Shen F, Xie Z H, Xia Y, Wu M C
Department of Hepatic Surgery IV, Shanghai Eastern Hepatobiliary Surgery Hospital, Shanghai 200433, China.
Zhonghua Wai Ke Za Zhi. 2019 Apr 1;57(4):241-246. doi: 10.3760/cma.j.issn.0529-5815.2019.04.001.
Intrahepatic cholangiocarcinoma(ICC)is a primary liver cancer with its incidence only after hepatocellular carcinoma.Liver resection is currently the only established effective treatment for patients with ICC.However,the resectability of ICC is low and the long-term survival after surgery is far from satisfactory. With the advances in the understanding of the biological characteristics and prognostic characteristics of ICC, surgical strategy and techniques have improved in recent years, and the long-term survival has also been increased. The accurate clinical diagnosis of ICC, R0 resection, routine lymphadenectomy, effective adjuvant therapy after R0 resection, and multidisciplinary treatment including re-hepatectomy for recurrent ICC are important for achieving an optimal outcome.Down-staging management for patients with unresectable ICC may provide a chance of R0 resection in some patients. Further research on the biological heterogeneity of ICC,and the improvement of surgical treatment or the establishment of new treatment methods are the main research directions in the future.
肝内胆管癌(ICC)是一种原发性肝癌,其发病率仅次于肝细胞癌。肝切除术是目前唯一已确立的针对ICC患者的有效治疗方法。然而,ICC的可切除性较低,术后长期生存率远不尽人意。随着对ICC生物学特性和预后特征认识的进展,近年来手术策略和技术有所改进,长期生存率也有所提高。ICC的准确临床诊断、R0切除、常规淋巴结清扫、R0切除术后有效的辅助治疗以及包括对复发性ICC进行再次肝切除在内的多学科治疗对于实现最佳治疗效果至关重要。对不可切除ICC患者进行降期处理可能会为部分患者提供R0切除的机会。对ICC生物学异质性的进一步研究以及手术治疗的改进或新治疗方法的建立是未来的主要研究方向。