Hilar cholangiocarcinoma (Klatskin tumor) – current treatment options


Authors: F. Bělina
Authors‘ workplace: Chirurgická klinika 2. LF UK a ÚVN Praha, přednosta: prof. MUDr. M. Ryska, CSc.
Published in: Rozhl. Chir., 2013, roč. 92, č. 1, s. 4-15.
Category: Review

Overview

Hilar cholangiocarcinoma is a rare tumor with a rather poor prognosis, and thus remains a challenge for diagnosis and treatment. The sole potentionally curative treatment is the complete resection of the tumor. A negative surgical margin is one of the most important factors in achieving prolonged survival. A preoperative evaluation of the tumor is important for the evaluation of resectability and the extent of surgery. Unfortunately, only a small number of patients with hilar cholangiocarcinoma is indicated for the radical procedure. Liver transplantation is not a standard method in the treatment of the Klatskin tumor and it is reserved only for carefully selected patients in a few transplant centres. The main aim of the palliative treatment is biliary drainage, reduction of the pain and pruritus and overall improvement of the quality of life. Adjuvant chemotherapy and radiotherapy are the important parts of the complex therapy, however, no definite regimen has been established to date. Further evidence is needed to define the role of liver transplantation and (neo)adjuvant new therapeutic modalities.

Key words:
hilar cholangiocarcinoma – radical surgery – palliative treatment – liver transplantation – (neo) adjuvant chemotherapy – radiotherapy


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