Liver Cancer pp 95-116 | Cite as

Treatment of Cholangiocarcinoma

  • Kelly M. McMasters
  • Steven A. Curley
Part of the M.D. Anderson Solid Tumor Oncology Series book series (MDA)


Cholangiocarcinomas, malignant tumors that arise from the intrahepatic or extrahepatic bile ducts, are rare, comprising fewer than 10% of primary malignancies of the liver.1 There are only about 4000 new cases of cholangiocarcinoma per year in the United States, being diagnosed most frequently during the fifth and sixth decades of life.2 The prognosis for patients with this disease remains dismal despite advances in the operative and nonoperative management.3–7


Bile Duct Hepatic Duct Extrahepatic Bile Duct Caudate Lobe Hilar Cholangiocarcinoma 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


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  1. 1.
    Anthony PP. Tumours and tumour-like lesions of the liver and biliary tract. In: MacSween RNM, Anthony PP, Scheuer PJ (eds) Pathology of the Liver, 2nd ed. Edinburgh, Churchill Livingstone, 1987, p. 574Google Scholar
  2. 2.
    Moto R, Kawarada Y. Diagnosis and treatment of cholangiocarcinoma and cystic adenocarcinoma of the liver. In: Okuda K, Ishak KG (eds) Neoplasms of the Liver. Tokyo, Springer, 1987, p.381Google Scholar
  3. 3.
    Pitt H, Dooley W, Yeo C, Cameron J. Malignancies of the biliary tract. Curr Probl Surg 32:1, 1995PubMedCrossRefGoogle Scholar
  4. 4.
    Blumgart LH, Stain SC. Surgical treatment of cholangiocarcinoma. In: Sugarbaker P (ed) Hepatobiliary Cancer. Boston, Kluwer, 1994, pp.75–96Google Scholar
  5. 5.
    Curley SA, Levin B, Rich TA. Liver and bile ducts. In: Abeloff MD, Armitage JO, Lichter AS, Niederhuber JE (eds) Clinical Oncology. New York, Churchill Livingstone, 1995, pp. 1305–1372Google Scholar
  6. 6.
    Blumgart LH, Benjamin IS. Cancer of the bile ducts In: Blumgart LH (ed) Surgery of the Liver and Biliary Tract. Edinburgh, Churchill Livingstone, 1994, pp. 967–995Google Scholar
  7. 7.
    Vauthey J-N, Blumgart LH. Recent advances in the management of cholangiocar-cinomas. Semin Liver Dis 14:109, 1994PubMedCrossRefGoogle Scholar
  8. 8.
    Nakeeb A, Pitt HA, Sohn TA, et al. Cholangiocarcinoma: a spectrum of intrahepatic, perihilar, and distal tumors. Ann Surg 224:463, 1996PubMedCrossRefGoogle Scholar
  9. 9.
    Bismuth H, Corlette MB. Intrahepatic cholangioenteric anastomosis in carcinoma of the hilus of the liver. Surg Gynecol Obstet 140:170, 1975PubMedGoogle Scholar
  10. 10.
    Jalanko H, Kuusela P, Roberts P, et al. Comparison of a new tumor marker, CA 19–9T, with a-fetoprotein and carcinoembryonic antigen in patients with upper gastrointestinal disease. J Clin Pathol 37:218, 1984PubMedCrossRefGoogle Scholar
  11. 11.
    Nichols JC, Gores GJ, LaRusso NF, et al. Diagnostic role of serum CA 19–9 for cholangiocarcinoma in patients with primary sclerosing cholangitis. Mayo Clin Proc 68:874, 1993PubMedGoogle Scholar
  12. 12.
    Ramage JK, Donaghy A, Farrant JM, et al. Serum tumor markers for the diagnosis of cholangiocarcinoma in primary sclerosing cholangitis. Gastroenterology 108:865, 1995PubMedCrossRefGoogle Scholar
  13. 13.
    Liver Cancer Study Group of Japan. Primary liver cancer in Japan. Cancer 54:1747, 1984CrossRefGoogle Scholar
  14. 14.
    Liver Cancer Study Group of Japan. Primary liver cancer in Japan: sixth report. Cancer 60:1400, 1987CrossRefGoogle Scholar
  15. 15.
    Okuda K. Liver Cancer Study Group of Japan. Primary liver cancers in Japan. Cancer 45:2663, 1980CrossRefGoogle Scholar
  16. 16.
    Liguory C, Canard JM. Tumours of the biliary system. Clin Gastroenterol 12:269, 1983PubMedGoogle Scholar
  17. 17.
    Chou FF, Sheen-Chen SM, Chen CL, et al. Prognostic factors of resectable intrahepatic cholangiocarcinoma. J Surg Oncol 59:40, 1995PubMedCrossRefGoogle Scholar
