The management of resectable intrahepatic cholangiocarcinoma remains a challenge due to the high risk of recurrence. Numerous clinical trials have identified effective systemic therapies for advanced biliary tract cancer; however, fewer trials have evaluated systemic therapies in the perioperative period. The objective of this review is to summarize the current recommendations regarding the diagnosis, surgical resection, and systemic therapy for anatomically resectable intrahepatic cholangiocarcinoma. Our review demonstrates that surgical resection with microscopic negative margins and lymphadenectomy remains the cornerstone of treatment. High-level evidence regarding specific systemic therapies for use in resectable intrahepatic cholangiocarcinoma remains sparse, as most of the evidence is extrapolated from trials involving heterogeneous tumor populations. Targeted therapies are an evolving practice for intrahepatic cholangiocarcinoma with most evidence coming from phase II trials. Future research is required to evaluate the use of neoadjuvant therapy for patients with resectable and borderline resectable disease.
可切除肝内胆管癌因其高复发风险，其治疗管理仍面临挑战。多项临床试验已证实晚期胆道癌的有效全身治疗方案，但针对围手术期全身治疗的研究相对较少。本综述旨在总结当前关于解剖学上可切除肝内胆管癌的诊断、手术切除及全身治疗的建议。研究表明，实现显微镜下切缘阴性并联合淋巴结清扫的手术切除仍是治疗基石。关于可切除肝内胆管癌特异性全身治疗的高质量证据仍显不足，现有证据多源自针对异质性肿瘤群体的试验数据。靶向治疗在肝内胆管癌领域处于发展探索阶段，多数证据来自II期临床试验。未来需进一步研究评估新辅助治疗在可切除及临界可切除患者中的应用价值。
Management of Intrahepatic Cholangiocarcinoma: A Narrative Review
肿瘤(癌症)患者之家