肝内胆管癌新辅助治疗共识与争议

肝内胆管癌(ICC)恶性程度高,症状隐匿,早期症状不明显,由于缺乏有效的筛查,确诊时多处于进展期,大多失去手术切除机会。目前,根治性手术仍是惟一可以使病人获得长期生存的治疗方式,但存在切除率低、术后易复发等难题。新辅助治疗能缩小原有病灶及转移的淋巴结,提高R0切除率,对于无法切除的局部晚期ICC,新辅助治疗可使局部进展的ICC降期为可切除,也可改善肝移植病人的预后。但目前对ICC行新辅助治疗的潜在效用仍存在争议。

Controversy and consensus on neoadjuvant therapy for intrahepatic cholangiocarcinoma

Controversy and consensus on neoadjuvant therapy for intrahepatic cholangiocarcinoma ZHANG Yan-qiao，ZHENG Tong-sen. Department of Gastrointestinal Medical Oncology，Harbin Medical University Cancer Hospital; Gastrointestinal Cancer Diagnosis and Treatment Center of Heilongjiang Province, Harbin 150081，China
Corresponding author：ZHANG Yan-qiao，E-mail：yanqiaozhang@126.com
Abstract Intrahepatic cholangiocarcinoma（ICC）has occult symptoms and is lack of specific clinical manifestations in the early stage. Due to the lack of effective screening，ICC is mostly in the advanced stage when diagnosed，and the opportunity for surgical resection is lost. Radical surgery is still the only treatment that can provide patients with long-term survival，but there is a low rate of radical resection. And it is easy to relapse after surgery. Neoadjuvant therapy can reduce the original focus and metastatic lymph nodes，and improve the rate of R0 resection. For unresectable locally advanced ICC，neoadjuvant therapy can reduce the locally advanced ICC to be resectable and can also improve the prognosis of patients with liver transplantation. However，the potential utility of neoadjuvant therapy in ICC is still controversial.