Pagina Iniziale » Fegato » Tumori del Fegato » Tumori maligni » ColangioK Intraepatico
Colangiocarcinoma
Immagine TC di un colangiocarcinoma intraepatico. Il tumore chiude le vie biliari del fegato sinistro, indicate dalla freccia.
Colangiocarcinomi
Tumore delle vie biliari
Tumori delle vie Biliari
Cosa è il colangiocarcinoma?
Il colangiocarcinoma è un tumore maligno e raro del fegato, che nasce dalle cellule che costituiscono le vie biliari.
Le vie biliari sono i canali che trasportano la bile prodotta dal fegato all’intestino, per favorire i meccanismi della digestione.
Le vie biliari si trovano dentro al fegato, fuori dal fegato e attraversano la testa del pancreas. Per questo motivo il colangiocarcinoma è:
- intraepatico: quando nasce all’interno del fegato;
- parailare: quando il tumore nasce all’ilo epatico: dove il dotto biliare della parte sinistra del fegato si unisce al dotto biliare della parte destra del fegato:
- extraepatico: quando nasce nella parte terminale della via biliare principale e/o nella testa del pancreas.
La prognosi del colangiocarcinoma è spesso sfavorevole: soltanto il 5-15% dei pazienti sopravvive a 5 anni dalla diagnosi.
Nel 60-70% dei casi la presenza del colangiocarcinoma è vista quando il tumore è già in fase avanzata o metastatica, a causa del fatto che i sintomi si manifestano spesso tardi ed è impossibile fare una diagnosi precoce in assenza di marcatori tumorali specifici.
Il colangiocarcinoma è un tumore comune ?
No. Il colangiocarcinoma è un tumore raro dalle vie biliari.
Colpisce circa 1,5 soggetti ogni 100 mila abitanti.
Il fatto che il colangiocarcinoma sia un tumore raro crea importanti problemi:
- diagnosi: il colangiocarcinoma è un tumore difficile da riconoscere e da diagnosticare con facilità;
- cura: il colangiocarcinoma non permette di eseguire studi importanti per trovare terapie idonee a causa del numero poco elevato di pazienti che ne sono portatori.
Per questi motivi, un paziente sospetto portatore di un colangiocarcinoma deve sempre essere consigliato di rivolgersi presso un Centro di Riferimento per questa malattia, che sono in Reparti di Chirurgia del Fegato o Reparti di Chirurgia Epatobiliopancreatica.
Come si cura il colangiocarcinoma?
La cura più efficace per il colangiocarcinoma è la chirurgia.
Gli interventi che sono eseguiti per il colangiocarcinoma sono sostanzialmente:
- la resezione epatica per il colangiocarcinoma che cresce all’interno del fegato;
- la resezione del pancreas (la duodenocefalopancreasectomia) per il colangiocarcinoma che cresce al di fuori dal fegato e/o dentro alla testa del pancreas.
In alcuni casi, il colangiocarcinoma non può essere operato, a causa delle sue caratteristiche o per l’avvenuta diffusione in altri organi.
Questi pazienti vengono allora trattati con la chemioterapia. In questi casi è importante conoscere lo stato della fusione del recettore 2 del fattore di crescita dei fibroblasti (FGFR2) che permette una terapia mirata con il farmaco Pemigatinib.
Questa analisi è fatta sul materiale tumorale prelevato tramite biopsia in centri specializzati per la cura del colangiocarcinoma,
- Ultimo aggiornamento della pagina: 03/10/2023
Linee Guida per la Diagnosi ed il Trattamento del Colangiocarcinoma
2023
Rushbrook S M; Kendall T J; Zen Y; Albazaz R; Manoharan P; Pereira S P; Sturgess R; Davidson B R; Malik H Z; Manas D; Heaton N; Prasad K R; Bridgewater J; Valle J W; Goody R; Hawkins M; Prentice W; Morement H; Walmsley M; Khan S A
British Society of Gastroenterology guidelines for the diagnosis and management of cholangiocarcinoma Journal Article
In: Gut, pp. gutjnl–2023–330029, 2023.
@article{Rushbrook2023-pd,
title = {British Society of Gastroenterology guidelines for the diagnosis and management of cholangiocarcinoma},
author = {Simon M Rushbrook and Timothy James Kendall and Yoh Zen and Raneem Albazaz and Prakash Manoharan and Stephen P Pereira and Richard Sturgess and Brian R Davidson and Hassan Z Malik and Derek Manas and Nigel Heaton and K Raj Prasad and John Bridgewater and Juan W Valle and Rebecca Goody and Maria Hawkins and Wendy Prentice and Helen Morement and Martine Walmsley and Shahid A Khan},
url = {https://gut.bmj.com/content/early/2023/09/27/gutjnl-2023-330029
https://gut.bmj.com/content/gutjnl/early/2023/09/27/gutjnl-2023-330029.full.pdf},
doi = {10.1136/gutjnl-2023-330029},
year = {2023},
date = {2023-09-01},
urldate = {2023-09-01},
journal = {Gut},
pages = {gutjnl–2023–330029},
publisher = {BMJ},
abstract = {These guidelines for the diagnosis and management of
cholangiocarcinoma (CCA) were commissioned by the British
Society of Gastroenterology liver section. The guideline writing
committee included a multidisciplinary team of experts from
various specialties involved in the management of CCA, as well
as patient/public representatives from AMMF (the
Cholangiocarcinoma Charity) and PSC Support. Quality of evidence
is presented using the Appraisal of Guidelines for Research and
Evaluation (AGREE II) format. The recommendations arising are to
be used as guidance rather than as a strict protocol-based
reference, as the management of patients with CCA is often
complex and always requires individual patient-centred
considerations.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
These guidelines for the diagnosis and management of
cholangiocarcinoma (CCA) were commissioned by the British
Society of Gastroenterology liver section. The guideline writing
committee included a multidisciplinary team of experts from
various specialties involved in the management of CCA, as well
as patient/public representatives from AMMF (the
Cholangiocarcinoma Charity) and PSC Support. Quality of evidence
is presented using the Appraisal of Guidelines for Research and
Evaluation (AGREE II) format. The recommendations arising are to
be used as guidance rather than as a strict protocol-based
reference, as the management of patients with CCA is often
complex and always requires individual patient-centred
considerations.
