Oncologic approach to tumors of the liver and hepatobiliary tract

Abstract:

Hepatobiliary tumors are associated with very poor survival rates. It is generally diagnosed in the advanced stage of the disease when surgical resection methods, liver transplants and locoregional treatments are of no efficacy. In recent years there has been progress regarding the implementation of systemic treatment methods, particularly the introduction of the drug sorafenib in HCC patients, as well as applying gemcitabin with cisplatin in patients with biliary forms of cancer in the biliary tract. A multidisciplinary approach to the treatment is necessary, and choosing the preferred patient (in an early stage of the disease, preserved liver functions) results in the possibility of providing a curative treatment approach, or a significantly better prognosis whilst using the applied methods. Patients with cancer in the hepatobiliary tract must be evaluated at a multidisciplinary level when there is potential for a radical, curative therapy (resection, transplantation). Patients who are not candidates can be treated with a locoregional approach (ablation or embolization). Unfortunately, most patients are in the advanced stages of cancer when diagnosed when systemic chemotherapy and/or care giving is the only treatment method possible, and only in palliative care. There are numerous new methods and drugs being tested and trialed, some of which will surely find their place in the treatment of tumors affecting the hepatobiliary tract. 

Key words:
biliary tract neoplasms; chemotherapy, cholangiocarcinoma; hepatocellular carcinoma; sorafenib