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J.Jpn. Surg. Soc.. 122(2): 147-152, 2021


Feature topic

WHAT IS BORDERLINE RESECTABLE INTRAHEPATIC CHOLANGIOCARCINOMA?

Department of Surgery, Institute of Gastroenterology, Tokyo Women’s Medical University, Tokyo, Japan

Shun-ichi Ariizumi, Masakazu Yamamoto

Intrahepatic cholangiocarcinoma (ICC) is a fatal disease because of frequent recurrence and death despite curative surgery. ICC with neither intrahepatic metastasis (IM) nor lymph node metastasis (LNM) is the best indication for hepatectomy because the 5-year survival rate is approximately 60%. On the other hand, ICC with both IM and LNM is not an indication for resection because the 5-year survival rate is 0% despite curative surgery. ICC with either IM or LNM is a borderline indication for resection, with 5-year survival rates of around 30%. Chemotherapy after surgery is recommended because better survival rates have been reported in patients with resectable ICC. Conversion surgery after chemotherapy is also recommended in patients with unresectable ICC. However, there is no recommendation for chemotherapy before surgery (neoadjuvant chemotherapy) in patients with resectable or borderline resectable ICC.


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