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SHR Neuro Cancer Cardio Lipid Metab Microb

Seehofer, D; Brunner, TB; Wege, H.
Current therapy concepts for local cholangiocarcinoma
ONKOLOGE. 2015; 21(11): 1054-1063. Doi: 10.1007/s00761-015-2931-3
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Co-authors Med Uni Graz: Brunner Thomas Baptist
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Abstract:: Cholangiocarcinomas (CCA) represent a complex disease, which requires close interdisciplinary cooperation. A selective search of the literature was carried out and is combined with a description of own experiences with the treatment of locoregional CCA. Surgical resection is the treatment of choice for CCAs, which are limited to the liver and/or the biliary tract; however, resection is only possible in 30-40 % of cases. Neoadjuvant treatment of operable tumors does not play a role in the standard therapeutic algorithm; however, in cases of local inoperable CCAs a secondary resectability can be achieved in individual cases by using chemotherapy and/or radiotherapy. The lymph node status is one of the most important prognostic factors after R0 resection. The estimated 5-year survival in lymph node negative tumors lies between 40 % and 60 % after resection of hilar CCA and between 30 % and 40 % after resection of intrahepatic CCA. The presence of lymph node metastases markedly impairs the prognosis (5-year survival < 20 %). No randomized trials addressing the question of a general or risk-adjusted adjuvant therapy are currently available. In non-resectable and locally confined perihilar CCAs, reduction of tumor mass via photodynamic therapy or transpapillary radiofrequency ablation improves biliary drainage. In cases of tumor progression during palliative chemotherapy initial positive results for radioembolization have been presented; however, due to the lack of randomized trials, radioembolization as an alternative or addition to chemotherapy cannot be integrated into a standardized therapeutic algorithm. Owing to the complexity of the disease and the lack of controlled trials, all therapeutic decisions should be discussed in a interdisciplinary tumor board.
Find related publications in this database (Keywords): Cholangiocarcinoma; Photodynamic therapy; Liver resection; Adjuvant therapy; Radio-embolization