Cholangiocarcinoma: The Current Status of Surgical Options including Liver Transplantation

Authors

Abdullah Esmail, Section of GI Oncology, Department of Medicine, Houston Methodist Cancer Center, Houston, TX 77030, USA.Follow
Mohamed Badheeb, Department of Internal Medicine, Yale New Haven Health, Bridgeport Hospital, Bridgeport, CT 06605, USA.Follow
Batool Alnahar, College of Medicine, Almaarefa University, Riyadh 13713, Saudi Arabia.Follow
Bushray Almiqlash, Zuckerman College of Public Health, Arizona State University, Tempe, AZ 85287, USA.
Yara Sakr, Department of GI Medical Oncology, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.Follow
Bayan Khasawneh, Section of GI Oncology, Department of Medicine, Houston Methodist Cancer Center, Houston, TX 77030, USA.Follow
Ebtesam Al-Najjar, Section of GI Oncology, Department of Medicine, Houston Methodist Cancer Center, Houston, TX 77030, USA.Follow
Hadeel Al-Rawi, Faculty of Medicine, The University of Jordan, Amman 11942, Jordan.
Ala Abudayyeh, Division of Internal Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
Yaser Rayyan, Department of Gastroenterology & Hepatology, Faculty of Medicine, The University of Jordan, Amman 11942, Jordan.
Maen Abdelrahim, Section of GI Oncology, Department of Medicine, Houston Methodist Cancer Center, Houston, TX 77030, USA.

Document Type

Article

Publication Title

Cancers

Abstract

Cholangiocarcinoma (CCA) poses a substantial threat as it ranks as the second most prevalent primary liver tumor. The documented annual rise in intrahepatic CCA (iCCA) incidence in the United States is concerning, indicating its growing impact. Moreover, the five-year survival rate after tumor resection is only 25%, given that tumor recurrence is the leading cause of death in 53-79% of patients. Pre-operative assessments for iCCA focus on pinpointing tumor location, biliary tract involvement, vascular encasements, and metastasis detection. Numerous studies have revealed that portal vein embolization (PVE) is linked to enhanced survival rates, improved liver synthetic functions, and decreased overall mortality. The challenge in achieving clear resection margins contributes to the notable recurrence rate of iCCA, affecting approximately two-thirds of cases within one year, and results in a median survival of less than 12 months for recurrent cases. Nearly 50% of patients initially considered eligible for surgical resection in iCCA cases are ultimately deemed ineligible during surgical exploration. Therefore, staging laparoscopy has been proposed to reduce unnecessary laparotomy. Eligibility for orthotopic liver transplantation (OLT) requires certain criteria to be granted. OLT offers survival advantages for early-detected unresectable iCCA; it can be combined with other treatments, such as radiofrequency ablation and transarterial chemoembolization, in specific cases. We aim to comprehensively describe the surgical strategies available for treating CCA, including the preoperative measures and interventions, alongside the current options regarding liver resection and OLT.

DOI

10.3390/cancers16111946

Publication Date

5-21-2024

Recommended Citation

Esmail, Abdullah; Badheeb, Mohamed; Alnahar, Batool; Almiqlash, Bushray; Sakr, Yara; Khasawneh, Bayan; Al-Najjar, Ebtesam; Al-Rawi, Hadeel; Abudayyeh, Ala; Rayyan, Yaser; and Abdelrahim, Maen, "Cholangiocarcinoma: The Current Status of Surgical Options including Liver Transplantation" (2024). Internal Medicine. 26.
https://scholar.bridgeporthospital.org/internal_medicine/26

Identifier

38893067 (pubmed); PMC11171350 (pmc); 10.3390/cancers16111946 (doi); cancers16111946 (pii)