cholangiocarcinoma (CCA) were commissioned by the British
Society of Gastroenterology liver section. The guideline writing
committee included a multidisciplinary team of experts from
various specialties involved in the management of CCA, as well
as patient/public representatives from AMMF (the
Cholangiocarcinoma Charity) and PSC Support. Quality of evidence
is presented using the Appraisal of Guidelines for Research and
Evaluation (AGREE II) format. The recommendations arising are to
be used as guidance rather than as a strict protocol-based
reference, as the management of patients with CCA is often
complex and always requires individual patient-centred
considerations.
easloffice@easloffice.eu E A; Liver E A
EASL-ILCA clinical practice guidelines on intrahepatic cholangiocarcinoma Journal Article
In: J. Hepatol., 2023.
@article{European_Association_for_the_Study_of_the_Liver_Electronic_address_easlofficeeaslofficeeu2023-gz,
title = {EASL-ILCA clinical practice guidelines on intrahepatic cholangiocarcinoma},
author = {European Association easloffice@easloffice.eu and European Association Liver},
url = {https://www.journal-of-hepatology.eu/article/S0168-8278(23)00185-X/fulltext
https://www.journal-of-hepatology.eu/action/showPdf?pii=S0168-8278%2823%2900185-X
},
doi = {10.1016/j.jhep.2023.03.010},
year = {2023},
date = {2023-03-01},
urldate = {2023-03-01},
journal = {J. Hepatol.},
abstract = {Intrahepatic cholangiocarcinoma (iCCA) emerges inside the liver
from bile ductules to the second-order bile ducts, represents the
second most frequent primary liver cancer besides hepatocellular
carcinoma and, unfortunately, is globally increasing in term of
incidence. The silent presentation, late diagnosis, the highly
aggressive nature and resistance to treatments lead to alarming
mortality. Early diagnosis, molecular characterization, accurate
staging and personalized multidisciplinary treatments represent
challenges for researchers and physicians. Unfortunately, these
challenges are beset by the high heterogeneity of iCCA at the
clinical, genomic, epigenetic and molecular levels that very
often preclude successful management. Nonetheless, in the last
few years, progress has been achieved in molecular
characterization, surgical management and targeted therapies. The
recent advance together with the awareness that iCCA represents a
distinct entity amongst the CCA family, led the ILCA and EASL
governing boards to commission and charge international experts
to draft dedicated guidelines to aid physicians towards an
evidence-based approach for the diagnostic, prognostic, and
therapeutic management of iCCA.},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Intrahepatic cholangiocarcinoma (iCCA) emerges inside the liver
from bile ductules to the second-order bile ducts, represents the
second most frequent primary liver cancer besides hepatocellular
carcinoma and, unfortunately, is globally increasing in term of
incidence. The silent presentation, late diagnosis, the highly
aggressive nature and resistance to treatments lead to alarming
mortality. Early diagnosis, molecular characterization, accurate
staging and personalized multidisciplinary treatments represent
challenges for researchers and physicians. Unfortunately, these
challenges are beset by the high heterogeneity of iCCA at the
clinical, genomic, epigenetic and molecular levels that very
often preclude successful management. Nonetheless, in the last
few years, progress has been achieved in molecular
characterization, surgical management and targeted therapies. The
recent advance together with the awareness that iCCA represents a
distinct entity amongst the CCA family, led the ILCA and EASL
governing boards to commission and charge international experts
to draft dedicated guidelines to aid physicians towards an
evidence-based approach for the diagnostic, prognostic, and
therapeutic management of iCCA.
from bile ductules to the second-order bile ducts, represents the
second most frequent primary liver cancer besides hepatocellular
carcinoma and, unfortunately, is globally increasing in term of
incidence. The silent presentation, late diagnosis, the highly
aggressive nature and resistance to treatments lead to alarming
mortality. Early diagnosis, molecular characterization, accurate
staging and personalized multidisciplinary treatments represent
challenges for researchers and physicians. Unfortunately, these
challenges are beset by the high heterogeneity of iCCA at the
clinical, genomic, epigenetic and molecular levels that very
often preclude successful management. Nonetheless, in the last
few years, progress has been achieved in molecular
characterization, surgical management and targeted therapies. The
recent advance together with the awareness that iCCA represents a
distinct entity amongst the CCA family, led the ILCA and EASL
governing boards to commission and charge international experts
to draft dedicated guidelines to aid physicians towards an
evidence-based approach for the diagnostic, prognostic, and
therapeutic management of iCCA.
2022
Vogel A; Bridgewater J; Edeline J; Kelley R K; Klümpen H J; Malka D; Primrose J N; Rimassa L; Stenzinger A; Valle J W; Ducreux M
Biliary tract cancer: ESMO Clinical Practice Guideline for diagnosis, treatment and follow-up Bachelor Thesis
2022, ISSN: 1569-8041.
@bachelorthesis{pmid36372281,
title = {Biliary tract cancer: ESMO Clinical Practice Guideline for diagnosis, treatment and follow-up},
author = {A Vogel and J Bridgewater and J Edeline and R K Kelley and H J Klümpen and D Malka and J N Primrose and L Rimassa and A Stenzinger and J W Valle and M Ducreux},
doi = {10.1016/j.annonc.2022.10.506},
issn = {1569-8041},
year = {2022},
date = {2022-11-01},
urldate = {2022-11-01},
journal = {Ann Oncol},
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Bowlus C L; Arrivé L; Bergquist A; Deneau M; Forman L; Ilyas S I; Lunsford K E; Martinez M; Sapisochin G; Shroff R; Tabibian J H; Assis D N
AASLD Practice Guidance on Primary Sclerosing Cholangitis and Cholangiocarcinoma Journal Article
In: Hepatology, 2022, ISSN: 1527-3350.
