Skip to main content

Advertisement

SpringerLink
Log in

Liver Transplantation for Cholangiocarcinoma: Insights into the Prognosis and the Evolving Indications

  • Gastrointestinal Cancers (J Meyer, Section Editor)
  • Published:
Current Oncology Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

Cholangiocarcinoma (CCA) is a rare malignancy of the biliary ducts that can be classified as intrahepatic, perihilar, or distal based on anatomic location. Although surgical resection can be curative, complete excision with negative margins is often difficult to achieve. In patients with unresectable disease, long-term survival is rarely seen with medical therapy alone. A multimodal treatment approach, including liver transplantation (LT) for select patients with unresectable CCA, should be considered.

Recent Findings

While currently only an approved indication for early, liver-limited, perihilar cholangiocarcinoma, promising results have been achieved for LT in localized intrahepatic disease. The absolute indication for transplant for intrahepatic tumors is currently the subject of multiple investigations. Continued advances in neoadjuvant/adjuvant therapy and better understanding of tumor biology may further augment the number of candidates for surgical therapies, with liver transplant acting as a promising tool to improve patient outcomes.

Summary

Thorough consideration for any expansion in the indication for liver transplant in malignancy is necessary in order to balance patient outcomes with utilization of the scarce donor organ resources.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Goldaracena N, Gorgen A, Sapisochin G. Current status of liver transplantation for cholangiocarcinoma. Liver Transpl. 2018;24(2):294–303. https://doi.org/10.1002/lt.24955.

    Article  PubMed  Google Scholar 

  2. Louis B. Jacques TSJ, Jyme Schafer, Lori Paserchia, Roya Lotfi. National Coverage Determination (Reconsideration) Liver Transplantation for Patients with Malignancies Decision memo for liver transplantation for malignancies (CAG-00091R): Centers for Medicare and Medicaid Services June 21, 2012.

  3. Heimbach JK, Gores GJ, Haddock MG, Alberts SR, Nyberg SL, Ishitani MB, et al. Liver transplantation for unresectable perihilar cholangiocarcinoma. Semin Liver Dis. 2004;24(2):201–7. https://doi.org/10.1055/s-2004-828896.

    Article  Google Scholar 

  4. Abou-Alfa GK, Andersen JB, Chapman W, Choti M, Forbes SJ, Gores GJ, et al. Advances in cholangiocarcinoma research: report from the third Cholangiocarcinoma Foundation Annual Conference. J Gastrointest Oncol. 2016;7(6):819–27. https://doi.org/10.21037/jgo.2016.11.11.

    Article  PubMed  PubMed Central  Google Scholar 

  5. Jackson PG, Evans S. Biliary System. Sabiston textbook of surgery. 20th ed. Chapter 54. Philadelphia, PA (Elsevier Inc); 2017. p. 1482–519.

    Chapter  Google Scholar 

  6. DeOliveira ML, Cunningham SC, Cameron JL, Kamangar F, Winter JM, Lillemoe KD, et al. Cholangiocarcinoma: thirty-one-year experience with 564 patients at a single institution. Ann Surg. 2007;245(5):755–62. https://doi.org/10.1097/01.sla.0000251366.62632.d3.

    Article  PubMed  PubMed Central  Google Scholar 

  7. 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. https://doi.org/10.1038/nrclinonc.2017.157.

    Article  CAS  PubMed  Google Scholar 

  8. Banales JM, Cardinale V, Carpino G, Marzioni M, Andersen JB, Invernizzi P, et al. Expert consensus document: cholangiocarcinoma: current knowledge and future perspectives consensus statement from the European Network for the Study of Cholangiocarcinoma (ENS-CCA). Nat Rev Gastroenterol Hepatol. 2016;13(5):261–80. https://doi.org/10.1038/nrgastro.2016.51.

