Neoadjuvant treatment strategies for intrahepatic cholangiocarcinoma

• 作者: Aslam M Ejaz Clifford Akateh Jordan M Cloyd Timothy Michael Pawlik
• 来源期刊: 世界肝病学杂志:英文版(电子版)
• 学科: 医学
• 关键词: Biliary tract cancer Preoperative therapy Conversion therapy Down-staging HEPATECTOMY Liver resection
• 年，卷（期）: 2020,（10）
• 页码范围: 693-708
• 页数: 16页
• 分类号: R73

摘要

Intrahepatic cholangiocarcinoma(ICC)is the second most common primary liver malignancy and is increasing in incidence.Long-term outcomes are optimized when patients undergo margin-negative resection followed by adjuvant chemotherapy.Unfortunately,a significant proportion of patients present with locally advanced,unresectable disease.Furthermore,recurrence rates are high even among patients who undergo surgical resection.The delivery of systemic and/or liver-directed therapies prior to surgery may increase the proportion of patients who are eligible for surgery and reduce recurrence rates by prioritizing early systemic therapy for this aggressive cancer.Nevertheless,the available evidence for neoadjuvant therapy in ICC is currently limited yet recent advances in liver directed therapies,chemotherapy regimens,and targeted therapies have generated increasing interest its role.In this article,we review the rationale for,current evidence for,and ongoing research efforts in the use of neoadjuvant therapy for ICC.