Surgical management of intrahepatic and hilar cholangiocarcinoma: liver resection versus liver transplantation

Authors

  • Ria P. Nirhali Department of General Surgery, Seth GSMC and KEMH, Mumbai, Maharashtra, India
  • Reshma M. Bhoir Department of General Surgery, Seth GSMC and KEMH, Mumbai, Maharashtra, India
  • Ram P. Prajapati Department of General Surgery, Seth GSMC and KEMH, Mumbai, Maharashtra, India
  • Ashish Y. Chaudhary Department of General Surgery, Seth GSMC and KEMH, Mumbai, Maharashtra, India
  • Rahul H. Uikey Department of General Surgery, Seth GSMC and KEMH, Mumbai, Maharashtra, India

DOI:

https://doi.org/10.18203/2349-2902.isj20231968

Keywords:

Cholangiocarcinoma, Liver transplantation, Liver resection, Loco-regional therapy, Outcomes, Survival

Abstract

The incidence of cholangiocarcinoma is increasing worldwide. Patients present with abdominal pain, whereas weight loss and malaise are symptoms of advanced disease. Jaundice occurs when there is hilar obstruction by the tumor. Surgical management involves resection of the affected hepatic segments or liver transplantation, which requires a dedicated multidisciplinary team approach, and promising outcomes are seen in high-volume centres. The authors employed a search strategy for databases like PubMed and Google Scholar. The authors then reviewed the articles using the preferred reporting items for systematic reviews and meta-analysis (PRISMA) guidelines and compared data concerning postoperative complications, recurrence rates, five-year survival rates and prognosis. Liver resection confers long-term survival in patients with intrahepatic cholangiocarcinoma, though the prognosis and morbidity of this procedure are still gloomy. Liver transplantation could be an option, either in early stages diagnosed in the context of chronic liver diseases or locally advanced tumors, when neoadjuvant treatments have achieved sustained tumor response without extrahepatic tumor spread.

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References

Petrowsky H, Hong JC. Current surgical management of hilar and intrahepatic cholangiocarcinoma: the role of resection and orthotopic liver transplantation. Transplant Proc. 2009;41(10):4023-35.

Cillo U, Fondevila C, Donadon M, Gringeri E, Mocchegiani F, Schlitt HJ, et al. Surgery for cholangiocarcinoma. Liver Int. 2019;39(1):143-55.

Schaefer B, Zoller H, Schneeberger S. Con: Liver transplantation for expanded criteria malignant diseases. Liver Transpl. 2018;24(1):104-11.

Ernani L, Martino RB, Andraus W, Fernandes ESM, Mello FPT, Andrade R, et al. Protocol for liver transplantation in hilar cholangiocarcinoma. Arq Bras Cir Dig. 2022;34(3):e1618.

Nimura Y, Kamiya J, Nagino M, Kanai M, Uesaka K, Kondo S, et al. Aggressive surgical treatment of hilar cholangiocarcinoma. J Hepatobiliary Pancreat Surg. 1998;5(1):52-61.

Croome KP, Rosen CB, Heimbach JK, Nagorney DM. Is Liver Transplantation Appropriate for Patients with Potentially Resectable De Novo Hilar Cholangiocarcinoma? J Am Coll Surg. 2015;221(1):130-9.

Moris D, Kostakis ID, Machairas N, Prodromidou A, Tsilimigras DI, Ravindra KV, et al. Comparison between liver transplantation and resection for hilar cholangiocarcinoma: A systematic review and meta-analysis. PLoS One. 2019;14(7):e0220527.

Rea DJ, Heimbach JK, Rosen CB, Haddock MG, Alberts SR, Kremers WK, et al. Liver transplantation with neoadjuvant chemoradiation is more effective than resection for hilar cholangiocarcinoma. Ann Surg. 2005;242(3):451-8.

Ethun CG, Lopez-Aguiar AG, Anderson DJ, Adams AB, Fields RC, Doyle MB, et al. Transplantation Versus Resection for Hilar Cholangiocarcinoma: An Argument for Shifting Treatment Paradigms for Resectable Disease. Ann Surg. 2018;267(5):797-805.