    Article  PubMed  Google Scholar 

  9. Sakamoto Y, Kokudo N, Matsuyama Y, Sakamoto M, Izumi N, Kadoya M, et al. Proposal of a new staging system for intrahepatic cholangiocarcinoma: analysis of surgical patients from a nationwide survey of the Liver Cancer Study Group of Japan. Cancer. 2016;122(1):61–70. https://doi.org/10.1002/cncr.29686.

    Article  Google Scholar 

  10. Spolverato G, Kim Y, Ejaz A, Alexandrescu S, Marques H, Aldrighetti L, et al. Conditional probability of long-term survival after liver resection for intrahepatic cholangiocarcinoma: a multi-institutional analysis of 535 patients. JAMA Surg. 2015;150(6):538–45. https://doi.org/10.1001/jamasurg.2015.0219.

    Article  Google Scholar 

  11. Wang Y, Li J, Xia Y, Gong R, Wang K, Yan Z, et al. Prognostic nomogram for intrahepatic cholangiocarcinoma after partial hepatectomy. J Clin Oncol. 2013;31(9):1188–95. https://doi.org/10.1200/JCO.2012.41.5984.

    Article  Google Scholar 

  12. Benson AB 3rd, Abrams TA, Ben-Josef E, Bloomston PM, Botha JF, Clary BM, et al. NCCN clinical practice guidelines in oncology: hepatobiliary cancers. J Natl Compr Cancer Netw. 2009;7(4):350–91. https://doi.org/10.6004/jnccn.2009.0027.

    Article  CAS  Google Scholar 

  13. Endo I, Gonen M, Yopp AC, Dalal KM, Zhou Q, Klimstra D, et al. Intrahepatic cholangiocarcinoma: rising frequency, improved survival, and determinants of outcome after resection. Ann Surg. 2008;248(1):84–96. https://doi.org/10.1097/SLA.0b013e318176c4d3.

    Article  Google Scholar 

  14. Hyder O, Hatzaras I, Sotiropoulos GC, Paul A, Alexandrescu S, Marques H, et al. Recurrence after operative management of intrahepatic cholangiocarcinoma. Surgery. 2013;153(6):811–8. https://doi.org/10.1016/j.surg.2012.12.005.

    Article  Google Scholar 

  15. Takahashi K, Obeid J, Burmeister CS, Bruno DA, Kazimi MM, Yoshida A, et al. Intrahepatic cholangiocarcinoma in the liver explant after liver transplantation: histological differentiation and prognosis. Ann Transplant. 2016;21:208–15. https://doi.org/10.12659/aot.895936.

    Article  PubMed  Google Scholar 

  16. Gupta R, Gupta J. Strategies to improve survival of patients with intrahepatic cholangiocarcinoma undergoing liver transplantation. Hepatology. 2017;65(5):1777–8. https://doi.org/10.1002/hep.28994.

    Article  PubMed  Google Scholar 

  17. Dierks J, Gaspersz MP, Belkouz A, van Vugt JLA, Coelen RJS, de Groot JWB, et al. Translating the ABC-02 trial into daily practice: outcome of palliative treatment in patients with unresectable biliary tract cancer treated with gemcitabine and cisplatin. Acta Oncol. 2018;57(6):807–12. https://doi.org/10.1080/0284186X.2017.1418532.

    Article  CAS  PubMed  Google Scholar 

  18. Hong TS, Wo JY, Yeap BY, Ben-Josef E, McDonnell EI, Blaszkowsky LS, et al. Multi-institutional phase II study of high-dose hypofractionated proton beam therapy in patients with localized, Unresectable hepatocellular carcinoma and intrahepatic cholangiocarcinoma. J Clin Oncol. 2016;34(5):460–8. https://doi.org/10.1200/JCO.2015.64.2710.

    Article  CAS  PubMed  Google Scholar 

  19. • Wong M, Kim J, George B, Eriksen C, Pearson T, Robbins J, et al. Downstaging locally advanced cholangiocarcinoma pre-liver transplantation: a prospective pilot study. J Surg Res. 2019;242:23–30. https://doi.org/10.1016/j.jss.2019.04.023Authors combined unresectable hilar and intrahepatic CCA to evaluate if downstaging followed by LT is feasible for management of locally advanced CCA. Although a short-term follow-up, 1-year survival comparable to prior studies of less advanced disease.