@article{pmid36083140,
title = {AASLD Practice Guidance on Primary Sclerosing Cholangitis and Cholangiocarcinoma},
author = {Christopher L Bowlus and Lionel Arrivé and Annika Bergquist and Mark Deneau and Lisa Forman and Sumera I Ilyas and Keri E Lunsford and Mercedes Martinez and Gonzalo Sapisochin and Rachna Shroff and James H Tabibian and David N Assis},
doi = {10.1002/hep.32771},
issn = {1527-3350},
year = {2022},
date = {2022-09-01},
urldate = {2022-09-01},
journal = {Hepatology},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
per lo Studio del Fegato (AISF) A I; International Hepato-PancreatoBiliaryAssociation I; di Oncologia Medica (AIOM) A I; Group A T C C U C; di Chirurgia (SIC) S I; di Gastroenterologia ed Endoscopia digestiva (SIGE) S I; di Radiologia Medica ed Interventistica (SIRM) S I; d’Organo (SITO) S I T
Colangiocarcinoma intraepatico e perilare. Linee Guida per la pratica clinica. Working paper
Sistema Nazionale Linee Guida (SNLG) dell’Istituto Superiore di Sanità., 2022.
@workingpaper{nokey,
title = {Colangiocarcinoma intraepatico e perilare. Linee Guida per la pratica clinica.},
author = {Associazione Italiana per lo Studio del Fegato (AISF) and International Hepato-PancreatoBiliaryAssociation,
(IT-IHPBA) and Associazione Italiana di Oncologia Medica (AIOM) and AMMF -The Cholangiocarcinoma
Charity (UK) CholangiocarcinomaWorking Group and Società Italiana di Chirurgia (SIC) and Società Italiana di
Gastroenterologia ed Endoscopia digestiva (SIGE) and Società Italiana di Radiologia Medica ed Interventistica
(SIRM) and Società Italiana Trapianti d’Organo (SITO)},
url = {https://snlg.iss.it/wp-content/uploads/2022/02/LG-100-AISF_ColangioCa.pdf},
year = {2022},
date = {2022-02-20},
urldate = {2022-02-20},
howpublished = {Sistema Nazionale Linee Guida (SNLG) dell’Istituto Superiore di Sanità.},
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}
Kubo S; Shinkawa H; Asaoka Y; Ioka T; Igaki H; Izumi N; Itoi T; Unno M; Ohtsuka M; Okusaka T; Kadoya M; Kudo M; Kumada T; Kokudo N; Sakamoto M; Sakamoto Y; Sakurai H; Takayama T; Nakashima O; Nagata Y; Hatano E; Harada K; Murakami T; Yamamoto M
Liver Cancer Study Group of Japan Clinical Practice Guidelines for Intrahepatic Cholangiocarcinoma Journal Article
In: Liver Cancer, vol. 11, no 4, pp. 290 – 314, 2022, ISSN: 22351795, (Cited by: 0; All Open Access, Gold Open Access, Green Open Access).
@article{Kubo2022290,
title = {Liver Cancer Study Group of Japan Clinical Practice Guidelines for Intrahepatic Cholangiocarcinoma},
author = {Shoji Kubo and Hiroji Shinkawa and Yoshinari Asaoka and Tatsuya Ioka and Hiroshi Igaki and Namiki Izumi and Takao Itoi and Michiaki Unno and Masayuki Ohtsuka and Takuji Okusaka and Masumi Kadoya and Masatoshi Kudo and Takashi Kumada and Norihiro Kokudo and Michiie Sakamoto and Yoshihiro Sakamoto and Hideyuki Sakurai and Tadatoshi Takayama and Osamu Nakashima and Yasushi Nagata and Etsuro Hatano and Kenichi Harada and Takamichi Murakami and Masakazu Yamamoto},
url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85134222582&doi=10.1159%2f000522403&partnerID=40&md5=85a60f3437ed401dcf4b7154c820b351},
doi = {10.1159/000522403},
issn = {22351795},
year = {2022},
date = {2022-01-01},
urldate = {2022-01-01},
journal = {Liver Cancer},
volume = {11},
number = {4},
pages = {290 – 314},
publisher = {S. Karger AG},
abstract = {This paper presents the first version of clinical practice guidelines for intrahepatic cholangiocarcinoma (ICC) established by the Liver Cancer Study Group of Japan. These guidelines consist of 1 treatment algorithm, 5 background statements, 16 clinical questions, and 1 clinical topic, including etiology, staging, pathology, diagnosis, and treatments. Globally, a high incidence of ICC has been reported in East and Southeast Asian countries, and the incidence has been gradually increasing in Japan and also in Western countries. Reported risk factors for ICC include cirrhosis, hepatitis B/C, alcohol consumption, diabetes, obesity, smoking, nonalcoholic steatohepatitis, and liver fluke infestation, as well as biliary diseases, such as primary sclerosing cholangitis, hepatolithiasis, congenital cholangiectasis, and Caroli disease. Chemical risk factors include thorium-232, 1,2-dichloropropane, and dichloromethane. CA19-9 and CEA are recommended as tumor markers for early detection and diagnostic of ICC. Abdominal ultrasonography, CT, and MRI are effective imaging modalities for diagnosing ICC. If bile duct invasion is suspected, imaging modalities for examining the bile ducts may be useful. In unresectable cases, tumor biopsy should be considered when deemed necessary for the differential diagnosis and drug therapy selection. The mainstay of treatment for patients with Child-Pugh class A or B liver function is surgical resection and drug therapy. If the patient has no regional lymph node metastasis (LNM) and has a single tumor, resection is the treatment of choice. If both regional LNM and multiple tumors are present, drug therapy is the first treatment of choice. If the patient has either regional LNM or multiple tumors, resection or drug therapy is selected, depending on the extent of metastasis or the number of tumors. If distant metastasis is present, drug therapy is the treatment of choice. Percutaneous ablation therapy may be considered for patients who are ineligible for surgical resection or drug therapy due to decreased hepatic functional reserve or comorbidities. For unresectable ICC without extrahepatic metastasis, stereotactic radiotherapy (tumor size ≤5 cm) or particle radiotherapy (no size restriction) may be considered. ICC is generally not indicated for liver transplantation, and palliative care is recommended for patients with Child-Pugh class C liver function. © 2022 The Author(s).},
