<abstract xmlns="http://www.w3.org/1999/xhtml"><sec id="j_raon-2020-0045_s_005_w2aab3b7c18b1b6b1aab1c16b1Aa"><h3>Background</h3><p>Intrahepatic cholangiocarcinoma (ICC) is the second most common liver primary tumour after hepatocellular carcinoma and represents 20% of all the cholangiocarcinomas. Its incidence is increasing and mortality rates are rising. Surgical resection is the only option to cure the disease, despite the high recurrence rates reported to be up to 80%. Intrahepatic recurrences may be still treated with curative intent in a small percentage of the patients. Unfortunately, due to lack of specific symptoms, most patients are diagnosed in a late stage of disease and often unsuitable for resection. Liver transplantation for ICC is still controversial. After the first published poor results, improving outcomes have been reported in highly selected cases, including locally advanced ICC treated with neoadjuvant chemotherapy, when successful in controlling tumour progression. Thus, liver transplantation should be considered a possible option within study protocols. When surgical management is not possible, palliative treatments include chemotherapy, radiotherapy and loco-regional treatments such as radiofrequency ablation, trans-arterial chemoembolization or radioembolization.</p></sec><sec id="j_raon-2020-0045_s_006_w2aab3b7c18b1b6b1aab1c16b2Aa"><h3>Conclusions</h3><p>This update on the management of ICC focusses on surgical treatments. Known and potential prognostic factors are highlighted in order to assist in treatment selection.</p></sec></abstract>

BackgroundIntrahepatic cholangiocarcinoma (ICC) is the second most common liver primary tumour after hepatocellular carcinoma and represents 20% of all the cholangiocarcinomas. Its incidence is increasing and mortality rates are rising. Surgical resection is the only option to cure the disease, despite the high recurrence rates reported to be up to 80%. Intrahepatic recurrences may be still treated with curative intent in a small percentage of the patients. Unfortunately, due to lack of specific symptoms, most patients are diagnosed in a late stage of disease and often unsuitable for resection. Liver transplantation for ICC is still controversial. After the first published poor results, improving outcomes have been reported in highly selected cases, including locally advanced ICC treated with neoadjuvant chemotherapy, when successful in controlling tumour progression. Thus, liver transplantation should be considered a possible option within study protocols. When surgical management is not possible, palliative treatments include chemotherapy, radiotherapy and loco-regional treatments such as radiofrequency ablation, trans-arterial chemoembolization or radioembolization.ConclusionsThis update on the management of ICC focusses on surgical treatments. Known and potential prognostic factors are highlighted in order to assist in treatment selection.

Current management of intrahepatic cholangiocarcinoma: from resection to palliative treatments

Radiology and Oncology

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

BackgroundIntrahepatic cholangiocarcinoma (ICC) is the second most common liver primary tumour after hepatocellular carcinoma and represents 20% of all the...

	Tumor diameter	Number of lesion	Extent of disease	Nodal Invasion	Vascular invasion	Metastatic disease	Other prognostic factors
LCSGJ9	Cut-off: 2 cm	Yes	Invasion serosa of the	Yes	Yes	Yes
NCCJ53		Yes		Yes	Yes		Symptoms
AJCC38	Cut-off: 5 cm		Yes	Yes	Yes	Yes
Wang et al.49	Yes	Yes		Yes	Yes	Yes	CACEA 19.9
Hyder et al.43	Yes	Yes		Yes	Yes		Cirrhosis Age

Current management of intrahepatic cholangiocarcinoma: from resection to palliative treatments

Article Category: Review

Published Online: Jul 29, 2020

Page range: 263 - 271

Received: May 10, 2020

Accepted: Jun 29, 2020

DOI: https://doi.org/10.2478/raon-2020-0045

© 2020 Ilenia Bartolini, Matteo Risaliti, Laura Fortuna, Carlotta Agostini, Maria Novella Ringressi, Antonio Taddei, Paolo Muiesan, published by Sciendo

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 3.0 License.

A comparison between the prognostic factors of the three main recognized staging systems (the Liver Cancer Study Group of Japan [LCSGJ]9, the National Cancer Center of Japan [NCCJ]53, and the American Joint Committee on Cancer [AJCC, 8th edition38], Wang et al.49 and Hyder et al.43 nomograms