Early detection and treatment of cholangiocarcinoma

Liver Transpl. 2000 Nov;6(6 Suppl 2):S30-4. doi: 10.1053/jlts.2000.18688.

Abstract

1. The major identified risk factor for the development of cholangiocarcinoma in Western countries is primary sclerosing cholangitis (PSC). 2. The diagnosis of cholangiocarcinoma in PSC requires a high index of suspicion because endoscopic brush cytology and/or biopsies and imaging studies are often negative for malignancy. Positron emission tomography is a promising imaging modality for the diagnosis of cholangiocarcinoma, even in patients with PSC. 3. A serum carbohydrate antigen 19-9 value greater than 100 U/mL has a sensitivity and specificity for cholangiocarcinoma of approximately 75% and 80%, respectively. 4. Liver transplantation is a viable therapeutic option for selected patients with early-stage cholangiocarcinoma. Outcomes are optimized by using preoperative radiation and chemotherapy and ensuring the absence of metastases by an exploratory laparotomy.

Publication types

  • Review

MeSH terms

  • Bile Duct Neoplasms / diagnosis*
  • Bile Duct Neoplasms / etiology
  • Bile Duct Neoplasms / therapy*
  • Bile Ducts, Intrahepatic*
  • Biomarkers, Tumor / blood
  • Biopsy
  • Cholangiocarcinoma / diagnosis*
  • Cholangiocarcinoma / etiology
  • Cholangiocarcinoma / therapy*
  • Cholangitis, Sclerosing / complications
  • Cytogenetics
  • Humans
  • Liver Transplantation
  • Neoadjuvant Therapy
  • Risk Factors
  • Tomography, Emission-Computed

Substances

  • Biomarkers, Tumor