note = {Cited by: 0; All Open Access, Gold Open Access, Green Open Access},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
This paper presents the first version of clinical practice guidelines for intrahepatic cholangiocarcinoma (ICC) established by the Liver Cancer Study Group of Japan. These guidelines consist of 1 treatment algorithm, 5 background statements, 16 clinical questions, and 1 clinical topic, including etiology, staging, pathology, diagnosis, and treatments. Globally, a high incidence of ICC has been reported in East and Southeast Asian countries, and the incidence has been gradually increasing in Japan and also in Western countries. Reported risk factors for ICC include cirrhosis, hepatitis B/C, alcohol consumption, diabetes, obesity, smoking, nonalcoholic steatohepatitis, and liver fluke infestation, as well as biliary diseases, such as primary sclerosing cholangitis, hepatolithiasis, congenital cholangiectasis, and Caroli disease. Chemical risk factors include thorium-232, 1,2-dichloropropane, and dichloromethane. CA19-9 and CEA are recommended as tumor markers for early detection and diagnostic of ICC. Abdominal ultrasonography, CT, and MRI are effective imaging modalities for diagnosing ICC. If bile duct invasion is suspected, imaging modalities for examining the bile ducts may be useful. In unresectable cases, tumor biopsy should be considered when deemed necessary for the differential diagnosis and drug therapy selection. The mainstay of treatment for patients with Child-Pugh class A or B liver function is surgical resection and drug therapy. If the patient has no regional lymph node metastasis (LNM) and has a single tumor, resection is the treatment of choice. If both regional LNM and multiple tumors are present, drug therapy is the first treatment of choice. If the patient has either regional LNM or multiple tumors, resection or drug therapy is selected, depending on the extent of metastasis or the number of tumors. If distant metastasis is present, drug therapy is the treatment of choice. Percutaneous ablation therapy may be considered for patients who are ineligible for surgical resection or drug therapy due to decreased hepatic functional reserve or comorbidities. For unresectable ICC without extrahepatic metastasis, stereotactic radiotherapy (tumor size ≤5 cm) or particle radiotherapy (no size restriction) may be considered. ICC is generally not indicated for liver transplantation, and palliative care is recommended for patients with Child-Pugh class C liver function. © 2022 The Author(s).
2021
Nagino M; Hirano S; Yoshitomi H; Aoki T; Uesaka K; Unno M; Ebata T; Konishi M; Sano K; Shimada K; Shimizu H; Higuchi R; Wakai T; Isayama H; Okusaka T; Tsuyuguchi T; Hirooka Y; Furuse J; Maguchi H; Suzuki K; Yamazaki H; Kijima H; Yanagisawa A; Yoshida M; Yokoyama Y; Mizuno T; Endo I
Clinical practice guidelines for the management of biliary tract cancers 2019: The 3rd English edition Journal Article
In: Journal of Hepato-Biliary-Pancreatic Sciences, vol. 28, no 1, pp. 26 – 54, 2021, ISSN: 18686974, (Cited by: 41).
@article{Nagino202126,
title = {Clinical practice guidelines for the management of biliary tract cancers 2019: The 3rd English edition},
author = {Masato Nagino and Satoshi Hirano and Hideyuki Yoshitomi and Taku Aoki and Katsuhiko Uesaka and Michiaki Unno and Tomoki Ebata and Masaru Konishi and Keiji Sano and Kazuaki Shimada and Hiroaki Shimizu and Ryota Higuchi and Toshifumi Wakai and Hiroyuki Isayama and Takuji Okusaka and Toshio Tsuyuguchi and Yoshiki Hirooka and Junji Furuse and Hiroyuki Maguchi and Kojiro Suzuki and Hideya Yamazaki and Hiroshi Kijima and Akio Yanagisawa and Masahiro Yoshida and Yukihiro Yokoyama and Takashi Mizuno and Itaru Endo},
url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85098000027&doi=10.1002%2fjhbp.870&partnerID=40&md5=e2f525f8a8276af922fc928beb153725},
doi = {10.1002/jhbp.870},
issn = {18686974},
year = {2021},
date = {2021-01-01},
urldate = {2021-01-01},
journal = {Journal of Hepato-Biliary-Pancreatic Sciences},
volume = {28},
number = {1},
pages = {26 – 54},
publisher = {Blackwell Publishing Asia},
abstract = {Background: The Japanese Society of Hepato-Biliary-Pancreatic Surgery launched the clinical practice guidelines for the management of biliary tract cancers (cholangiocarcinoma, gallbladder cancer, and ampullary cancer) in 2007, then published the 2nd version in 2014. Methods: In this 3rd version, clinical questions (CQs) were proposed on six topics. The recommendation, grade for recommendation, and statement for each CQ were discussed and finalized by an evidence-based approach. Recommendations were graded as Grade 1 (strong) or Grade 2 (weak) according to the concepts of the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system. Results: The 31 CQs covered the six topics: (a) prophylactic treatment, (b) diagnosis, (c) biliary drainage, (d) surgical treatment, (e) chemotherapy, and (f) radiation therapy. In the 31 CQs, 14 recommendations were rated strong and 14 recommendations weak. The remaining three CQs had no recommendation. Each CQ includes a statement of how the recommendations were graded. Conclusions: This latest guideline provides recommendations for important clinical aspects based on evidence. Future collaboration with the cancer registry will be key for assessing the guidelines and establishing new evidence. © 2020 Japanese Society of Hepato-Biliary-Pancreatic Surgery},
