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Vascular Resection for Intrahepatic Cholangiocarcinoma: Current Considerations
Ruslan Alikhanov1, Anna Dudareva2, Miguel Ángel Trigo3
1Department of Liver and Pancreatic Surgery, Department of Transplantation, Moscow Clinical Scientific Centre, 111123 Moscow, Russia.
Journal of Clinical Medicine
|September 10, 2021
Summary
Aggressive surgery for intrahepatic cholangiocarcinoma (iCCA) offers curative potential but recurrence is common. Multimodal treatments combining surgery with neoadjuvant chemotherapy and radiotherapy are necessary to improve outcomes for this liver cancer.
Area of Science:
- Hepatobiliary surgery
- Surgical oncology
- Gastroenterology
Background:
- Intrahepatic cholangiocarcinoma (iCCA) comprises about 10% of primary liver cancers.
- Surgical resection is the sole potentially curative option for iCCA, even with macrovascular invasion.
Purpose of the Study:
- To evaluate the role and limitations of aggressive surgical resection in intrahepatic cholangiocarcinoma.
- To highlight the need for multimodal treatment strategies to improve oncological outcomes.
Main Methods:
- Review of surgical approaches for iCCA, including extended liver resection, major vascular resection, and specialized procedures like ALPPS.
- Analysis of recurrence rates and long-term survival following aggressive surgical management.
Main Results:
- Aggressive surgical resection, including complex procedures, can achieve complete tumor removal in selected iCCA cases.
- Despite aggressive surgery, high rates of tumor recurrence and poor long-term oncological results are frequently observed.
Conclusions:
- Surgery alone is insufficient to significantly improve prognosis for intrahepatic cholangiocarcinoma.
- Multimodal treatment, incorporating neoadjuvant chemotherapy, radiotherapy, and adjuvant therapies, is essential for enhancing patient outcomes in iCCA.
