Kim Hyo Jung
Department of Internal Medicine, Hallym University Sacred Heart Hospital, Dongan-gu, Anyang, Korea.
Korean J Gastroenterol. 2005 Jul;46(1):20-7.
Hilar cholangiocarcinoma represent the majority of cholangiocarcinoma, accounting for 40-60% of whole cases. Complete resection remains the most effective and only potentially curative therapy for cholangiocarcinoma. Important factors for resection of cholangiocarcinoma such as diagnostic methods and clinical staging has been improved. Cancer staging system should be useful for guiding treatment and predicting the chance of survival. After Bismuth-Corlette classification was reported, several staging systems has been proposed and updated to accomplish this purpose. Currently 6(th) ed. American Joint Committee on Cancer (AJCC) staging, 2nd ed. Japanese Society of Biliary Surgery (JSBS) classification and modified Memorial Sloan-Kettering Cancer Center (MSKCC) classification are used worldwide for staging of hilar cholangiocarcinoma. These systems consider not only the tumor extent but also local biological factors that affect the resectability, but the priority among them has not yet been evaluated and randomized studies are being expected to verify this.
肝门部胆管癌占胆管癌的大多数,占全部病例的40%-60%。完整切除仍然是胆管癌最有效且唯一可能治愈的治疗方法。胆管癌切除的重要因素如诊断方法和临床分期已得到改善。癌症分期系统应有助于指导治疗并预测生存机会。在报道了比氏(Bismuth-Corlette)分类后,已提出并更新了几种分期系统以实现这一目的。目前,美国癌症联合委员会(AJCC)第6版分期、日本胆道外科学会(JSBS)第2版分类以及改良的纪念斯隆凯特琳癌症中心(MSKCC)分类在全球范围内用于肝门部胆管癌的分期。这些系统不仅考虑肿瘤范围,还考虑影响可切除性的局部生物学因素,但它们之间的优先级尚未评估,期待随机研究来验证这一点。