  18. 18.
    Pichlmayr R, Lamesch P, Weimann A, Tusch G, Ringe B. Surgical treatment of cholangiocellular carcinoma. World J Surg 19:83, 1995PubMedCrossRefGoogle Scholar
  19. 19.
    Sansalone CV, Colella G, Caccamo L, et al. Orthotopic liver transplantation for primary biliary tumors: Milan multicenter experience. Transplant Proc 26:3561, 1994PubMedGoogle Scholar
  20. 20.
    Goldstein RM, Stone M, Tillery GW, et al. Is liver transplantation indicated for cholangiocarcinoma? Am J Surg 166:768, 1993PubMedCrossRefGoogle Scholar
  21. 21.
    Fardel D. Malignant neoplasms of the extrahepatic biliary ducts. Ann Surg 76:205, 1922CrossRefGoogle Scholar
  22. 22.
    Altemeier WA, Gall EA, Zinninger MM, et al. Sclerosing carcinoma of the major intrahepatic bile ducts. Arch Surg 75:450, 1957CrossRefGoogle Scholar
  23. 23.
    Klatskin G. Adenocarcinoma of the hepatic duct at its bifurcation within the porta hepatis. Am J Med 38:241, 1965PubMedCrossRefGoogle Scholar
  24. 24.
    Wheeler PG, Dawson JL, Nunnerly H, et al. Newer techniques in the diagnosis and treatment of proximal bile duct carcinoma: an analysis of 41 consecutive patients. Q J Med 50:247, 1981PubMedGoogle Scholar
  25. 25.
    Okuda K, Ohto M, Tsuchiya Y. The role of ultrasound, percutaneous transhepatic cholangiography, computed tomographic scanning, and magnetic resonance imaging in the preoperative assessment of bile duct cancer. World J Surg 12:18, 1988PubMedCrossRefGoogle Scholar
  26. 26.
    Garber ST, Donald JJ, Lees WR. Cholangiocarcinoma: ultrasound features and correlation of tumor position with survival. Abdom Imaging 18:69, 1993CrossRefGoogle Scholar
  27. 27.
    Neumaie, CE, Bertolotto M, Perrone R, et al. Staging of hilar cholangiocarcinoma with ultrasound. J Clin Ultrasound 23:173, 1995CrossRefGoogle Scholar
  28. 28.
    Elias E, Hamlyn AN, Jain S, et al. A randomized trial of percutaneous transhepatic cholangiography with the Chiba needle versus ERCP for bile duct visualization in jaundice. Gastroenterology 71:439, 1976PubMedGoogle Scholar
  29. 29.
    Tanaka M, Ogawa Y, Matsumoto S, et al. The role of endoscopic retrograde cholangiopancreatography in preoperative assessment of bile duct cancer. World J Surg 12:27, 1988PubMedCrossRefGoogle Scholar
  30. 30.
    Voyles CR, Bowley NJ, Allison DJ, et al. Carcinoma of the proximal extrahepatic biliary tree, radiologic assessment and therapeutic alternatives. Ann Surg 197:188, 1983PubMedCrossRefGoogle Scholar
  31. 31.
    Blumgart LH, Baer HU. Hilar and intrahepatic biliary-euteric anastomosis. In: Blumgart LH (ed) Surgery of the Liver and Biliary Tract. Edinburgh, Churchill Livingstone, 1994Google Scholar
  32. 32.
    Alexandre JH, Dehni N, Bouillot JL. Stented hepaticojejunostomies after resection for cholangiocarcinoma allow access for subsequent diagnosis and therapy. Am J Surg 169:428, 1995PubMedCrossRefGoogle Scholar
  33. 33.
    Mittal B, Deutsch M, Iwatsuki S. Primary cancers of the extrahepatic biliary passages. Int J Radiat Oncol Biol Phys 11:849, 1985PubMedCrossRefGoogle Scholar
  34. 34.
    Mizumoto R, Kawarada Y, Suzuki H. Surgical treatment of hilar carcinoma of the bile duct. Surg Gynecol Obstet 162:153, 1986PubMedGoogle Scholar
  35. 35.
    Mizumoto R, Suzuki H. Surgical anatomy of the hepatic hilum with special reference to the caudate lobe. World J Surg 12:2, 1988PubMedCrossRefGoogle Scholar
  36. 36.
    Bengmark S, Ekberg H, Evander A, et al. Major liver resection for hilar cholangiocarcinoma. Ann Surg 207:120, 1988PubMedCrossRefGoogle Scholar
  37. 37.
    Iwasaki Y, Okamura T, Ozaki A, et al. Surgical treatment for carcinoma at the confluence of the major hepatic ducts. Surg Gynecol Obstet 162:457, 1986PubMedGoogle Scholar