    Article  PubMed  Google Scholar 

  20. Goldstein RM, Stone M, Tillery GW, Senzer N, Levy M, Husberg BS, et al. Is liver transplantation indicated for cholangiocarcinoma? Am J Surg. 1993;166(6):768–71; discussion 71-2. https://doi.org/10.1016/s0002-9610(05)80696-8.

    Article  CAS  Google Scholar 

  21. Pichlmayr R, Weimann A, Oldhafer KJ, Schlitt HJ, Klempnauer J, Bornscheuer A, et al. Role of liver transplantation in the treatment of unresectable liver cancer. World J Surg. 1995;19(6):807–13. https://doi.org/10.1007/bf00299775.

  22. Becker NS, Rodriguez JA, Barshes NR, O'Mahony CA, Goss JA, Aloia TA. Outcomes analysis for 280 patients with cholangiocarcinoma treated with liver transplantation over an 18-year period. J Gastrointest Surg. 2008;12(1):117–22. https://doi.org/10.1007/s11605-007-0335-4.

    Article  PubMed  Google Scholar 

  23. OPTN. Policy 9.6: Specific Standardized MELD or PELD Score Exceptions. November 11, 2019. Available from: https://optn.transplant.hrsa.gov/media/2197/policy-notice-july-2017-national-liver-review-board.pdf. Accessed 11 Nov 2019.

  24. Mansour JC, Aloia TA, Crane CH, Heimbach JK, Nagino M, Vauthey JN. Hilar cholangiocarcinoma: expert consensus statement. HPB (Oxford). 2015;17(8):691–9. https://doi.org/10.1111/hpb.12450.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Hasegawa S, Ikai I, Fujii H, Hatano E, Shimahara Y. Surgical resection of hilar cholangiocarcinoma: analysis of survival and postoperative complications. World J Surg. 2007;31(6):1256–63. https://doi.org/10.1007/s00268-007-9001-y.

    Article  PubMed  Google Scholar 

  26. Rea DJ, Munoz-Juarez M, Farnell MB, Donohue JH, Que FG, Crownhart B, et al. Major hepatic resection for hilar cholangiocarcinoma: analysis of 46 patients. Arch Surg. 2004;139(5):514–23; discussion 23-5. https://doi.org/10.1001/archsurg.139.5.514.

    Article  Google Scholar 

  27. 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; discussion 8-61. https://doi.org/10.1097/01.sla.0000179678.13285.fa.

  28. Zamora-Valdes D, Heimbach JK. Liver transplant for cholangiocarcinoma. Gastroenterol Clin N Am. 2018;47(2):267–80. https://doi.org/10.1016/j.gtc.2018.01.002.

    Article  Google Scholar 

  29. Meyer CG, Penn I, James L. Liver transplantation for cholangiocarcinoma: results in 207 patients. Transplantation. 2000;69(8):1633–7. https://doi.org/10.1097/00007890-200004270-00019.

    Article  CAS  PubMed  Google Scholar 

  30. De Vreede I, Steers JL, Burch PA, Rosen CB, Gunderson LL, Haddock MG, et al. Prolonged disease-free survival after orthotopic liver transplantation plus adjuvant chemoirradiation for cholangiocarcinoma. Liver Transpl. 2000;6(3):309–16. https://doi.org/10.1053/lv.2000.6143.

    Article  PubMed  Google Scholar 

  31. Panjala C, Nguyen JH, Al-Hajjaj AN, Rosser BA, Nakhleh RE, Bridges MD, et al. Impact of neoadjuvant chemoradiation on the tumor burden before liver transplantation for unresectable cholangiocarcinoma. Liver Transpl. 2012;18(5):594–601. https://doi.org/10.1002/lt.22462.

