title: Surgical management of intrahepatic cholangiocarcinoma in the modern era: advances and challenges.
abstract: Intrahepatic cholangiocarcinoma (ICC) is one of the few gastrointestinal cancers with increasing incidence and mortality worldwide. Unlike hepatocellular carcinoma (HCC) which arises usually in a cirrhotic environment ICC frequently arises in the context of normal hepatic parenchyma. Surgical resection represents the mainstay of curative treatment, with minimally invasive approaches being increasingly utilized. Despite good surgical outcomes, most patients suffer from disease recurrence and eventually succumb to their disease. Effective adjuvant treatments are therefore needed. For unresectable disease hepatic artery utilization techniques are becoming more widely used. New treatments for non metastatic disease such as proton beam therapy (PBT) are also emerging. Systemic chemotherapy is also changing and targeted biologic agents are being added to conventional chemotherapeutic agents.
authors.affiliation: Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, USA; Department of Surgery, University of Arizona, Tucson, AZ 85721, USA; 4th Department of Surgery, University of Athens Medical School, Attikon Hospital, Athens, Greece.
authors.forename: Ioannis T
authors.initials: IT
authors.lastname: Konstantinidis
authors.affiliation: 4th Department of Surgery, University of Athens Medical School, Attikon Hospital, Athens, Greece.
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Arkadopoulos
authors.affiliation: Department of Surgery, Massachusetts General Hospital, Wang 460, 15 Parkman Street, Boston, MA 02114, USA. cferrone@partners.org.
authors.forename: Cristina R
authors.initials: CR
authors.lastname: Ferrone
mesh_terms: D001650:Bile Duct Neoplasms / Q000601:surgery*; D001653:Bile Ducts, Intrahepatic / Q000601:surgery*; D018281:Cholangiocarcinoma / Q000601:surgery*; D019468:Disease Management; D006801:Humans; D011379:Prognosis
keywords: Intrahepatic cholangiocarcinoma (ICC); intra-arterial therapies (IATs); minimally invasive approaches; multimodality treatment; proton beam therapy (PBT); surgical resection