Khan SA, Davidson BR, Goldin R, et al. (2002) Guidelines for the diagnosis and treatment of cholangiocarcinoma: consensus document. Gut, 51 Suppl 6:VI1-9
DIAGNOSIS
Clinical Features: Cholangiocarcinoma usually presents after the disease is advanced. This is particularly true with more proximal intrahepatic and perihilar tumours obstructing one duct, which often present with systemic manifestations of malignancy, such as malaise, fatigue, and weight loss. Some cases are detected incidentally as a result of deranged liver function tests, or ultrasound scans performed for other indications.
TREATMENT
Surgery: Surgery is the only curative treatment for patients with cholangiocarcinoma. Surgery cures the minority of patients with cholangiocarcinoma, with a 9–18% five year survival for proximal bile duct lesions and 20–30% for distal lesions.
Resectable Tumors: Median survival for patients with intrahepatic cholangiocarcinoma:
– without hilar involvement is 18–30 months;
– with perihilar tumour is 12–24 months;
– five year survival rates of up to 40% have been reported for intrahepatic cholangiocarcinoma (best results in
Japan), and 20% for hilar cholangiocarcinoma.
Chemotherapy: Partial response rates to newer single agents, such as gemcitabine, vary from 20% to 30%
Levels of Evidence: Table A1
DIAGNOSIS
Clinical Features: Cholangiocarcinoma usually presents after the disease is advanced. This is particularly true with more proximal intrahepatic and perihilar tumours obstructing one duct, which often present with systemic manifestations of malignancy, such as malaise, fatigue, and weight loss. Some cases are detected incidentally as a result of deranged liver function tests, or ultrasound scans performed for other indications.
TREATMENT
Surgery: Surgery is the only curative treatment for patients with cholangiocarcinoma. Surgery cures the minority of patients with cholangiocarcinoma, with a 9–18% five year survival for proximal bile duct lesions and 20–30% for distal lesions.
Resectable Tumors: Median survival for patients with intrahepatic cholangiocarcinoma:
– without hilar involvement is 18–30 months;
– with perihilar tumour is 12–24 months;
– five year survival rates of up to 40% have been reported for intrahepatic cholangiocarcinoma (best results in
Japan), and 20% for hilar cholangiocarcinoma.
Chemotherapy: Partial response rates to newer single agents, such as gemcitabine, vary from 20% to 30%
Levels of Evidence: Table A1
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