Portal de Periódicos da CAPES

Classification, Diagnosis, and Management of Cholangiocarcinoma

2012; Elsevier BV; Volume: 11; Issue: 1 Linguagem: Inglês

10.1016/j.cgh.2012.09.009

1542-7714

Nataliya Razumilava, Gregory J. Gores,

Pediatric Hepatobiliary Diseases and Treatments

CCAs arise from different topographic regions of the biliary tree; each subtype is characterized by its unique behavior (Figure 6). Cross-sectional imaging studies and ERC with brush cytology analysis are mainstays of evaluation that can be enhanced by EUS and assays for serum levels of CA19-9. Treatment options for CCA are limited and should be tailored for each tumor subtype with respect to its extent, other liver diseases, level of vascular involvement, and presence of metastases. The only effective therapies are resection with negative tumor margins, for all CCA subtypes, and liver transplantation, for a subset of early stage pCCAs. Systemic chemotherapy with gemcitabine and cisplatin is a pragmatic practice standard for patients with inoperable tumors, although more effective therapies need to be developed. There is insufficient evidence for the efficacy of chemoradiation as a neoadjuvant, aside from liver transplantation neoadjuvant protocols. Increasing our understanding of the pathogenesis of CCA could lead to more effective therapies.Figure 6Key points in approach to CCA. FISH, fluorescent in situ hybridization.View Large Image Figure ViewerDownload Hi-res image Download (PPT)