Liver transplantation in the management of cholangiocarcinoma:Evolution and contemporary advances  

作　　者：Aditya Borakati Farid Froghi Ricky H Bhogal Vasileios K Mavroeidis 

机构地区：[1]Department of HPB and Liver Transplantation Surgery,Royal Free Hospital NHS Foundation Trust,London NW32QG,United Kingdom [2]Department of Academic Surgery,The Royal Marsden NHS Foundation Trust,London SW36JJ,United Kingdom

出　　处：《World Journal of Gastroenterology》2023年第13期1969-1981,共13页世界胃肠病学杂志（英文版）

摘　　要：Cholangiocarcinoma(CCA)is an aggressive malignancy arising from the biliary epithelium.It may occur at any location along the biliary tree with the perihilar area being the most common.Prognosis is poor with 5-year overall survival at less than 10%,typically due to unresectable disease at presentation.Radical surgical resection with clear margins offers a chance of cure in patients with resectable tumours,but is frequently not possible due to locally advanced disease.On the other hand,orthotopic liver transplantation(LT)allows for a radical and potentially curative resection for these patients,but has been historically controversial due to the limited supply of donor grafts and previously poor outcomes.In patients with perihilar CCA,within specific criteria and following the implementation of a protocol combining neoadjuvant chemoradiation and LT,excellent results have been achieved in the last decades,resulting in its increasing acceptance as an indication for LT and the standard of care in several centres with significant experience.However,in intrahepatic CCA,the role of LT remains controversial and owing to dismal previous results it is not an accepted indication.Nevertheless,more recent studies have demonstrated favourable results with LT in early intrahepatic CCA,indicating that,under defined criteria,its role may increase in the future.This review highlights the history and contemporary advances of LT in CCA,with particular focus on the improving outcomes of LT in intrahepatic and perihilar CCA and future perspectives.

关 键 词：CHOLANGIOCARCINOMA Klatskin tumor Liver transplantation Liver cancer Liver resection Neoadjuvant therapy 

分 类 号：R735.8[医药卫生—肿瘤]