Advertisement

Adjuvant and Palliative Treatments

  • Alfredo Guglielmi
  • Andrea Ruzzenente
  • Calogero Iacono
Chapter
Part of the Updates in Surgery book series (UPDATESSURG)

Abstract

The role of adjuvant and palliative chemo- and radiotherapy in the treatment of intrahepatic cholangiocarcinoma (ICC) is controversial. There are no prospective and randomised studies or large series that provide conclusive indications regarding the efficacy of these therapies in ICC. Moreover, the majority of oncologic papers in the literature that address this topic include intrahepatic and extrahepatic (hilar, middle and distal) cancers and even gallbladder carcinoma. Consequently, specific data for each localisation concerning treatment indication, dosage, type of approach and results are lacking.

Keywords

Gallbladder Carcinoma Intrahepatic Cholangiocarcinoma Peripheral Cholangiocarcinoma Implanted Port System Unresectable Cholangiocarcinoma 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Jan YY, Yeh CN, Yeh TS, Chen TC (2005) Prognostic analysis of surgical treatment of peripheral cholangiocarcinoma: two decades of experience at Chang Grung Memorial Hospital. World J Gastroenterol 11 (12):1779–1784CrossRefGoogle Scholar
  2. 2.
    Asakura H, Ohtsuka M, Ito H et al (2005) Long-term survival after extended surgical resection of intrahepatic cholangiocarcinoma with extensive lymph-node metastasis. Hepatogastroenterology 52 (63):722–724PubMedGoogle Scholar
  3. 3.
    Puhalla H, Schuell B, Pokorny H et al (2005) Treatment and outcome of intrahepatic cholangiocellular carcinoma. Am J Surg 189 (2):173–177CrossRefGoogle Scholar
  4. 4.
    Miwa S, Miyagawa S, Kobayashi A et al (2006) Predictive factors for intrahepatic cholangiocarcinoma recurrence in the liver following surgery. J Gastroenterol 41 (9):893–900CrossRefGoogle Scholar
  5. 5.
    Fu XH, Tang ZH, Zong M et al (2004) Clinicopathologic features, diagnosis and surgical treatment of intrahepatic cholangiocarcinoma in 104 patients. Hepatobiliary Pancreat Dis Int 3 (2):279–283Google Scholar
  6. 6.
    Knox JJ, Hedley D, Oza A et al (2005) Combining gemcitabine and capecitabine in patients with advanced biliary cancer: a phase II trial. J Clin Oncol 23 (10):2332–2338CrossRefGoogle Scholar
  7. 7.
    Thongprasert S (2005) The role of chemotherapy in cholangiocarcinoma. Ann Oncol 16 (Suppl 2):ii93–ii96CrossRefGoogle Scholar
  8. 8.
    Kelley ST, Bloomston M, Serafini F et al (2004) Cholangiocarcinoma: advocate an aggressive operative approach with adjuvant chemotherapy. Am Surg 70 (9):743–748; discussion 748–749PubMedGoogle Scholar
  9. 9.
    Khan SA, Davidson BR, Goldin R et al; British Society of Gastroenterology (2002) Guidelines for the diagnosis and treatment of cholangiocarcinoma: consensus document. Gut 51 (Suppl 6):VI1–VI9PubMedPubMedCentralGoogle Scholar
  10. 10.
    Casavilla FA, Marsh JW, Iwatsuki S et al (1997) Hepatic resection and transplantation for peripheral cholangiocarcinoma. J Am Coll Surg 185 (5):429–436CrossRefGoogle Scholar
  11. 11.
    Tanaka N, Yamakado K, Nakatsuka A et al (2002) Arterial chemoinfusion therapy through an implanted port system for patients with unresectable intrahepatic cholangiocarcinoma-initial experience. Eur J Radiol 41 (1):42–48CrossRefGoogle Scholar
  12. 12.
