Intrahepatic, perihilar and distal cholangiocarcinoma

Management and outcomes

David Waseem, Tushar C Patel

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Introduction and aims. Cholangiocarcinomas are a heterogeneous group of tumors that can be classified into three clinically distinct types of cancers, intrahepatic, perihilar and distal cholangiocarcinoma. The inconsistent use of nomenclature for these cancers has obscured a true knowledge of the epidemiology, natural history and response to therapy of these cancers. Our aims were to define demographic characteristics, management and outcomes of these three distinct cancer types. Materials and methods. A retrospective study of patients enrolled in an institutional cancer registry from 1992 to 2010. Median survival was compared between different treatment modalities over three time periods for the three types of cholangiocarcinoma at different stages of the disease using Kaplan Meyer analysis. Results. 242 patients were identified. All cases were reviewed and classified into intrahepatic (90 patients), distal (48 patients) or perihilar (104 patients) cholangiocarcinomas. These cancers differed in median age of onset, gender distribution, median survival and stage. 13.8% of patients presented with stage I, 5.8% with stage II, 9.6% with stage III, 28% with stage IV, with 41.8% having unknown stage. The overall median survival was 15.8 months, and was 23, 25, 14, and 4.5 months for stages I, II, III, and IV respectively. Surgery improved survival in both early and advanced stages. Multimodality therapies further improved outcomes, particularly for perihilar cholangiocarcinoma. Conclusion. Perihilar, distal and intrahepatic cholangiocarcinoma vary in their presentation, natural history and therapeutic approach to management. A consistently applied classification is essential for meaningful interpretation of studies of these cancers.

Original languageEnglish (US)
Pages (from-to)133-139
Number of pages7
JournalAnnals of Hepatology
Volume16
Issue number1
DOIs
StatePublished - Jan 1 2017

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Klatskin Tumor
Cholangiocarcinoma
Neoplasms
Survival
Natural History
Therapeutics
Age of Onset
Terminology
Registries
Epidemiology
Retrospective Studies
Demography

Keywords

  • Biliary cancers
  • Management
  • Natural history
  • Survival

ASJC Scopus subject areas

  • Hepatology

Cite this

Intrahepatic, perihilar and distal cholangiocarcinoma : Management and outcomes. / Waseem, David; Patel, Tushar C.

In: Annals of Hepatology, Vol. 16, No. 1, 01.01.2017, p. 133-139.

Research output: Contribution to journalArticle

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