Iwatsuki S, Todo S, Marsh JW, Madariaga JR, Lee RG, Dvorchik I, et al. Treatment of hilar cholangiocarcinoma (Klatskin tumors) with hepatic resection or transplantation. J Am Coll Surg. 1998;187(4):358-64.

Hong JC, Jones CM, Duffy JP, Petrowsky H, Farmer DG, French S, et al. Comparative analysis of resection and liver transplantation for intrahepatic and hilar cholangiocarcinoma: a 24-year experience in a single center. Arch Surg. 2011;146(6):683-9.

De Martin E, Rayar M, Golse N, Dupeux M, Gelli M, Gnemmi V, et al. Analysis of Liver Resection Versus Liver Transplantation on Outcome of Small Intrahepatic Cholangiocarcinoma and Combined Hepatocellular-Cholangiocarcinoma in the Setting of Cirrhosis. Liver Transpl. 2020;26(6):785-98.

Hue JJ, Rocha FG, Ammori JB, Hardacre JM, Rothermel LD, Chavin KD, et al. A comparison of surgical resection and liver transplantation in the treatment of intrahepatic cholangiocarcinoma in the era of modern chemotherapy: An analysis of the National Cancer Database. J Surg Oncol. 2021;123(4):949-56.

Panayotova GG, Guarrera JV, Lunsford KE. Should We Reevaluate Liver Transplantation as an Alternative to Resection for the Treatment of Intrahepatic Cholangiocarcinoma? Liver Transpl. 2020;26(6):748-50.

Lindnér P, Norrby J, Olausson M, Rizell M, Cahlin C, Friman S. Survival after liver transplantation for cholangiocarcinoma has increased during the last decade. Transplant Proc. 2003;35(2):811-2.

Nakeeb A, Pitt HA, Sohn TA, Coleman J, Abrams RA, Piantadosi S, et al. Cholangiocarcinoma. A spectrum of intrahepatic, perihilar, and distal tumors. Ann Surg. 1996;224(4):463-73.

Varma V, Mehta N, Kumaran V, Nundy S. Indications and contraindications for liver transplantation. Int J Hepatol. 2011;121862.

Gu J, Bai J, Shi X, Zhou J, Qiu Y, Wu Y, et al. Efficacy and safety of liver transplantation in patients with cholangiocarcinoma: a systematic review and meta-analysis. Int J Cancer. 2012;130(9):2155-63.

Ziogas IA, Giannis D, Economopoulos KP, Hayat MH, Montenovo MI, Matsuoka LK, et al. Liver Transplantation for Intrahepatic Cholangiocarcinoma: A Meta-analysis and Meta-regression of Survival Rates. Transplantation. 2021;105(10):2263-71.

Blechacz B. Cholangiocarcinoma: Current Knowledge and New Developments. Gut Liver. 2017;11(1):13-26.

Rizvi S, Khan SA, Hallemeier CL, Kelley RK, Gores GJ. Cholangiocarcinoma - evolving concepts and therapeutic strategies. Nat Rev Clin Oncol. 2018;15(2):95-111.

Kelley RK, Hirose R, Venook AP. Can we cure cholangiocarcinoma with neoadjuvant chemoradiation and liver transplantation? Time for a multicenter trial. Liver Transpl. 2012;18(5):509-13.

Neumann UP, Schmeding M. Role of surgery in cholangiocarcinoma: From resection to transplantation. Best Pract Res Clin Gastroenterol. 2015;29(2):295-308.

Panayotova GG, Paterno F, Guarrera JV, Lunsford KE. Liver Transplantation for Cholangiocarcinoma: Insights into the Prognosis and the Evolving Indications. Curr Oncol Rep. 2020;22(5):49.

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Published

2023-06-28

How to Cite

Nirhali, R. P., Bhoir, R. M., Prajapati, R. P., Chaudhary, A. Y., & Uikey, R. H. (2023). Surgical management of intrahepatic and hilar cholangiocarcinoma: liver resection versus liver transplantation . International Surgery Journal, 10(7), 1198–1203. https://doi.org/10.18203/2349-2902.isj20231968

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Section

Systematic Reviews