Is there a place for liver transplantation in cases with unresectable central cholangiocarcinoma?

• Main Authors: Nicolae Bacalbașa, Irina Balescu, Mihaela Vilcu, Iulian Brezean, Alin Bodog
• Format: Article
• Language: English
• Published: Digital ProScholar Media 2018-11-01
• Series: Journal of Clinical and Investigative Surgery
• Subjects:  unresectable; central cholangiocarcinoma; liver transplantation
• Online Access: https://www.proscholar.org/jcis/archive/2018/3.2/57.61.pdf

Central cholangiocarcinoma represents a very aggressive malignancy associated with poor survival rats especially due to the fact that most patients are diagnosed in advanced stages of the disease when curative resection is no longer feasible. In order to try improving the long-term outcomes of these patients, especially in unresectable cases liver transplantation has been proposed with promising results. This is a literature review of the largest studies focused on this subject. Cholangiocarcinomas remain aggressive tumors with poor outcomes whenever surgery with curative intent is not feasible. Currently, the largest experience accumulated consists of neoadjuvant external beam radiotherapy in association with beam radiation, 5 fluorouracil and capecitabine followed by orthotopic liver transplantation. Following this therapeutic protocol excellent long-term outcomes have been reported even if vascular involvement is present.