Session I: Controversies in Hepatobiliary Malignancy
Early detection and treatment of cholangiocarcinoma
Article first published online: 30 DEC 2003
Copyright © 2000 American Association for the Study of Liver Diseases
Supplement: Advances and Controversies in Liver Transplantation
Volume 6, Issue Supplement 6B, pages s30–s34, November 2000
How to Cite
Gores, G. J. (2000), Early detection and treatment of cholangiocarcinoma. Liver Transpl, 6: s30–s34. doi: 10.1053/jlts.2000.18688
- Issue published online: 30 DEC 2003
- Article first published online: 30 DEC 2003
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.