  38. 38.
    White TT. Skeletization resection and central hepatic resection in the treatment of bile duct cancer. World J Surg 12:48, 1988PubMedCrossRefGoogle Scholar
  39. 39.
    Pinson CW, Rossi RL. Extended right hepatic lobectomy, left hepatic lobectomy, and skeletonization resection for proximal bile duct cancer. World J Surg 12:52, 1988PubMedCrossRefGoogle Scholar
  40. 40.
    Washburn WK, Lewis WD, Jenkins RL. Aggressive surgical resection for cholangiocarcinoma. Arch Surg 130:270, 1995PubMedCrossRefGoogle Scholar
  41. 41.
    Baer HU, Stain SC, Dennison AR, Eggers B, Blumgart LH. Improvements in survival by aggressive resections of hilar cholangiocarcinoma. Ann Surg 217:20, 1993PubMedCrossRefGoogle Scholar
  42. 42.
    Cameron JL, Pitt HA, Zinner MJ, et al. Management of proximal cholangiocar-cinomas by surgical resection and radiotherapy. Am J Surg 159:91, 1990PubMedCrossRefGoogle Scholar
  43. 43.
    Schoenthaler R, Phillips TL, Castro J, et al. Carcinoma of the extrahepatic bile ducts: the University of California at San Francisco experience. Ann Surg 219:264, 1994CrossRefGoogle Scholar
  44. 44.
    Buskirk SJ, Gunderson LL, Schild SE, et al. Analysis of failure after curative irradiation of extrahepatic bile duct carcinoma. Ann Surg 215:125, 1992PubMedCrossRefGoogle Scholar
  45. 45.
    Alden ME, Mohiuddin M. The impact of radiation dose in combined external beam and intraluminal IR-192 brachytherapy for bile duct cancer. Int J Radiat Biol Phys 28:945, 1994CrossRefGoogle Scholar
  46. 46.
    Tollenaar RA, vende Veld CJ, Taat CW, et al. External radiotherapy and extrahepatic bile duct cancer. Eur J Surg 157:587, 1991PubMedGoogle Scholar
  47. 47.
    Gonzalez Gonzalez D, Gerard JP, Maners AW, et al. Results of radiation therapy in carcinoma of the proximal bile duct (Klatskin tumor). Semin Liver Dis 10:131, 1990CrossRefGoogle Scholar
  48. 48.
    Hayes JK, Sapozink MD, Miller FJ. Definitive radiation therapy in bile duct carcinoma. Int J Radiat Oncol Biol Phys 15:735, 1988PubMedCrossRefGoogle Scholar
  49. 49.
    Pitt HA, Nakeeb A, Abrams RA, et al. Perihilar cholangiocarcinoma: postoperative radiotherapy does not improve survival. Ann Surg 221:788, 1995PubMedCrossRefGoogle Scholar
  50. 50.
    McMasters KM, Tuttle TM, Leach SD, et al. Neoadjuvant chemoradiation for extrahepatic cholangiocarcinoma. Am J Surg 174:605, 1997PubMedCrossRefGoogle Scholar
  51. 51.
    Evans DB, Abbruzzese JL, Cleary KR et al. Rapid-fractionation pre-operative chemoradiation for malignant periampullary neoplasms. J R Coll Surg Edinb 40:319, 1995PubMedGoogle Scholar
  52. 52.
    Oberfield RA, Rossi RL. The role of chemotherapy in the treatment of bile duct cancer. World J Surg 12:105, 1988PubMedCrossRefGoogle Scholar
  53. 53.
    Curley SA, Cameron JL: Hilar bile duct cancer: a diagnostic and therapeutic challenge. Cancer Bull 44:309, 1992.Google Scholar
  54. 54.
    Lai ECS, Tompkins RK, Roslyn JJ, et al. Proximal bile duct cancer: quality of survival. Ann Surg 205:111, 1987PubMedCrossRefGoogle Scholar
  55. 55.
    Nagorney DM, Donohue JH, Farnell MB, et al. Outcomes after curative resections of cholangiocarcinoma. Arch Surg 128:8T71, 1993CrossRefGoogle Scholar
  56. 56.
    Tompkins RK, Thomas D, Wile A, et al. Prognostic factors in bile duct carcinoma. Ann Surg 194:447, 1981PubMedCrossRefGoogle Scholar
  57. 57.
    Ouchi K, Suzuki M, Hashimoto L, et al. Histologic findings and prognostic factors in carcinoma of the upper bile duct. Am J Surg 157:552, 1989PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 1998

Authors and Affiliations

  • Kelly M. McMasters
  • Steven A. Curley

There are no affiliations available

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