肝内胆管癌综合治疗的进展与争议

Advances and controversies of multidisciplinary regimen for intrahepatic cholangiocarcinoma

肝内胆管癌是发生于肝内但起源于胆道上皮的恶性肿瘤,其独特的生物学特性异于原发性肝细胞癌和肝外胆管癌,恶性程度高,预后极差。目前根治性外科手术仍是治愈肝内胆管癌的唯一手段,但仅有少数病人可以获得根治性切除机会,且术后5年生存率低。近年来随着对肝内胆管癌分子发病机制的研究进展,其治疗方式已从单纯手术切除过渡到以手术为基石的多学科系统综合治疗模式,并得到业界广泛认可。尽管当前综合治疗取得了很多进展,部分晚期病人通过系统转化治疗获得了R0手术切除机会,但仍存有较多争议,仍需大样本、多中心的前瞻性研究来获得翔实可靠的数据来解决争议,让病人更好地获益。

Intrahepatic cholangiocarcinoma(ICC)is a malignant hepatic tumor originating from intrahepatic biliary epithelium.The unique biologic characters of ICC differ from those of primary hepatocellular carcinoma and extrahepatic cholangiocarcinoma.Its prognosis remains extremely poor.Currently radical surgery represents the only curative option for ICC.Unfortunately,only few patients undergo radical resection and 5-year survival rate of ICC has been quite low.It has been widely accepted that therapeutic mode of ICC is experiencing a fundamental change from simple surgical resection to a multidisciplinary comprehensive regimen.Some ongoing controversies may be resolved by robust data through future multicentric perspective trials with large samples.