Akateh Clifford, Ejaz Aslam M, Pawlik Timothy Michael, Cloyd Jordan M
Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, OH 43210, United States.
Department of Surgery, The Ohio State University, Columbus, OH 43210, United States.
World J Hepatol. 2020 Oct 27;12(10):693-708. doi: 10.4254/wjh.v12.i10.693.
Intrahepatic cholangiocarcinoma (ICC) is the second most common primary liver malignancy and is increasing in incidence. Long-term outcomes are optimized when patients undergo margin-negative resection followed by adjuvant chemotherapy. Unfortunately, a significant proportion of patients present with locally advanced, unresectable disease. Furthermore, recurrence rates are high even among patients who undergo surgical resection. The delivery of systemic and/or liver-directed therapies prior to surgery may increase the proportion of patients who are eligible for surgery and reduce recurrence rates by prioritizing early systemic therapy for this aggressive cancer. Nevertheless, the available evidence for neoadjuvant therapy in ICC is currently limited yet recent advances in liver directed therapies, chemotherapy regimens, and targeted therapies have generated increasing interest its role. In this article, we review the rationale for, current evidence for, and ongoing research efforts in the use of neoadjuvant therapy for ICC.
肝内胆管癌（ICC）是第二常见的原发性肝脏恶性肿瘤，其发病率正在上升。当患者接受切缘阴性切除并辅以辅助化疗时，长期预后最佳。不幸的是，相当一部分患者就诊时已处于局部晚期、无法切除的疾病状态。此外，即使在接受手术切除的患者中，复发率也很高。术前进行全身和/或肝靶向治疗可能会增加符合手术条件的患者比例，并通过优先对这种侵袭性癌症进行早期全身治疗来降低复发率。然而，目前关于ICC新辅助治疗的现有证据有限，不过肝靶向治疗、化疗方案和靶向治疗的最新进展引发了人们对其作用的越来越浓厚的兴趣。在本文中，我们综述了ICC使用新辅助治疗的理论依据、现有证据以及正在进行的研究工作。
