Predictors of Disease Recurrence Following Neoadjuvant Chemoradiotherapy and Liver Transplantation for Unresectable Perihilar Cholangiocarcinoma

  title={Predictors of Disease Recurrence Following Neoadjuvant Chemoradiotherapy and Liver Transplantation for Unresectable Perihilar Cholangiocarcinoma},
  author={Julie K. Heimbach and Gregory J. Gores and Michael G. Haddock and Steven R. Alberts and Rachel A. Pedersen and Walter K. Kremers and Scott L. Nyberg and Michael B. Ishitani and Charles B. Rosen},
Background. Sixty-five patients with unresectable hilar cholangiocarcinoma (CCA) have undergone orthotopic liver transplantation (OLT) after neoadjuvant chemoradiotherapy per a clinical care protocol developed in 1993. We reviewed our experience with the aim to identify clinicopathological predictors of disease recurrence. Methods. All patients with CCA that underwent OLT at our institution between 1993 and January 1, 2006 were treated in accord with our published protocol. We analyzed multiple… 

Neoadjuvant chemoradiotherapy followed by liver transplantation for unresectable cholangiocarcinoma: a single-centre national experience.

In selected patients with unresectable CCA, long-term survival can be achieved using neoadjuvant chemoradiotherapy and OLT although short-term mortality is high.

Surgery for cholangiocarcinoma: the role of liver transplantation.

Neoadjuvant chemoradiation and OLT achieves significantly lower recurrence and higher long-term survival rates than resection, OLT alone, or medical treatment in hilar CCA.

Neoadjuvant Chemoradiotherapy and Liver Transplantation for Unresectable Hilar Cholangiocarcinoma: The Irish Experience of the Mayo Protocol

Neoadjuvant chemoradiotherapy followed by liver transplantation substantially increases the survival of patients with unresectable hCCA, andchieving a pathologic complete response confers a significant survival benefit.

Liver transplantation for hilar cholangiocarcinoma—a single-centre experience

Acceptable survival rates can be achieved by transplantation for hilar cholangiocarcinoma with lymph node metastases as the only exclusion criterion.

Outcome of Transplant-fallout Patients With Unresectable Cholangiocarcinoma

In highly selected patients initially suitable for OLT, the mortality rate for cholangiocarcinoma was high in patients who became ineligible forOLT, however, their survival was comparable to expected survival for patients with locally advanced or metastatic disease treated with nontransplant therapies.

Predictors of pretransplant dropout and posttransplant recurrence in patients with perihilar cholangiocarcinoma

Outcome following neoadjuvant chemoradiation and liver transplantation for perihilar CCA is excellent and risk of dropout is related to patient and tumor characteristics and this can be used to guide patient counseling before enrollment.

Impact of neoadjuvant chemoradiation on the tumor burden before liver transplantation for unresectable cholangiocarcinoma

  • C. PanjalaJ. Nguyen D. Harnois
  • Medicine
    Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society
  • 2012
The LT protocol for CC was found to be promising for patients with truly extrahepatic CC and for patients within stages I to IIB of the American Joint Committee on Cancer Staging system, but the results were notably poor for Patients with stage III extrahePatic CC (median survival = 1.2 years).

Efficacy of neoadjuvant chemoradiation, followed by liver transplantation, for perihilar cholangiocarcinoma at 12 US centers.

Patients with perihilar cholangiocarcinoma who were treated with neoadjuvant therapy followed up by liver transplantation at 12 US centers had a 65% rate of recurrence-free survival after 5 years, showing this therapy to be highly effective.



Liver Transplantation with Neoadjuvant Chemoradiation is More Effective than Resection for Hilar Cholangiocarcinoma

Liver transplantation with neoadjuvant chemoradiation achieved better survival with less recurrence than conventional resection and should be considered as an alternative to resection for patients with localized, node-negative hilar CCA.

Liver transplantation for unresectable perihilar cholangiocarcinoma.

Neoadjuvant chemoradiotherapy with liver transplantation achieves excellent results for patients with localized, regional lymph node negative, hilar cholangiocarcinoma.

Is liver transplantation indicated for cholangiocarcinoma?

Until a better adjuvant therapy protocol is developed, it is questionable whether unresectable cholangiocarcinoma should be considered an indication for liver transplantation.

Liver transplantation for cholangiocarcinoma: results in 207 patients.

Because of the high rate of recurrent tumor and lack of positive prognostic variables, transplantation should seldom be used as a treatment for cholangiocarcinoma, and more effective adjuvant therapies are necessary.

Neoadjuvant chemoradiation for extrahepatic cholangiocarcinoma.

Preliminary experience with liver transplantation in selected patients with unresectable hilar cholangiocarcinoma.

Liver transplantation for cholangiocellular carcinoma: Analysis of a single‐center experience and review of the literature

  • M. ShimodaD. Farmer R. Busuttil
  • Medicine
    Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society
  • 2001
It is indicated that early survival after LT for CCC is acceptable and three‐year disease‐free survival is achieved in approximately 30% of patients, which can be improved by applying strict selection criteria based on prognostic variables identified in this study.

Staging, Resectability, and Outcome in 225 Patients With Hilar Cholangiocarcinoma

By taking full account of local tumor extent, the proposed staging system for hilar cholangiocarcinoma accurately predicts resectability, the likelihood of metastatic disease, and survival.

Results of Postoperative Radiotherapy for Resectable Hilar Cholangiocarcinoma

Additional radiotherapy after resection of hilar cholangiocarcinoma significantly improved survival and is recommended by giving external beam irradiation but not intraluminal brachytherapy.