note = {Cited by: 41},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Background: The Japanese Society of Hepato-Biliary-Pancreatic Surgery launched the clinical practice guidelines for the management of biliary tract cancers (cholangiocarcinoma, gallbladder cancer, and ampullary cancer) in 2007, then published the 2nd version in 2014. Methods: In this 3rd version, clinical questions (CQs) were proposed on six topics. The recommendation, grade for recommendation, and statement for each CQ were discussed and finalized by an evidence-based approach. Recommendations were graded as Grade 1 (strong) or Grade 2 (weak) according to the concepts of the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system. Results: The 31 CQs covered the six topics: (a) prophylactic treatment, (b) diagnosis, (c) biliary drainage, (d) surgical treatment, (e) chemotherapy, and (f) radiation therapy. In the 31 CQs, 14 recommendations were rated strong and 14 recommendations weak. The remaining three CQs had no recommendation. Each CQ includes a statement of how the recommendations were graded. Conclusions: This latest guideline provides recommendations for important clinical aspects based on evidence. Future collaboration with the cancer registry will be key for assessing the guidelines and establishing new evidence. © 2020 Japanese Society of Hepato-Biliary-Pancreatic Surgery
2020
Alvaro D; Hassan C; Cardinale V; Carpino G; Fabris L; Gringeri E; Granata V; Mutignani M; Morement H; Giuliante F; Guglielmi A; Ridola L; Marzioni M; Grazi G; Guido M; Giulio E D; Tonini G; Pantano F; Venere R; Bragazzi M C; Biancanello F; Faccioli J; Giannetti A; Cintolo M; Giunta M D; Gambato M; Lasagni A; Izzo F; Avallone A; Banales J; Rossi M; Catalano C; Laghi A; D'amati G; Mancino M G
Italian Clinical Practice Guidelines on Cholangiocarcinoma – Part I: Classification, diagnosis and staging Journal Article
In: Digestive and Liver Disease, vol. 52, no 11, pp. 1282 – 1293, 2020, ISSN: 15908658, (Cited by: 23).
@article{Alvaro20201282,
title = {Italian Clinical Practice Guidelines on Cholangiocarcinoma – Part I: Classification, diagnosis and staging},
author = {Domenico Alvaro and Cesare Hassan and Vincenzo Cardinale and Guido Carpino and Luca Fabris and Enrico Gringeri and Vincenza Granata and Massimiliano Mutignani and Helen Morement and Felice Giuliante and Alfredo Guglielmi and Lorenzo Ridola and Marco Marzioni and Gianluca Grazi and Maria Guido and Emilio Di Giulio and Giuseppe Tonini and Francesco Pantano and Rosanna Venere and Maria Consiglia Bragazzi and Francesca Biancanello and Jessica Faccioli and Aurora Giannetti and Marcello Cintolo and Michela Di Giunta and Martina Gambato and Alberto Lasagni and Francesco Izzo and Antonio Avallone and Jesus Banales and Massimo Rossi and Carlo Catalano and Andrea Laghi and Giulia D'amati and Maria Grazia Mancino},
url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85090489680&doi=10.1016%2fj.dld.2020.06.045&partnerID=40&md5=506a895d20e629c0f967b85df789dea7},
doi = {10.1016/j.dld.2020.06.045},
issn = {15908658},
year = {2020},
date = {2020-01-01},
urldate = {2020-01-01},
journal = {Digestive and Liver Disease},
volume = {52},
number = {11},
pages = {1282 – 1293},
publisher = {Elsevier B.V.},
abstract = {Cholangiocarcinoma (CCA) is the second most common primary liver cancer, characterized by a poor prognosis and resistance to chemotherapeutics. The progressive increase in CCA incidence and mortality registered worldwide in the last two decades and the need to clarify various aspects of clinical management have prompted the Italian Association for the Study of the Liver (AISF) to commission the drafting of dedicated guidelines in collaboration with a group of Italian scientific societies. These guidelines have been formulated in accordance with the Italian National Institute of Health indications and developed by following the GRADE method and related advancements. © 2020 Editrice Gastroenterologica Italiana S.r.l.},
note = {Cited by: 23},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Cholangiocarcinoma (CCA) is the second most common primary liver cancer, characterized by a poor prognosis and resistance to chemotherapeutics. The progressive increase in CCA incidence and mortality registered worldwide in the last two decades and the need to clarify various aspects of clinical management have prompted the Italian Association for the Study of the Liver (AISF) to commission the drafting of dedicated guidelines in collaboration with a group of Italian scientific societies. These guidelines have been formulated in accordance with the Italian National Institute of Health indications and developed by following the GRADE method and related advancements. © 2020 Editrice Gastroenterologica Italiana S.r.l.
Alvaro D; Hassan C; Cardinale V; Carpino G; Fabris L; Gringeri E; Granata V; Mutignani M; Morement H; Giuliante F; Guglielmi A; Ridola L; Tonini G; Marzioni M; Grazi G; Guido M; Giulio E D; Pantano F; Venere R; Bragazzi M C; Biancanello F; Faccioli J; Giannetti A; Cintolo M; Giunta M D; Gambato M; Lasagni A; Izzo F; Avallone A; Banales J; Rossi M; Catalano C; Laghi A; D'amati G; Mancino M G
Italian Clinical Practice Guidelines on Cholangiocarcinoma – Part II: Treatment Journal Article
In: Digestive and Liver Disease, vol. 52, no 12, pp. 1430 – 1442, 2020, ISSN: 15908658, (Cited by: 20).
