Surgery and chemotherapy for intrahepatic cholangiocarcinoma
Surgery and chemotherapy for intrahepatic cholangiocarcinoma
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DOI：
10.4254/wjh.v2.i2.58
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发表时间：
2010-02-27
影响因子：
2.4
通讯作者：
Takeura, Chinatsu
中科院分区：
文献类型：
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作者：
Morise, Zenichi;Sugioka, Atsushi;Takeura, Chinatsu
胆管癌起源于胆管上皮，分为肝内胆管癌（ICC）和肝外胆管癌（ECC），包括肝门胆管癌。近年来，ICC的发病率和死亡率在世界范围内呈上升趋势。完整的手术切除是治愈ICC的唯一方法。然而，这些肿瘤的局部区域扩展通常是先进的肝内和淋巴结转移在诊断时。可切除率相当低且可变（18%-70%）。据报道，手术切除后的5年生存率为20%-40%。ICC切除后的中位生存时间为12-37.4个月。由于ICC罕见，在化疗研究中仅报道了少数ICC病例，并伴有ECC、胆囊癌和壶腹癌。然而，在一些报告中，达到了显著的抗癌效果，反应率高达40%，中位生存期为一年。虽然肝切除术后ICC复发率高，但残余肝和肺是初步根治性手术后复发的主要部位。在我们的研究中，有几个患者通过反复手术和化疗获得了长期生存。反复手术，结合新的有效化疗方案，可以提高ICC患者的生存率。(c)2010年百世登。All rights reserved.
Cholangiocarcinoma, arising from bile duct epithelium, is categorized into intrahepatic cholangiocarcinoma (ICC) and extrahepatic cholangiocarcinoma (ECC), including hilarcholangiocarcinoma. Recently, there has been a worldwide increase in the incidence and mortality from ICC. Complete surgical resection is the only approach to cure the patients with ICC. However, locoregional extension of these tumors is usually advanced with intrahepatic and lymph-node metastases at the time of diagnosis. Resectability rates are quite low and variable (18%-70%). The five-year survival rate after surgical resection was reported to be 20%-40%. Median survival time after ICC resection was 12-37.4 mo. Only a small number of ICC cases, accompanied with ECC, gall bladder carcinoma, and ampullary carcinoma, have been reported in the studies of chemotherapy due to the rarity of the disease. However, in some reports, significant anti-cancer effects were achieved with a response rate of up to 40% and a median survival of one year. Although recurrence rate after hepatectomy is high for the patients with ICC, the residual liver and the lung are the main sites of recurrence after tentative curative surgical resection. Several patients in our study had a long-term survival with repeated surgery and chemotherapy. Repeated surgery, combined with new effective regimens of chemotherapy, could benefit the survival of ICC patients. (c) 2010 Baishideng. All rights reserved.