Intrahepatic Cholangiocarcinoma

Ramy El-Diwany; Timothy M Pawlik; Aslam Ejaz

doi:10.1016/j.soc.2019.06.002

Intrahepatic Cholangiocarcinoma

Surg Oncol Clin N Am. 2019 Oct;28(4):587-599. doi: 10.1016/j.soc.2019.06.002.

Authors

Ramy El-Diwany¹, Timothy M Pawlik², Aslam Ejaz³

Affiliations

¹ Department of Surgery, Johns Hopkins University, 600 N. Wolfe St, Tower 110 Baltimore, MD 21287, USA.
² Department of Surgery, The Ohio State University, 320 W. 10th Avenue, M-260 Starling Loving Hall, Columbus, OH 43210, USA.
³ Department of Surgery, Johns Hopkins University, 600 N. Wolfe St, Tower 110 Baltimore, MD 21287, USA. Electronic address: aslam.ejaz@osumc.edu.

PMID: 31472907
DOI: 10.1016/j.soc.2019.06.002

Abstract

Intrahepatic cholangiocarcinoma (ICC) arises from the epithelial cells of the intrahepatic and extrahepatic bile ducts and occurs proximal to the segmental biliary ducts. Risk factors include chronic hepatitis and cirrhosis, biliary inflammatory diseases, and hepatobiliary flukes, although in most cases, no known risk factor is identified. ICC is highly aggressive, with long-term survival only observed in patients with a complete R0 surgical resection. Technical and physiologic resectability should be considered when performing an operative plan. Nodal involvement is among the most important prognostic factors associated with survival and a porta hepatis lymphadenectomy should be performed at the time of resection. Adjuvant chemotherapy can provide a significant survival benefit for patients with more advanced or aggressive tumors. Systemic, locoregional, and targeted therapies exist for patients with unresectable or metastatic disease.

Keywords: Cholangiocarcionma; Hepatobiliary; Intrahepatic cholangiocarcinoma.

Publication types

Review

MeSH terms

Bile Duct Neoplasms / pathology*
Bile Duct Neoplasms / therapy*
Cholangiocarcinoma / pathology*
Cholangiocarcinoma / therapy*
Combined Modality Therapy
Humans
Liver Neoplasms / pathology*
Liver Neoplasms / therapy*
Prognosis