    Article  PubMed  Google Scholar 

  32. Loveday BPT, Knox JJ, Dawson LA, Metser U, Brade A, Horgan AM, et al. Neoadjuvant hyperfractionated chemoradiation and liver transplantation for unresectable perihilar cholangiocarcinoma in Canada. J Surg Oncol. 2017;117(2):213–9. https://doi.org/10.1002/jso.24833.

    Article  CAS  Google Scholar 

  33. •• 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. https://doi.org/10.1016/j.jamcollsurg.2015.01.064The authors show an OS benefit for de novo hCCA for patients undergoing NT + LT vs resection. There is no survival difference after adjusting for lymph node status and R0 resection between LT and LR – highlighting that LT should be reserved for unresectable disease. For borderline resectable disease (B-C IV) the authors note survival benefit in LT group.

    Article  PubMed  Google Scholar 

  34. Heimbach JK, Gores GJ, Haddock MG, Alberts SR, Pedersen R, Kremers W, et al. Predictors of disease recurrence following neoadjuvant chemoradiotherapy and liver transplantation for unresectable perihilar cholangiocarcinoma. Transplantation. 2006;82(12):1703–7. https://doi.org/10.1097/01.tp.0000253551.43583.d1.

    Article  CAS  Google Scholar 

  35. Darwish Murad S, Kim WR, Harnois DM, Douglas DD, Burton J, Kulik LM, et al. Efficacy of neoadjuvant chemoradiation, followed by liver transplantation, for perihilar cholangiocarcinoma at 12 US centers. Gastroenterology. 2012;143(1):88–98 e3; quiz e14. https://doi.org/10.1053/j.gastro.2012.04.008.

    Article  PubMed  Google Scholar 

  36. Rosen CB, Heimbach JK, Gores GJ. Surgery for cholangiocarcinoma: the role of liver transplantation. HPB (Oxford). 2008;10(3):186–9. https://doi.org/10.1080/13651820801992542.

    Article  CAS  Google Scholar 

  37. • Mantel HT, Westerkamp AC, Adam R, Bennet WF, Seehofer D, Settmacher U, et al. Strict selection alone of patients undergoing liver transplantation for hilar cholangiocarcinoma is associated with improved survival. PLoS One. 2016;11(6):e0156127. https://doi.org/10.1371/journal.pone.0156127Authors performed subgroup analysis of patients who meet Mayo Protocol patient selection criteria but did not undergo NT, showing 5-year survival of 59%, comparable to studies evaluating NT+LT for hCCA.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  38. 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. https://doi.org/10.1371/journal.pone.0220527.

    Article  CAS  Google Scholar 

  39. Lunsford KE, Heyne K, Abdelwahab R, Ali H, Mobley CM, Saharia A, et al. Liver transplant outcomes for locally advanced intrahepatic cholangiocarcinoma are comparable to hilar cholangiocarcinoma within Mayo criteria: a single center experience. Transplantation. 2019;103(8S):309–10. https://doi.org/10.1097/01.tp.0000580472.17422.db.

    Article  Google Scholar 

  40. Grendar J, Grendarova P, Sinha R, Dixon E. Neoadjuvant therapy for downstaging of locally advanced hilar cholangiocarcinoma: a systematic review. HPB (Oxford). 2014;16(4):297–303. https://doi.org/10.1111/hpb.12150.

    Article  Google Scholar 

  41. 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. https://doi.org/10.1097/SLA.0000000000002574.

    Article  Google Scholar 

  42. Chun YS, Javle M. Systemic and adjuvant therapies for intrahepatic cholangiocarcinoma. Cancer Control. 2017;24(3):1073274817729241. https://doi.org/10.1177/1073274817729241.

    Article  PubMed  PubMed Central  Google Scholar 

  43. Lee AJ, Chun YS. Intrahepatic cholangiocarcinoma: the AJCC/UICC 8th edition updates. Chin Clin Oncol. 2018;7(5):52. https://doi.org/10.21037/cco.2018.07.03.

