title: Surgery and chemotherapy for intrahepatic cholangiocarcinoma.
abstract: Cholangiocarcinoma, arising from bile duct epithelium, is categorized into intrahepatic cholangiocarcinoma (ICC) and extrahepatic cholangiocarcinoma (ECC), including hilarcholangiocarcinoma. Recently, there has been a worldwide increase in the incidence and mortality from ICC. Complete surgical resection is the only approach to cure the patients with ICC. However, locoregional extension of these tumors is usually advanced with intrahepatic and lymph-node metastases at the time of diagnosis. Resectability rates are quite low and variable (18%-70%). The five-year survival rate after surgical resection was reported to be 20%-40%. Median survival time after ICC resection was 12-37.4 mo. Only a small number of ICC cases, accompanied with ECC, gall bladder carcinoma, and ampullary carcinoma, have been reported in the studies of chemotherapy due to the rarity of the disease. However, in some reports, significant anti-cancer effects were achieved with a response rate of up to 40% and a median survival of one year. Although recurrence rate after hepatectomy is high for the patients with ICC, the residual liver and the lung are the main sites of recurrence after tentative curative surgical resection. Several patients in our study had a long-term survival with repeated surgery and chemotherapy. Repeated surgery, combined with new effective regimens of chemotherapy, could benefit the survival of ICC patients.
authors.affiliation: Zenichi Morise, Atsushi Sugioka, Takamasa Tokoro, Yoshinao Tanahashi, Yasuhiro Okabe, Tadashi Kagawa, Chinatsu Takeura, Department of Surgery, Fujita Health University School of Medicine, 1-98 Dengakugakubo, Kutsukake-cho, Toyoake, Aichi 470-1192, Japan.
authors.forename: Zenichi
authors.initials: Z
authors.lastname: Morise
authors.forename: Atsushi
authors.initials: A
authors.lastname: Sugioka
authors.forename: Takamasa
authors.initials: T
authors.lastname: Tokoro
authors.forename: Yoshinao
authors.initials: Y
authors.lastname: Tanahashi
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Okabe
authors.forename: Tadashi
authors.initials: T
authors.lastname: Kagawa
authors.forename: Chinatsu
authors.initials: C
authors.lastname: Takeura