Table of Contents Author Guidelines Submit a Manuscript
Gastroenterology Research and Practice
Volume 2016, Article ID 8732521, 13 pages
http://dx.doi.org/10.1155/2016/8732521
Research Article

Extensive Use of Interventional Therapies Improves Survival in Unresectable or Recurrent Intrahepatic Cholangiocarcinoma

1Klinik für Radiologie und Nuklearmedizin, Universitätsklinikum Magdeburg, Leipziger Strasse 44, 39120 Magdeburg, Germany
2Zentrum für Gastrointestinale Tumoren (ZeGIT), Universitätsklinikum Magdeburg, Leipziger Strasse 44, 39120 Magdeburg, Germany
3Deutsche Akademie für Mikrotherapie (DAfMT), Leipziger Strasse 44, 39120 Magdeburg, Germany
4Klinik für Gastroenterologie, Hepatologie und Infektiologie, Universitätsklinikum Magdeburg, Leipziger Strasse 44, 39120 Magdeburg, Germany
5Klinik für Allgemein-, Viszeral- und Gefäßchirurgie, Universitätsklinikum Magdeburg, Leipziger Strasse 44, 39120 Magdeburg, Germany

Received 12 October 2015; Accepted 20 December 2015

Academic Editor: Mohamad H. Imam

Copyright © 2016 Ricarda Seidensticker et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Aim. To assess the outcomes of patients with unresectable intrahepatic cholangiocellular carcinoma (ICC) treated by a tailored therapeutic approach, combining systemic with advanced image-guided local or locoregional therapies. Materials and Methods. Treatment followed an algorithm established by a multidisciplinary GI-tumor team. Treatment options comprised ablation (RFA, CT-guided brachytherapy) or locoregional techniques (TACE, radioembolization, i.a. chemotherapy). Results. Median survival was 33.1 months from time of diagnosis and 16.0 months from first therapy. UICC stage analysis showed a median survival of 15.9 months for stage I, 9 months for IIIa, 18.4 months for IIIc, and 13 months for IV. Only the number of lesions, baseline serum CEA and serum CA19-9, and objective response (RECIST) were independently associated with survival. Extrahepatic metastases had no influence. Conclusion. Patients with unresectable ICC may benefit from hepatic tumor control provided by local or locoregional therapies. Future prospective study formats should focus on supplementing systemic therapy by classes of interventions (“toolbox”) rather than specific techniques, that is, local ablation leading to complete tumor destruction (such as RFA) or locoregional treatment leading to partial remission (such as radioembolization). This trial is registered with German Clinical Trials Registry (Deutsche Register Klinischer Studien), DRKS-ID: DRKS00006237.