Singal Amit, Welling Theodore H, Marrero Jorge A
Department of Internal Medicine, University of Michigan, 3912 Taubman Center, SPC 5362, Ann Arbor, MI 48109, USA.
Expert Rev Anticancer Ther. 2009 Apr;9(4):491-502. doi: 10.1586/era.09.5.
Cholangiocarcinoma is a rare malignancy arising from the bile duct epithelium with a grim prognosis. Although complete resection may be curative, it is feasible only in a minority of cases owing to local extension of the tumor. Early experiences with liver transplantation were discouraging, given the high rates of tumor recurrence and poor patient survival. Trials with aggressive transplantation methods and adjuvant chemotherapy did not yield significantly better outcomes. Recently, stringent patient selection and neoadjuvant chemoradiation have yielded promising results with 5-year survival rates as high as 76%. Factors associated with recurrence after transplantation include advanced age, history of cholecystectomy, elevated serum glycoprotein cancer antigen 19-9 level, a discreet mass on imaging and an interval from enrollment to transplant greater than 100 days.
胆管癌是一种起源于胆管上皮的罕见恶性肿瘤，预后较差。尽管完整切除可能治愈，但由于肿瘤局部扩散，仅在少数病例中可行。鉴于肿瘤复发率高和患者生存率低，早期肝移植的经验并不乐观。采用积极的移植方法和辅助化疗的试验并未取得明显更好的结果。最近，严格的患者选择和新辅助放化疗取得了令人鼓舞的结果，5年生存率高达76%。移植后复发相关因素包括高龄、胆囊切除术史、血清糖蛋白癌抗原19-9水平升高、影像学上的隐匿性肿块以及从入组到移植的间隔时间超过100天。
