholangiopancreatography, positron emission tomography scan, endoscopic ultrasound and computed tomography scans are the most frequently used modalities for diagnosis and tumor staging. Adjuvant therapy, palliative chemotherapy and radiotherapy have been relatively ineffective for inoperable CC. For most of these patients biliary stenting provides effective palliation. Photodynamic therapy is an emerging palliative treatment that seems to provide pain relief, improve biliary patency and increase survival. The clinical utility of other emerging therapies such as transarterial chemoembolization, hepatic arterial chemoinfusion and high intensity intraductal ultrasound needs further study.

Author information

Author/s: Aljiffry, Murad (M); Walsh, Mark J (MJ); Molinari, Michele (M);

Affiliation: Department of Surgery, Queen Elizabeth II Health Science Centre, Dalhousie University, Victoria Building, Halifax, Nova Scotia, B3H 2Y9, Canada.

Journal and publication information

Publication Type: Journal Article; Review

Journal: World journal of gastroenterology : WJG (World J Gastroenterol), published in China. (Language: eng)

Reference: 2009-Sep; vol 15 (issue 34) : pp 4240-62

Dates: Created 2009/09/14; Completed 2009/09/30;

PMID: 19750567, status: MEDLINE (last retrieval date: 9/30/2009, IMS Date: )

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

External Links for this article
(including full text providers, if available):

Click Electronic Full-text Provider Links to see options for finding the electronic full text links to this article. Note there may be a subscription or fee required for access to the full text. See our FAQ for information on finding FREE full text articles.

This article may also be located in paper journal collections available in many libraries. Use the Journal and Publication Information above to find the full article.