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

@article{Heimbach2006PredictorsOD,
  title={Predictors of Disease Recurrence Following Neoadjuvant Chemoradiotherapy and Liver Transplantation for Unresectable Perihilar Cholangiocarcinoma},
  author={J. Heimbach and G. Gores and M. Haddock and S. Alberts and R. Pedersen and W. Kremers and S. Nyberg and M. Ishitani and C. Rosen},
  journal={Transplantation},
  year={2006},
  volume={82},
  pages={1703-1707}
}
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… Expand
Neoadjuvant chemoradiotherapy followed by liver transplantation for unresectable cholangiocarcinoma: a single-centre national experience.
TLDR
In selected patients with unresectable CCA, long-term survival can be achieved using neoadjuvant chemoradiotherapy and OLT although short-term mortality is high. Expand
Surgery for cholangiocarcinoma: the role of liver transplantation.
TLDR
Neoadjuvant chemoradiation and OLT achieves significantly lower recurrence and higher long-term survival rates than resection, OLT alone, or medical treatment in hilar CCA. Expand
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Rates of residual CCA in liver explants and recurrences after transplantation are comparable for patients with and without pretreatment pathological confirmation of CCA and attest to the accuracy of clinical diagnostic criteria. Expand
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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. Expand
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Acceptable survival rates can be achieved by transplantation for hilar cholangiocarcinoma with lymph node metastases as the only exclusion criterion. Expand
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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. Expand
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TLDR
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. Expand
Downstaging Locally Advanced Cholangiocarcinoma Pre-Liver Transplantation: A Prospective Pilot Study.
TLDR
This is the first prospective study to show successful NT downstaging of unresectable locally advanced hilar and intrahepatic CCA before OLT, and NT-OLT for select patients with locally advanced comedy cholangiocarcinoma achieved acceptable short-term recurrence-free survival. Expand
Impact of neoadjuvant chemoradiation on the tumor burden before liver transplantation for unresectable cholangiocarcinoma
  • C. Panjala, J. Nguyen, +7 authors D. Harnois
  • Medicine
  • Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society
  • 2012
TLDR
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). Expand
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TLDR
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. Expand
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