Document Detail

Cholangiocarcinoma--controversies and challenges.
MedLine Citation:
PMID:  21460876     Owner:  NLM     Status:  MEDLINE    
Cholangiocarcinomas are a diverse group of tumors that are presumed to originate from the biliary tract epithelium either within the liver or the biliary tract. These cancers are often difficult to diagnose, their pathogenesis is poorly understood, and their dismal prognosis has resulted in a nihilistic approach to their management. The two major clinical phenotypes are intrahepatic, mass-forming tumors and large ductal tumors. Among the ductal cancers, lesions at the liver hilum are most prevalent. The risk factors, clinical presentation, natural history and management of these two types of cholangiocarcinoma are distinct. Efforts to improve outcomes for patients with these diseases are affected by several challenges to effective management. For example, designations based on anatomical characteristics have been inconsistently applied, which has confounded analysis of epidemiological trends and assessment of risk factors. The evaluation of therapeutic options, particularly systemic therapies, has been limited by a lack of appreciation of the different phenotypes. Controversies exist regarding the appropriate workup and choice of management approach. However, new and emerging tools for improved diagnosis, expanded indications for surgical approaches, an emerging role for locoregional and intrabiliary therapies and improved systemic therapies provide optimism and hope for improved outcomes in the future.
Tushar Patel
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Nature reviews. Gastroenterology & hepatology     Volume:  8     ISSN:  1759-5053     ISO Abbreviation:  Nat Rev Gastroenterol Hepatol     Publication Date:  2011 Apr 
Date Detail:
Created Date:  2011-04-04     Completed Date:  2011-07-21     Revised Date:  2014-09-14    
Medline Journal Info:
Nlm Unique ID:  101500079     Medline TA:  Nat Rev Gastroenterol Hepatol     Country:  England    
Other Details:
Languages:  eng     Pagination:  189-200     Citation Subset:  IM    
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MeSH Terms
Bile Duct Neoplasms / epidemiology,  pathology,  therapy*
Bile Ducts, Intrahepatic*
Cholangiocarcinoma / epidemiology,  pathology,  therapy*
Combined Modality Therapy
Neoplasm Staging
Risk Factors
Grant Support

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