@article{Alvaro20201430,
title = {Italian Clinical Practice Guidelines on Cholangiocarcinoma – Part II: Treatment},
author = {Domenico Alvaro and Cesare Hassan and Vincenzo Cardinale and Guido Carpino and Luca Fabris and Enrico Gringeri and Vincenza Granata and Massimiliano Mutignani and Helen Morement and Felice Giuliante and Alfredo Guglielmi and Lorenzo Ridola and Giuseppe Tonini and Marco Marzioni and Gianluca Grazi and Maria Guido and Emilio Di Giulio and Francesco Pantano and Rosanna Venere and Maria Consiglia Bragazzi and Francesca Biancanello and Jessica Faccioli and Aurora Giannetti and Marcello Cintolo and Michela Di Giunta and Martina Gambato and Alberto Lasagni and Francesco Izzo and Antonio Avallone and Jesus Banales and Massimo Rossi and Carlo Catalano and Andrea Laghi and Giulia D'amati and Maria Grazia Mancino},
url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-85097004048&doi=10.1016%2fj.dld.2020.08.030&partnerID=40&md5=0d57247083149aa3927829d7d27ec2de},
doi = {10.1016/j.dld.2020.08.030},
issn = {15908658},
year = {2020},
date = {2020-01-01},
urldate = {2020-01-01},
journal = {Digestive and Liver Disease},
volume = {52},
number = {12},
pages = {1430 – 1442},
publisher = {Elsevier B.V.},
abstract = {Currently, the only curative treatment for cholangiocarcinoma (CCA) is surgical resection, though this treatment is possible in less than 40% of patients. However, recent improvements in preoperative management have led to a higher number of patients who are candidates for this procedure. For unresectable patients, progress is ongoing in terms of locoregional and chemoradiation treatments and target therapies, especially in the definition of patient selection criteria. This is the second part of the Italian CCA guidelines, dealing with CCA treatment, that have been formulated in accordance with Italian National Institute of Health indications and developed according to the GRADE method and related advancements. © 2020 Editrice Gastroenterologica Italiana S.r.l.},
note = {Cited by: 20},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
Currently, the only curative treatment for cholangiocarcinoma (CCA) is surgical resection, though this treatment is possible in less than 40% of patients. However, recent improvements in preoperative management have led to a higher number of patients who are candidates for this procedure. For unresectable patients, progress is ongoing in terms of locoregional and chemoradiation treatments and target therapies, especially in the definition of patient selection criteria. This is the second part of the Italian CCA guidelines, dealing with CCA treatment, that have been formulated in accordance with Italian National Institute of Health indications and developed according to the GRADE method and related advancements. © 2020 Editrice Gastroenterologica Italiana S.r.l.
2016
Valle J W; Borbath I; Khan S A; Huguet F; Gruenberger T; Arnold D; Committee O E G
Biliary cancer: ESMO clinical practice guidelines for diagnosis, treatment and follow-up Journal Article
In: Annals of Oncology, vol. 27, pp. v28 – v37, 2016, ISSN: 09237534, (Cited by: 329; All Open Access, Bronze Open Access).
@article{Valle2016v28,
title = {Biliary cancer: ESMO clinical practice guidelines for diagnosis, treatment and follow-up},
author = {J. W. Valle and I. Borbath and S. A. Khan and F. Huguet and T. Gruenberger and D. Arnold and On ESMO Guidelines Committee},
url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-84995766824&doi=10.1093%2fannonc%2fmdw324&partnerID=40&md5=13cce31dda4f3895d07e2dea0d1c53d4},
doi = {10.1093/annonc/mdw324},
issn = {09237534},
year = {2016},
date = {2016-01-01},
urldate = {2016-01-01},
journal = {Annals of Oncology},
volume = {27},
pages = {v28 – v37},
publisher = {Oxford University Press},
note = {Cited by: 329; All Open Access, Bronze Open Access},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
2015
Mansour J C; Aloia T A; Crane C H; Heimbach J K; Nagino M; Vauthey J
Hilar Cholangiocarcinoma: Expert consensus statement Journal Article
In: HPB, vol. 17, no 8, pp. 691 – 699, 2015, ISSN: 1365182X, (Cited by: 219; All Open Access, Bronze Open Access, Green Open Access).
