Reuters Health Information (2005-09-26): Transplant and chemoradiation combat cholangiocarcinoma
Transplant and chemoradiation combat cholangiocarcinoma
Last Updated: 2005-09-26 16:25:28 -0400 (Reuters Health)
NEW YORK (Reuters Health) - A combination approach
involving chemoradiation and liver transplantation appears effective in
certain patients with hilar cholangiocarcinoma, researchers report in
the September issue of Annals of Surgery.
"Combined preoperative radiotherapy and 5-FU chemosensitization with
subsequent liver transplantation achieves excellent results for highly
selected patients with hilar cholangiocarcinoma," investigator Dr.
Charles B. Rosen told Reuters Health.
"Initial results," he added, "exceed those reported with
conventional resection and compare favorably with the results of liver
transplantation for other indications."
Dr. Rosen and colleagues at the Mayo Clinic, Rochester, Minnesota
came to this conclusion following review of the results in patients
treated over a 10-year period.
In total, 71 were considered for transplantation and 38 underwent
the procedure. Operative staging was used to limit transplantation to
patients with localized disease and no lymph node metastases.
Of 54 patients who were assessed for resection, 26 underwent resection. The remaining 28 had unresectable disease.
In the transplantation group, survival at 1 year was 92%, and at 2
and 5 years it was 82%. Corresponding proportions in the resection
group were 82%, 48% and 21%. Moreover, the recurrence rate in the
transplant patients was 13%, versus 27% in the resection group.
Thus, concluded Dr. Rosen, "hilar cholangiocarcinoma -- once a
transplant contraindication -- has re-emerged as an indication for
liver transplantation when combined with effective preoperative
Ann Surg 2005;242:451-461.