Current Perspectives in Liver Transplantation for Perihilar Cholangiocarcinoma
Author
Giovinazzo, FrancescoPascale, Marco Maria
Cardella, Francesca
Picarelli, Matteo
Molica, Serena
Zotta, Francesca
Martullo, Annamaria
Clarke, George
Frongillo, Francesco
Grieco, Antonio
Agnes, Salvatore
Publication date
2023-03-01
Metadata
Show full item recordAbstract
Cholangiocarcinoma (CCA) encompasses all malignant neoplasms arising from the epithelial cells of the biliary tree. About 40% of CCAs are perihilar, involving the bile ducts distal to the second-order biliary branches and proximal to the cystic duct implant. About two-thirds of pCCAs are considered unresectable at the time of diagnosis or exploration. When resective surgery is deemed unfeasible, liver transplantation (LT) could be an effective alternative. The overall survival rates after LT at 1 and 3 years are 91% and 81%, respectively. The overall five-year survival rate after transplantation is 73% (79% for patients with underlying PSC and 63% for de novo pCCA). Multicenter case series reported a 5-year disease-free survival rate of ~65%. However, different protocols, including neoadjuvant therapy, have been proposed. The scarcity of organ availability represents a crucial limiting factor in recommending LT preferentially in treating pCCA. Living donor transplantations and marginal cadaveric allografts have proven to be exciting options to overcome organ shortage. Management of jaundice and cholangitis is still challenging for these patients and could impact LT listing. Whether to adopt surgical resection or LT as standard-of-care in pCCA is still a matter of debate, and more prospective studies are needed.Citation
Giovinazzo F, Pascale MM, Cardella F, Picarelli M, Molica S, Zotta F, Martullo A, Clarke G, Frongillo F, Grieco A, Agnes S. Current Perspectives in Liver Transplantation for Perihilar Cholangiocarcinoma. Curr Oncol. 2023 Mar 1;30(3):2942-2953. doi: 10.3390/curroncol30030225.Type
ArticleAdditional Links
https://www.mdpi.com/1718-7729/30/3/225PMID
36975438Journal
Current OncologyPublisher
MDPIae974a485f413a2113503eed53cd6c53
10.3390/curroncol30030225