    Article  PubMed  Google Scholar 

  44. Lamarca A, Ross P, Wasan HS, Hubner RA, McNamara MG, Lopes A, et al. Advanced intrahepatic cholangiocarcinoma: post-hoc analysis of the ABC-01, -02 and -03 clinical trials. J Natl Cancer Inst. 2019. https://doi.org/10.1093/jnci/djz071.

  45. Jackson MW, Amini A, Jones BL, Rusthoven CG, Schefter TE, Goodman KA. Treatment selection and survival outcomes with and without radiation for unresectable, Localized Intrahepatic Cholangiocarcinoma. Cancer J. 2016;22(4):237–42. https://doi.org/10.1097/PPO.0000000000000213.

    Article  CAS  PubMed  Google Scholar 

  46. Lee DD, Croome KP, Musto KR, Melendez J, Tranesh G, Nakhleh R, et al. Liver transplantation for intrahepatic cholangiocarcinoma. Liver Transpl. 2018;24(5):634–44. https://doi.org/10.1002/lt.25052.

    Article  Google Scholar 

  47. Boehm LM, Jayakrishnan TT, Miura JT, Zacharias AJ, Johnston FM, Turaga KK, et al. Comparative effectiveness of hepatic artery based therapies for unresectable intrahepatic cholangiocarcinoma. J Surg Oncol. 2015;111(2):213–20. https://doi.org/10.1002/jso.23781.

    Article  PubMed  Google Scholar 

  48. Bridgewater J, Galle PR, Khan SA, Llovet JM, Park JW, Patel T, et al. Guidelines for the diagnosis and management of intrahepatic cholangiocarcinoma. J Hepatol. 2014;60(6):1268–89. https://doi.org/10.1016/j.jhep.2014.01.021.

    Article  PubMed  Google Scholar 

  49. Sapisochin G, de Lope CR, Gastaca M, de Urbina JO, Lopez-Andujar R, Palacios F, et al. Intrahepatic cholangiocarcinoma or mixed hepatocellular-cholangiocarcinoma in patients undergoing liver transplantation: a Spanish matched cohort multicenter study. Ann Surg. 2014;259(5):944–52. https://doi.org/10.1097/SLA.0000000000000494.

    Article  CAS  PubMed  Google Scholar 

  50. • Sapisochin G, Facciuto M, Rubbia-Brandt L, Marti J, Mehta N, Yao FY, et al. Liver transplantation for “very early” intrahepatic cholangiocarcinoma: international retrospective study supporting a prospective assessment. Hepatology. 2016;64(4):1178–88. https://doi.org/10.1002/hep.28744Multicenter, international retrospective analysis pooling data from 17 major transplant centers, showing improved survival and lower recurrence with early iCCA. Despite decreased survival and higher recurrence rate with advanced disease, when stratified by differentiation, poorly differentiated tumors carry increased risk.

    Article  CAS  PubMed  Google Scholar 

  51. • De Martin EG, Rayar M, Gelli M, Dupeux M, Gnemmi V, Golse N, et al. Intrahepatic cholangiocarcinoma within Milan criteria in the setting of cirrhosis: liver resection versus liver transplant. Liver Transpl. 2019; In press; Authors show improved outcomes with LT vs resection for iCCA. They further stratify patients based on lesion size, showing acceptable outcomes when LT is performed for larger lesions, with survival superior to LR. Median diameter of largest nodule associated with survival and recurrence in all patients.

  52. 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. https://doi.org/10.1001/archsurg.2011.116.

    Article  Google Scholar 

  53. •• Lunsford KE, Javle M, Heyne K, Shroff RT, Abdel-Wahab R, Gupta N, et al. Liver transplantation for locally advanced intrahepatic cholangiocarcinoma treated with neoadjuvant therapy: a prospective case-series. Lancet Gastroenterol Hepatol. 2018;3(5):337–48. https://doi.org/10.1016/S2468-1253(18)30045-1First prospective series with protocolized approach to LT for iCCA. Unlike prior studies, no tumor size restriction, selection based on chemotherapy response. Authors show tumor biology as key predictive factor for outcomes.

