Open AccessLiver transplantation for hilar cholangiocarcinoma
Author(s) -
R Robles,
Francisco SánchezBueno,
Pablo Ramı́rez,
Roberto Brusadín,
Pascual Parrilla
Publication year - 2013
Publication title -
world journal of gastroenterology
Language(s) - Uncategorized
Resource type - Journals
SCImago Journal Rank - 1.427
H-Index - 155
eISSN - 2219-2840
pISSN - 1007-9327
DOI - 10.3748/wjg.v19.i48.9209
Subject(s) - medicine , neoadjuvant therapy , liver transplantation , survival rate , klatskin tumor , stage (stratigraphy) , surgery , radiation therapy , overall survival , chemotherapy , transplantation , oncology , resection , cancer , paleontology , breast cancer , biology
The most appropriate treatment for Klatskin tumor (KT) with a curative intention is multimodal therapy based on achieving resection with tumour-free margins (R0 resections) combined with other types of neoadjuvant or adjuvant treatment (the most important factor affecting KT survival is the possibility of R0 resections, achieving 5-year survival rate of 40%-50%). Thirty to forty percent of patients with KT are inoperable and present a 5-year survival rate of 0%. In irresectable non-disseminated KT patients, using liver transplantation without neoadjuvant treatment, the 5-year survival rate increase to 38%, reaching 50% survival in early stage. In selected cases, with liver transplantation and neoadjuvant treatment (chemotherapy and radiotherapy), the actuarial survival rate is 65% at 5 years and 59% at 10 years. In conclusion, correct staging, neoadjuvant treatment, living donor and priority on the liver transplant waiting list may lead to improved results.