Cholangiocarcinoma: improving biliary drainage with PDT.

Abstract

1 d holangiocarcinoma is a disease that is challenging to both iagnose and treat. Only a minority of patients present at a tage suitable for attempted curative surgical resection and year survival rates remain as low as 5% in most series [1]. uch of the morbidity of cholangiocarcinoma is caused by omplications of biliary obstruction—–a rationale for treatents such as PDT, which aim to optimise biliary drainage nd thereby improve survival and quality of life. In the comprehensive review by Allison et al. in the curent edition of the journal [2], the authors address the iagnostic and therapeutic challenges in cholangiocarcioma. They also summarise the clinical trial data on PDT or cholangiocarcinoma and conclude that current evidence uggests PDT improves the outcome of patients with this ifficult disease, but that further studies are required. In his respect, a phase III trial (PHOTOSTENT-02) is underway n the UK (EudraCT number 2005-001173-96) which aims to etermine whether PDT improves the survival and quality of ife of patients with locally advanced or metastatic biliary ract cancer. There are a number of specific issues to the use of DT in the management of patients with cholangiocarcioma. As the authors point out, the classification and staging f cholangiocarcinoma can be complicated by confusing omenclature and difficulties with imaging small volume umours, which make comparison of trial data difficult. In heir review, the authors classify hilar tumours as extraepatic, which differs from the intrahepatic classification f the International Classification of Diseases for Oncology ICD-O-3). Indeed, there have been calls for alternatives to he ICD-0-3 staging system [3,4] which classify peripheral ntrahepatic tumours, with their different biology and surical management, separately to those arising from major ile ducts, which may be accessible by endoscopic or perutaneous biliary approaches and therefore amenable to

DOI: 10.1016/j.pdpdt.2009.06.002

Cite this paper

@article{Chapman2009CholangiocarcinomaIB, title={Cholangiocarcinoma: improving biliary drainage with PDT.}, author={Michael Huw Chapman and Stephen P. Pereira}, journal={Photodiagnosis and photodynamic therapy}, year={2009}, volume={6 2}, pages={82-3} }