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Diagnostic-therapeutic management of bile duct cancer

World Journal of Clinical Cases 2019年第14期7卷 1732-1752页

作者： José María Huguet Miriam Lobo José Mir Labrador Carlos Boix Cecilia Albert Luis Ferrer-Barceló Ana B Durá Patricia Suárez Isabel Iranzo Mireia Gil-Raga celia baez de burgos Javier Sempere Digestive Disease department General University Hospital of ValenciaValencia 46014Spain Medical Oncology department General University Hospital of ValenciaValencia 46014Spain Unidad Hepática Avanzada Servicio de Cirugía General y DigestivaGeneral University Hospital of ValenciaValencia 46014Spain Medical Oncology department Hospital de RequenaRequena 46340Spain

Biliary tract cancer, or cholangiocarcinoma, comprises a heterogeneous group of malignant tumors that can emerge at any part of the biliary tree. This group is the second most common type of primary liver cancer. Diagnosis is usually based on symptoms, which may be heterogeneous, and nonspecific biomarkers in serum and biopsy specimens, as well as on imaging techniques. Endoscopy-based diagnosis is essential, since it enables biopsy specimens to be taken. In addition, it can help with locoregional staging of distal tumors. Endoscopic retrograde cholangiopancreatography is a key technique for the evaluation and treatment of malignant biliary tumors. Correct staging of cholangiocarcinoma is essential in order to be able to determine the degree of resectability and assess the results of treatment. The tumor is staged based on the TNM classification of the American Joint Committee on Cancer. The approach will depend on the classification of the tumor. Thus, some patients with early-stage disease could benefit from surgery;complete surgical resection is the cornerstone of cure. However, only a minority of patients are diagnosed in the early stages and are suitable candidates for resection. In the subset of patients diagnosed with locally advanced or metastatic disease, chemotherapy has been used to improve outcome and to delay tumor progression. The approach to biliary tract tumors should be multidisciplinary, involving experienced endoscopists, oncologists, radiologists, and surgeons.

关键词： Bile duct cancer Cholangiocarcinoma Management Diagnosis Incidence Multidisciplinary treatment

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