    Valverde A, Bonhomme N, Farges O et al (1999) J Hepatobiliary Pancreat Surg 6 (2):122–127CrossRefGoogle Scholar
  13. 13.
    Zeng ZC, Tang ZY, Fan J et al (2006) Consideration of the role of radiotherapy for unresectable intrahepatic cholangiocarcinoma: a retrospective analysis of 75 patients. Cancer J 12 (2):113–122PubMedGoogle Scholar
  14. 14.
    Higuchi R, Yamamoto M, Hatori T et al (2006) Intrahepatic cholangiocarcinoma with lymph-node metastasis successfully treated by immunotherapy with CD3-activated T cells and dendritic cells after surgery: report of a case. Surg Today 36 (6):559–562CrossRefGoogle Scholar
  15. 15.
    Zgodzinski W, Espat NJ (2005) Radiofrequency ablation for incidentally identified primary intrahepatic cholangiocarcinoma. World J Gastroenterol 11 (33):5239–5240PubMedPubMedCentralGoogle Scholar
  16. 16.
    Chiou YY, Hwang JI, Chou YH et al (2005) Percutaneous ultrasound-guided radiofrequency ablation of intrahepatic cholangiocarcinoma. Kaohsiung J Med Sci 21 (7):304–309CrossRefGoogle Scholar
  17. 17.
    Slakey DP (2002) Radiofrequency ablation of recurrent cholangiocarcinoma. Am Surg 68 (4):395–397PubMedGoogle Scholar
  18. 18.
    Mazhar D, Stebbing J, Bower M (2006) Chemotherapy for advanced cholangiocarcinoma: what is standard treatment? Future Oncol 2 (4):509–514CrossRefGoogle Scholar
  19. 19.
    Cantore M, Mambrini A, Fiorentini G et al (2005) Phase II study of hepatic intraarterial epirubicin and cisplatin, with systemic 5-fluorouracil in patients with unresectable biliary tract tumours. Cancer 103 (7):1402–1407CrossRefGoogle Scholar
  20. 20.
    Vogl TJ, Schwarz W, Eichler K et al (2006) Hepatic intraarterial chemotherapy with gemcitabine in patients with unresectable cholangiocarcinomas and liver metastases of pancreatic cancer: a clinical study on maximum tolerable dose and treatment efficacy. J Cancer Res Clin Oncol 132 (11):745–755CrossRefGoogle Scholar
  21. 21.
    Mambrini A, Guglielmi A, Pacetti P et al (2007) Capecitabine plus hepatic intraarterial epirubicin and cisplatin in unresectable biliary cancer: a phase II study. Anticancer Res (in press)Google Scholar
  22. 22.
    Huang TW, Wang CH, Hsieh CB (2007) Effects of the anti-epidermal growth factor receptor antibody cetuximab on cholangiocarcinoma of the liver. Onkologie 30 (3):129–131PubMedGoogle Scholar
  23. 23.
    Sprinzl MF, Schimanski CC, Moehler M et al (2006) Gemcitabine in combination with EGF-Receptor antibody (Cetuximab) as a treatment of cholangiocarcinoma: a case report. BMC Cancer 6:190CrossRefGoogle Scholar
  24. 24.
    Kirchhoff T, Zender L, Merkesdal S et al (2005) Initial experience from a combination of systemic and regional chemotherapy in the treatment of patients with nonresectable cholangiocellular carcinoma in the liver. World J Gastroenterol 11 (8):1091–1095CrossRefGoogle Scholar
  25. 25.
    Burger I, Hong K, Schulick R et al (2005) Transcatheter arterial chemoembolization in unresectable cholangiocarcinoma: initial experience in a single institution. J Vasc Interv Radiol 16 (3):353–361CrossRefGoogle Scholar

Copyright information

© Springer 2008

Authors and Affiliations

  • Alfredo Guglielmi
    • 1
  • Andrea Ruzzenente
    • 1
  • Calogero Iacono
    • 1
  1. 1.General Surgery A, Department of Surgery and GastroenterologyUniversity Hospital G.B. RossiVeronaItaly

Personalised recommendations