@article{Mansour2015691,
title = {Hilar Cholangiocarcinoma: Expert consensus statement},
author = {John C. Mansour and Thomas A. Aloia and Christopher H. Crane and Julie K. Heimbach and Masato Nagino and Jean-Nicolas Vauthey},
url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-84936991861&doi=10.1111%2fhpb.12450&partnerID=40&md5=c91ee89909b1b8597130265eaa6ed597},
doi = {10.1111/hpb.12450},
issn = {1365182X},
year = {2015},
date = {2015-01-01},
urldate = {2015-01-01},
journal = {HPB},
volume = {17},
number = {8},
pages = {691 – 699},
publisher = {Blackwell Publishing Ltd},
abstract = {An American Hepato-Pancreato-Biliary Association (AHPBA)-sponsored consensus meeting of expert panellists met on 15 January 2014 to review current evidence on the management of hilar cholangiocarcinoma in order to establish practice guidelines and to agree consensus statements. It was established that the treatment of patients with hilar cholangiocarcinoma requires a coordinated, multidisciplinary approach to optimize the chances for both durable survival and effective palliation. An adequate diagnostic and staging work-up includes high-quality cross-sectional imaging; however, pathologic confirmation is not required prior to resection or initiation of a liver transplant trimodal treatment protocol. The ideal treatment for suitable patients with resectable hilar malignancy is resection of the intra- and extrahepatic bile ducts, as well as resection of the involved ipsilateral liver. Preoperative biliary drainage is best achieved with percutaneous transhepatic approaches and may be indicated for patients with cholangitis, malnutrition or hepatic insufficiency. Portal vein embolization is a safe and effective strategy for increasing the future liver remnant (FLR) and is particularly useful for patients with an FLR of <30%. Selected patients with unresectable hilar cholangiocarcinoma should be evaluated for a standard trimodal protocol incorporating external beam and endoluminal radiation therapy, systemic chemotherapy and liver transplantation. Post-resection chemoradiation should be offered to patients who show high-risk features on surgical pathology. Chemoradiation is also recommended for patients with locally advanced, unresectable hilar cancers. For patients with locally recurrent or metastatic hilar cholangiocarcinoma, first-line chemotherapy with gemcitabine and cisplatin is recommended based on multiple Phase II trials and a large randomized controlled trial including a heterogeneous population of patients with biliary cancers. © 2015 International Hepato-Pancreato-Biliary Association.},
note = {Cited by: 219; All Open Access, Bronze Open Access, Green Open Access},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
An American Hepato-Pancreato-Biliary Association (AHPBA)-sponsored consensus meeting of expert panellists met on 15 January 2014 to review current evidence on the management of hilar cholangiocarcinoma in order to establish practice guidelines and to agree consensus statements. It was established that the treatment of patients with hilar cholangiocarcinoma requires a coordinated, multidisciplinary approach to optimize the chances for both durable survival and effective palliation. An adequate diagnostic and staging work-up includes high-quality cross-sectional imaging; however, pathologic confirmation is not required prior to resection or initiation of a liver transplant trimodal treatment protocol. The ideal treatment for suitable patients with resectable hilar malignancy is resection of the intra- and extrahepatic bile ducts, as well as resection of the involved ipsilateral liver. Preoperative biliary drainage is best achieved with percutaneous transhepatic approaches and may be indicated for patients with cholangitis, malnutrition or hepatic insufficiency. Portal vein embolization is a safe and effective strategy for increasing the future liver remnant (FLR) and is particularly useful for patients with an FLR of <30%. Selected patients with unresectable hilar cholangiocarcinoma should be evaluated for a standard trimodal protocol incorporating external beam and endoluminal radiation therapy, systemic chemotherapy and liver transplantation. Post-resection chemoradiation should be offered to patients who show high-risk features on surgical pathology. Chemoradiation is also recommended for patients with locally advanced, unresectable hilar cancers. For patients with locally recurrent or metastatic hilar cholangiocarcinoma, first-line chemotherapy with gemcitabine and cisplatin is recommended based on multiple Phase II trials and a large randomized controlled trial including a heterogeneous population of patients with biliary cancers. © 2015 International Hepato-Pancreato-Biliary Association.
Weber S M; Ribero D; O'Reilly E M; Kokudo N; Miyazaki M; Pawlik T M
Intrahepatic Cholangiocarcinoma: Expert consensus statement Journal Article
In: HPB, vol. 17, no 8, pp. 669 – 680, 2015, ISSN: 1365182X, (Cited by: 239; All Open Access, Bronze Open Access, Green Open Access).
@article{Weber2015669,
title = {Intrahepatic Cholangiocarcinoma: Expert consensus statement},
author = {Sharon M. Weber and Dario Ribero and Eileen M. O'Reilly and Norihiro Kokudo and Masaru Miyazaki and Timothy M. Pawlik},
url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-84936990315&doi=10.1111%2fhpb.12441&partnerID=40&md5=44758468378be4a8cbc6a6af005d471c},
doi = {10.1111/hpb.12441},
issn = {1365182X},
year = {2015},
date = {2015-01-01},
urldate = {2015-01-01},
journal = {HPB},
volume = {17},
number = {8},
pages = {669 – 680},
publisher = {Blackwell Publishing Ltd},
abstract = {An American Hepato-Pancreato-Biliary Association (AHPBA)-sponsored consensus meeting of expert panellists met on 15 January 2014 to review current evidence on the management of intrahepatic cholangiocarcinoma (ICC) in order to establish practice guidelines and to agree on consensus statements. The treatment of ICC requires a coordinated, multidisciplinary approach to optimize survival. Biopsy is not necessary if the surgeon suspects ICC and is planning curative resection, although biopsy should be obtained before systemic or locoregional therapies are initiated. Assessment of resectability is best accomplished using cross-sectional imaging [computed tomography (CT) or magnetic resonance imaging (MRI)], but the role of positron emission tomography (PET) is unclear. Resectability in ICC is defined by the ability to completely remove the disease while leaving an adequate liver remnant. Extrahepatic disease, multiple bilobar or multicentric tumours, and lymph node metastases beyond the primary echelon are contraindications to resection. Regional lymphadenectomy should be considered a standard part of surgical therapy. In patients with high-risk features, the routine use of diagnostic laparoscopy is recommended. The preoperative diagnosis of combined hepatocellular carcinoma and cholangiocarcinoma (cHCC-CC) by imaging studies is extremely difficult. Surgical resection remains the mainstay of treatment, but survival is worse than in HCC alone. There are no adequately powered, randomized Phase III trials that can provide definitive recommendations for adjuvant therapy for ICC. Patients with high-risk features (lymphovascular invasion, multicentricity or satellitosis, large tumours) should be encouraged to enrol in clinical trials and to consider adjuvant therapy. Cisplatin plus gemcitabine represents the standard-of-care, front-line systemic therapy for metastatic ICC. Genomic analyses of biliary cancers support the development of targeted therapeutic interventions. © 2015 International Hepato-Pancreato-Biliary Association.},
note = {Cited by: 239; All Open Access, Bronze Open Access, Green Open Access},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
An American Hepato-Pancreato-Biliary Association (AHPBA)-sponsored consensus meeting of expert panellists met on 15 January 2014 to review current evidence on the management of intrahepatic cholangiocarcinoma (ICC) in order to establish practice guidelines and to agree on consensus statements. The treatment of ICC requires a coordinated, multidisciplinary approach to optimize survival. Biopsy is not necessary if the surgeon suspects ICC and is planning curative resection, although biopsy should be obtained before systemic or locoregional therapies are initiated. Assessment of resectability is best accomplished using cross-sectional imaging [computed tomography (CT) or magnetic resonance imaging (MRI)], but the role of positron emission tomography (PET) is unclear. Resectability in ICC is defined by the ability to completely remove the disease while leaving an adequate liver remnant. Extrahepatic disease, multiple bilobar or multicentric tumours, and lymph node metastases beyond the primary echelon are contraindications to resection. Regional lymphadenectomy should be considered a standard part of surgical therapy. In patients with high-risk features, the routine use of diagnostic laparoscopy is recommended. The preoperative diagnosis of combined hepatocellular carcinoma and cholangiocarcinoma (cHCC-CC) by imaging studies is extremely difficult. Surgical resection remains the mainstay of treatment, but survival is worse than in HCC alone. There are no adequately powered, randomized Phase III trials that can provide definitive recommendations for adjuvant therapy for ICC. Patients with high-risk features (lymphovascular invasion, multicentricity or satellitosis, large tumours) should be encouraged to enrol in clinical trials and to consider adjuvant therapy. Cisplatin plus gemcitabine represents the standard-of-care, front-line systemic therapy for metastatic ICC. Genomic analyses of biliary cancers support the development of targeted therapeutic interventions. © 2015 International Hepato-Pancreato-Biliary Association.
