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Interventional Radiology Therapies for Intrahepatic Cholangiocarcinoma

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Diagnosis and Management of Cholangiocarcinoma

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Abstract

Most patients with intrahepatic cholangiocarcinoma are diagnosed at an advanced stage with a poor prognosis. Although surgical resection and liver transplant are potentially curative treatment options, only a minority of patients have resectable disease at the time of diagnosis. Additional palliative treatments for unresectable intrahepatic cholangiocarcinoma, including systemic chemotherapy, have limited efficacy. Interventional radiology offers several minimally invasive locoregional treatment options for liver-confined and liver-dominant metastatic disease, including percutaneous thermal ablation, transarterial chemoembolization, and transarterial radioembolization. These interventions are important additions to therapy that are generally well-tolerated by patients. This chapter provides an overview of the different interventional radiology treatments for unresectable intrahepatic cholangiocarcinoma and summarizes the available clinical data.

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Abbreviations

CCA:

Cholangiocarcinoma

cTACE:

Conventional transarterial chemoembolization

DEB-TACE:

Drug-eluting bead transarterial chemoembolization

ECOG:

Eastern Cooperative Oncology Group

Gy:

Gray

HCC:

Hepatocellular carcinoma

iCCA:

Intrahepatic cholangiocarcinoma

IR:

Interventional radiology

LT:

Liver transplantation

MAA:

Macro-aggregated albumin

MELD:

Model for End-Stage Liver Disease

MWA:

Microwave ablation

RECIST:

Response Evaluation Criteria in Solid Tumours

RFA:

Radiofrequency ablation

TACE:

Transarterial chemoembolization

TAE:

Bland transarterial embolization

TARE:

Transarterial radioembolization

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Authors and Affiliations

  1. Department of Radiology, Massachusetts General Hospital, Boston, MA, USA

    Thomas J. An

  2. Division of Interventional Radiology, Department of Radiology, Massachusetts General Hospital, Boston, MA, USA

    Eric Wehrenberg-Klee

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Correspondence to Eric Wehrenberg-Klee .

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  1. Division of Gastroenterology, Department of Medicine, Olive View-UCLA Medical Center, Sylmar, CA, USA

    James H. Tabibian

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An, T.J., Wehrenberg-Klee, E. (2021). Interventional Radiology Therapies for Intrahepatic Cholangiocarcinoma. In: Tabibian, J.H. (eds) Diagnosis and Management of Cholangiocarcinoma. Springer, Cham. https://doi.org/10.1007/978-3-030-70936-5_18

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