    Article  PubMed  Google Scholar 

  54. Lunsford KE, Heyne K, Abdelwahab R, Ali H, Mobley CM, Saharia A et al. Sustained biologic response to neoadjuvant therapy predicts excellent liver transplant outcomes for locally advanced intrahepatic cholangiocarcinoma. Am J Transplant. 2019: 19(American Society of Transplant Surgeons: 19th Annual State of the Art Winter Symposium):13–97.

  55. Rayar M, Levi Sandri GB, Houssel-Debry P, Camus C, Sulpice L, Boudjema K. Multimodal therapy including yttrium-90 radioembolization as a bridging therapy to liver transplantation for a huge and locally advanced intrahepatic cholangiocarcinoma. J Gastrointestin Liver Dis. 2016;25(3):401–4. https://doi.org/10.15403/jgld.2014.1121.253.y90.

    Article  PubMed  Google Scholar 

  56. Shroff RT, Javle MM, Xiao L, Kaseb AO, Varadhachary GR, Wolff RA, et al. Gemcitabine, cisplatin, and nab-paclitaxel for the treatment of advanced biliary tract cancers: a phase 2 clinical trial. JAMA Oncol. 2019;5(6):824–30. https://doi.org/10.1001/jamaoncol.2019.0270.

    Article  Google Scholar 

  57. Zhu AX, Borger DR, Kim Y, Cosgrove D, Ejaz A, Alexandrescu S, et al. Genomic profiling of intrahepatic cholangiocarcinoma: refining prognosis and identifying therapeutic targets. Ann Surg Oncol. 2014;21(12):3827–34. https://doi.org/10.1245/s10434-014-3828-x.

    Article  PubMed  PubMed Central  Google Scholar 

  58. Jain A, Kwong LN, Javle M. Genomic profiling of biliary tract cancers and implications for clinical practice. Curr Treat Options in Oncol. 2016;17(11):58. https://doi.org/10.1007/s11864-016-0432-2.

    Article  Google Scholar 

  59. Chu KJ, Lu CD, Dong H, Fu XH, Zhang HW, Yao XP. Hepatitis B virus-related combined hepatocellular-cholangiocarcinoma: clinicopathological and prognostic analysis of 390 cases. Eur J Gastroenterol Hepatol. 2014;26(2):192–9. https://doi.org/10.1097/MEG.0b013e3283625df9.

    Article  CAS  PubMed  Google Scholar 

  60. Sempoux C, Jibara G, Ward SC, Fan C, Qin L, Roayaie S, et al. Intrahepatic cholangiocarcinoma: new insights in pathology. Semin Liver Dis. 2011;31(1):49–60. https://doi.org/10.1055/s-0031-1272839.

    Article  Google Scholar 

  61. Vilchez V, Shah MB, Daily MF, Pena L, Tzeng CW, Davenport D, et al. Long-term outcome of patients undergoing liver transplantation for mixed hepatocellular carcinoma and cholangiocarcinoma: an analysis of the UNOS database. HPB (Oxford). 2016;18(1):29–34. https://doi.org/10.1016/j.hpb.2015.10.001.

    Article  Google Scholar 

  62. Magistri P, Tarantino G, Serra V, Guidetti C, Ballarin R, Di Benedetto F. Liver transplantation and combined hepatocellular-cholangiocarcinoma: feasibility and outcomes. Dig Liver Dis. 2017;49(5):467–70. https://doi.org/10.1016/j.dld.2017.01.166.