2014
Bridgewater J; Galle P R; Khan S A; Llovet J M; Park J; Patel T; Pawlik T M; Gores G J
Guidelines for the diagnosis and management of intrahepatic cholangiocarcinoma Journal Article
In: Journal of Hepatology, vol. 60, no 6, pp. 1268 – 1289, 2014, ISSN: 01688278, (Cited by: 829; All Open Access, Hybrid Gold Open Access).
@article{Bridgewater20141268,
title = {Guidelines for the diagnosis and management of intrahepatic cholangiocarcinoma},
author = {John Bridgewater and Peter R. Galle and Shahid A. Khan and Josep M. Llovet and Joong-Won Park and Tushar Patel and Timothy M. Pawlik and Gregory J. Gores},
url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-84900992727&doi=10.1016%2fj.jhep.2014.01.021&partnerID=40&md5=5cab75948c6b8ab221075d0723024e5c},
doi = {10.1016/j.jhep.2014.01.021},
issn = {01688278},
year = {2014},
date = {2014-01-01},
urldate = {2014-01-01},
journal = {Journal of Hepatology},
volume = {60},
number = {6},
pages = {1268 – 1289},
publisher = {Elsevier B.V.},
note = {Cited by: 829; All Open Access, Hybrid Gold Open Access},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
2012
Khan S A; Davidson B R; Goldin R D; Heaton N; Karani J; Pereira S P; Rosenberg W M C; Tait P; Taylor-Robinson S D; Thillainayagam A V; Thomas H C; Wasan H
Guidelines for the diagnosis and treatment of cholangiocarcinoma: An update Journal Article
In: Gut, vol. 61, no 12, pp. 1657 – 1669, 2012, ISSN: 14683288, (Cited by: 541; All Open Access, Green Open Access, Hybrid Gold Open Access).
@article{Khan20121657,
title = {Guidelines for the diagnosis and treatment of cholangiocarcinoma: An update},
author = {Shahid A. Khan and Brian R. Davidson and Robert D. Goldin and Nigel Heaton and John Karani and Stephen P. Pereira and William M. C. Rosenberg and Paul Tait and Simon D. Taylor-Robinson and Andrew V. Thillainayagam and Howard C. Thomas and Harpreet Wasan},
url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-84868708514&doi=10.1136%2fgutjnl-2011-301748&partnerID=40&md5=c1db8472e50ae708b8a03c9ad45c65b2},
doi = {10.1136/gutjnl-2011-301748},
issn = {14683288},
year = {2012},
date = {2012-01-01},
urldate = {2012-01-01},
journal = {Gut},
volume = {61},
number = {12},
pages = {1657 – 1669},
abstract = {The British Society of Gastroenterology guidelines on the management of cholangiocarcinoma were originally published in 2002. This is the first update since then and is based on a comprehensive review of the recent literature, including data from randomised controlled trials, systematic reviews, meta-analyses, cohort, prospective and retrospective studies.},
note = {Cited by: 541; All Open Access, Green Open Access, Hybrid Gold Open Access},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
The British Society of Gastroenterology guidelines on the management of cholangiocarcinoma were originally published in 2002. This is the first update since then and is based on a comprehensive review of the recent literature, including data from randomised controlled trials, systematic reviews, meta-analyses, cohort, prospective and retrospective studies.
2011
Eckel F; Brunner T; Jelic S
Biliary cancer: ESMO clinical practice guidelines for diagnosis, treatment and follow-up Journal Article
In: Annals of Oncology, vol. 22, no SUPPL. 6, pp. vi40–vi44, 2011, ISSN: 09237534, (Cited by: 76; All Open Access, Bronze Open Access, Green Open Access).
@article{Eckel2011vi40,
title = {Biliary cancer: ESMO clinical practice guidelines for diagnosis, treatment and follow-up},
author = {F. Eckel and T. Brunner and S. Jelic},
url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-80052766009&doi=10.1093%2fannonc%2fmdr375&partnerID=40&md5=b8404dbe3484e1964c504e713487db13},
doi = {10.1093/annonc/mdr375},
issn = {09237534},
year = {2011},
date = {2011-01-01},
urldate = {2011-01-01},
journal = {Annals of Oncology},
volume = {22},
number = {SUPPL. 6},
pages = {vi40–vi44},
publisher = {Oxford University Press},
note = {Cited by: 76; All Open Access, Bronze Open Access, Green Open Access},
keywords = {},
pubstate = {published},
tppubtype = {article}
}
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