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Treatment of Intrahepatic Cholangiocarcinoma—A Multidisciplinary Approach

SIMPLE SUMMARY: This review discusses multimodality treatment strategies for intrahepatic cholangiocarcinoma (iCC). Surgical resection remains the only potentially curative therapeutic option and the central cornerstone of treatment. Adjuvant systemic treatment will be recommended after resection or...

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Autores principales: Krenzien, Felix, Nevermann, Nora, Krombholz, Alina, Benzing, Christian, Haber, Philipp, Fehrenbach, Uli, Lurje, Georg, Pelzer, Uwe, Pratschke, Johann, Schmelzle, Moritz, Schöning, Wenzel
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8773654/
https://www.ncbi.nlm.nih.gov/pubmed/35053523
http://dx.doi.org/10.3390/cancers14020362
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author Krenzien, Felix
Nevermann, Nora
Krombholz, Alina
Benzing, Christian
Haber, Philipp
Fehrenbach, Uli
Lurje, Georg
Pelzer, Uwe
Pratschke, Johann
Schmelzle, Moritz
Schöning, Wenzel
author_facet Krenzien, Felix
Nevermann, Nora
Krombholz, Alina
Benzing, Christian
Haber, Philipp
Fehrenbach, Uli
Lurje, Georg
Pelzer, Uwe
Pratschke, Johann
Schmelzle, Moritz
Schöning, Wenzel
author_sort Krenzien, Felix
collection PubMed
description SIMPLE SUMMARY: This review discusses multimodality treatment strategies for intrahepatic cholangiocarcinoma (iCC). Surgical resection remains the only potentially curative therapeutic option and the central cornerstone of treatment. Adjuvant systemic treatment will be recommended after resection or in the palliative setting. Increasing knowledge of phenotypic subclassification and molecular profiling allows investigation of targeted therapies as (neo-)adjuvant treatment. High-dose brachytherapy, internal radiation therapy, and transarterial chemoembolization are among the interventional treatment options being evaluated for unresectable iCC. Given the multiple options of multidisciplinary management, any treatment strategy should be discussed in a multidisciplinary tumor board and treatment should be directed by a specialized treatment center. ABSTRACT: Intrahepatic cholangiocarcinoma (iCC) is distinguished as an entity from perihilar and distal cholangiocarcinoma and gallbladder carcinoma. Recently, molecular profiling and histopathological features have allowed further classification. Due to the frequent delay in diagnosis, the prognosis for iCC remains poor despite major technical advances and multimodal therapeutic approaches. Liver resection represents the therapeutic backbone and only curative treatment option, with the functional residual capacity of the liver and oncologic radicality being deciding factors for postoperative and long-term oncological outcome. Furthermore, in selected cases and depending on national guidelines, liver transplantation may be a therapeutic option. Given the often advanced tumor stage at diagnosis or the potential for postoperative recurrence, locoregional therapies have become increasingly important. These strategies range from radiofrequency ablation to transarterial chemoembolization to selective internal radiation therapy and can be used in combination with liver resection. In addition, adjuvant and neoadjuvant chemotherapies as well as targeted therapies and immunotherapies based on molecular profiles can be applied. This review discusses multimodal treatment strategies for iCC and their differential use.
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spelling pubmed-87736542022-01-21 Treatment of Intrahepatic Cholangiocarcinoma—A Multidisciplinary Approach Krenzien, Felix Nevermann, Nora Krombholz, Alina Benzing, Christian Haber, Philipp Fehrenbach, Uli Lurje, Georg Pelzer, Uwe Pratschke, Johann Schmelzle, Moritz Schöning, Wenzel Cancers (Basel) Review SIMPLE SUMMARY: This review discusses multimodality treatment strategies for intrahepatic cholangiocarcinoma (iCC). Surgical resection remains the only potentially curative therapeutic option and the central cornerstone of treatment. Adjuvant systemic treatment will be recommended after resection or in the palliative setting. Increasing knowledge of phenotypic subclassification and molecular profiling allows investigation of targeted therapies as (neo-)adjuvant treatment. High-dose brachytherapy, internal radiation therapy, and transarterial chemoembolization are among the interventional treatment options being evaluated for unresectable iCC. Given the multiple options of multidisciplinary management, any treatment strategy should be discussed in a multidisciplinary tumor board and treatment should be directed by a specialized treatment center. ABSTRACT: Intrahepatic cholangiocarcinoma (iCC) is distinguished as an entity from perihilar and distal cholangiocarcinoma and gallbladder carcinoma. Recently, molecular profiling and histopathological features have allowed further classification. Due to the frequent delay in diagnosis, the prognosis for iCC remains poor despite major technical advances and multimodal therapeutic approaches. Liver resection represents the therapeutic backbone and only curative treatment option, with the functional residual capacity of the liver and oncologic radicality being deciding factors for postoperative and long-term oncological outcome. Furthermore, in selected cases and depending on national guidelines, liver transplantation may be a therapeutic option. Given the often advanced tumor stage at diagnosis or the potential for postoperative recurrence, locoregional therapies have become increasingly important. These strategies range from radiofrequency ablation to transarterial chemoembolization to selective internal radiation therapy and can be used in combination with liver resection. In addition, adjuvant and neoadjuvant chemotherapies as well as targeted therapies and immunotherapies based on molecular profiles can be applied. This review discusses multimodal treatment strategies for iCC and their differential use. MDPI 2022-01-12 /pmc/articles/PMC8773654/ /pubmed/35053523 http://dx.doi.org/10.3390/cancers14020362 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Krenzien, Felix
Nevermann, Nora
Krombholz, Alina
Benzing, Christian
Haber, Philipp
Fehrenbach, Uli
Lurje, Georg
Pelzer, Uwe
Pratschke, Johann
Schmelzle, Moritz
Schöning, Wenzel
Treatment of Intrahepatic Cholangiocarcinoma—A Multidisciplinary Approach
title Treatment of Intrahepatic Cholangiocarcinoma—A Multidisciplinary Approach
title_full Treatment of Intrahepatic Cholangiocarcinoma—A Multidisciplinary Approach
title_fullStr Treatment of Intrahepatic Cholangiocarcinoma—A Multidisciplinary Approach
title_full_unstemmed Treatment of Intrahepatic Cholangiocarcinoma—A Multidisciplinary Approach
title_short Treatment of Intrahepatic Cholangiocarcinoma—A Multidisciplinary Approach
title_sort treatment of intrahepatic cholangiocarcinoma—a multidisciplinary approach
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8773654/
https://www.ncbi.nlm.nih.gov/pubmed/35053523
http://dx.doi.org/10.3390/cancers14020362
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