    Article  PubMed  Google Scholar 

  63. Lunsford KE, Court C, Seok Lee Y, Lu DS, Naini BV, Harlander-Locke MP, et al. Propensity-matched analysis of patients with mixed hepatocellular-cholangiocarcinoma and hepatocellular carcinoma undergoing liver transplantation. Liver Transpl. 2018;24(10):1384–97. https://doi.org/10.1002/lt.25058.

    Article  Google Scholar 

  64. Abdelfattah MR, Abaalkhail F, Al-Manea H. Misdiagnosed or incidentally detected hepatocellular carcinoma in explanted livers: lessons learned. Ann Transplant. 2015;20:366–72. https://doi.org/10.12659/AOT.893782.

    Article  CAS  PubMed  Google Scholar 

  65. Chan AC, Lo CM, Ng IO, Fan ST. Liver transplantation for combined hepatocellular cholangiocarcinoma. Asian J Surg. 2007;30(2):143–6. https://doi.org/10.1016/S1015-9584(09)60149-4.

    Article  PubMed  Google Scholar 

  66. Sapisochin G, Fidelman N, Roberts JP, Yao FY. Mixed hepatocellular cholangiocarcinoma and intrahepatic cholangiocarcinoma in patients undergoing transplantation for hepatocellular carcinoma. Liver Transpl. 2011;17(8):934–42. https://doi.org/10.1002/lt.22307.

    Article  PubMed  Google Scholar 

  67. Elshamy M, Presser N, Hammad AY, Firl DJ, Coppa C, Fung J, et al. Liver transplantation in patients with incidental hepatocellular carcinoma/cholangiocarcinoma and intrahepatic cholangiocarcinoma: a single-center experience. Hepatobiliary Pancreat Dis Int. 2017;16(3):264–70. https://doi.org/10.1016/s1499-3872(17)60016-x.

    Article  Google Scholar 

  68. Javle M, Bekaii-Saab T, Jain A, Wang Y, Kelley RK, Wang K, et al. Biliary cancer: utility of next-generation sequencing for clinical management. Cancer. 2016;122(24):3838–47. https://doi.org/10.1002/cncr.30254.

    Article  CAS  PubMed  Google Scholar 

  69. Lee H, Ross JS. The potential role of comprehensive genomic profiling to guide targeted therapy for patients with biliary cancer. Ther Adv Gastroenterol. 2017;10(6):507–20. https://doi.org/10.1177/1756283X17698090.

    Article  CAS  Google Scholar 

  70. Yang JD, Campion MB, Liu MC, Chaiteerakij R, Giama NH, Ahmed Mohammed H, et al. Circulating tumor cells are associated with poor overall survival in patients with cholangiocarcinoma. Hepatology. 2016;63(1):148–58. https://doi.org/10.1002/hep.27944.

    Article  PubMed  Google Scholar 

Download references

Funding

This work was supported by internal funding from Rutgers New Jersey Medical School and RWJBarnabas Health.

Author information

Authors and Affiliations

  1. Division of Transplant and Hepatobiliary Surgery, Department of Surgery, Center for Immunity and Inflammation, Rutgers New Jersey Medical School, 185 South Orange Ave, MSB G586, Newark, NJ, 07103, USA

    Guergana G. Panayotova, Flavio Paterno, James V. Guarrera & Keri E. Lunsford

Authors
  1. Guergana G. Panayotova
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Flavio Paterno
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. James V. Guarrera
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Keri E. Lunsford
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Keri E. Lunsford.

Ethics declarations

Conflict of Interest

Guergana G. Panayotova, Flavio Paterno, James V. Guarrera, and Keri E. Lunsford declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

This article is part of the Topical Collection on Gastrointestinal Cancers

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Panayotova, G.G., Paterno, F., Guarrera, J.V. et al. Liver Transplantation for Cholangiocarcinoma: Insights into the Prognosis and the Evolving Indications. Curr Oncol Rep 22, 49 (2020). https://doi.org/10.1007/s11912-020-00910-1

Download citation

  • Published:

  • DOI: https://doi.org/10.1007/s11912-020-00910-1

Keywords

Search

Navigation