Background: Cholangiocarcinomas (CC) as well as gallbladder cancers are relatively rare and intractable diseases. Clinical, pathological, and epidemiological studies on these tumors have been under investigation. The current status and/or topics on biliary tract cancers have been reported in the East West Association of Liver Tumor (EWALT), held in Milano, Italy in 2015. Summary: All the authors, herein, specifcally reported the current status and leading-edge findings on biliary tract cancers as the following sequence: epidemiology of CC, surgical therapy for intrahepatic CC, surgical therapy for perihilar CC, surgical therapy for gallblad der cancer, chemotherapy for biliary tract cancers, and new histological features in CC. Key Message: The present review article will update the knowledge on biliary tract cancers, en hancing the quality of daily clinical practice. However, many features about these cancers remain unknown; further studies are required to establish disease-specific optimal treatment strategies.

Keywords:
Biliary tract cancer, Cholangiocarcinoma, Gallbladder cancer
1.
Bergquist A, von Seth E: Epidemiology of cholangiocarcinoma. Best Pract Res Clin Gastroenterol 2015;29:221-232.
2.
Cardinale V, Semeraro R, Torrice A, Gatto M, Napoli C, Bragazzi MC, Gentile R, Alvaro D: Intra-hepatic and extra-hepatic cholangiocarcinoma: New insight into epidemiology and risk factors. World J Gastrointest Oncol 2010;2:407-416.
3.
Alvaro D, Crocetti E, Ferretti S, Bragazzi MC, Capocaccia R, AISF Cholangiocarcinoma committee: Descriptive epidemiology of cholangiocarcinoma in Italy. Dig Liver Dis 2010; 42: 490-495.
4.
Rizvi S, Gores GJ: Pathogenesis, diagnosis, and management of cholangiocarcinoma. Gastroenterology 2013;145:1215-1229.
5.
Tyson GL, El-Serag HB: Risk factors for cholangiocarcinoma. Hepatology 2011;54:173-184.
6.
Kobayashi M, Ikeda K, Saitoh S, Suzuki F, Tsubota A, Suzuki Y, Arase Y, Murashima N, Chayama K, Kumada H: Incidence of primary cholangiocellular carcinoma of the liver in Japanese patients with hepatitis C virus-related cirrhosis. Cancer 2000;88:2471-2477.
7.
Tanaka M, Tanaka H, Tsukuma H, Ioka A, Oshima A, Nakahara T: Risk factors for intrahepatic cholangio-carcinoma: a possible role of hepatitis B virus. J Viral Hepat 2010;17:742-748.
8.
Kumagai S, Kurumatani N, Arimoto A, Ichihara G: Cholangiocarcinoma among offset colour proof-printing workers exposed to 1,2-dichloropropane and/or dichloromethane. Occup Environ Med 2013;70:508-510.
9.
Weber SM, Ribero D, O'Reilly EM, Kokudo N, Miyazaki M, Pawlik TM: Intrahepatic cholangiocarcinoma: expert consensus statement. HPB (Oxford) 2015;17:669-680.
10.
Ribero D, Pinna AD, Guglielmi A, Ponti A, Nuzzo G, Giulini SM, Aldrighetti L, Calise F, Gerunda GE, Tomatis M, Amisano M, Berloco P, Torzilli G, Capussotti L, Italian Intrahepatic Cholangiocarcinoma Study Group: Surgical Approach for Long-term Survival of Patients With Intrahepatic Cholangiocarcinoma: A Multi-institutional Analysis of 434 Patients. Arch Surg 2012;147:1107-1113.
11.
Farges O, Fuks D, Boleslawski E, Le Treut YP, Castaing D, Laurent A, Ducerf C, Rivoire M, Bachellier P, Chiche L, Nuzzo G, Regimbeau JM: Influence of surgical margins on outcome in patients with intrahepatic cholangiocarcinoma: a multicenter study by the AFC-IHCC-2009 study group. Ann Surg 2011;254:824-829, discussion 830.
12.
Uenishi T, Ariizumi S, Aoki T, Ebata T, Ohtsuka M, Tanaka E, Yoshida H, Imura S, Ueno M, Kokudo N, Nagino M, Hirano S, Kubo S, Unno M, Shimada M, Yamaue H, Yamamoto M, Miyazaki M, Takada T: Proposal of a new staging system for mass-forming intrahepatic cholangiocarcinoma: a multicenter analysis by the Study Group for Hepatic Surgery of the Japanese Society of Hepato-Biliary-Pancreatic Surgery. J Hepatobiliary Pancreat Sci 2014;21:499-508.
13.
de Jong MC, Nathan H, Sotiropoulos GC, Paul A, Alexandrescu S, Marques H, Pulitano C, Barroso E, Clary BM, Aldrighetti L, Ferrone CR, Zhu AX, Bauer TW, Walters DM, Gamblin TC, Nguyen KT, Turley R, Popescu I, Hubert C, Meyer S, Schulick RD, Choti MA, Gigot JF, Mentha G, Pawlik TM: Intrahepatic cholangiocarcinoma: an international multi-institutional analysis of prognostic factors and lymph node assessment. J Clin Oncol 2011;29:314 0 -3145.
14.
Ito T, Ebata T, Yokoyama Y, Igami T, Sugawara G, Mizuno T, Shimoyama Y, Nagino M: The pathologic correlation between liver and portal vein invasion in perihilar cholangiocarcinoma: evaluating the oncologic rationale for the American Joint Committee on Cancer definitions of T2 and T3 tumors. World J Surg 2014;38:3215-3221.
15.
Ebata T, Yokoyama Y, Igami T, Sugawara G, Takahashi Y, Nimura Y, Nagino M: Hepatopancreatoduodenectomy for cholangiocarcinoma: a single-center review of 85 consecutive patients. Ann Surg 2012;256:297-305.
16.
Nagino M, Nimura Y, Nishio H, Ebata T, Igami T, Matsushita M, Nishikimi N, Kamei Y: Hepatectomy with simultaneous resection of the portal vein and hepatic artery for advanced perihilar cholangiocarcinoma: an audit of 50 consecutive cases. Ann Surg 2010;252:115-123.
17.
Ebata T, Kosuge T, Hirano S, Unno M, Yamamoto M, Miyazaki M, Kokudo N, Miyagawa S, Takada T, Nagino M: Proposal to modify the International Union Against Cancer staging system for perihilar cholangiocarcinomas. Br J Surg 2014;101:79-88.
18.
Nagino M, Ebata T, Yokoyama Y, Igami T, Sugawara G, Takahashi Y, Nimura Y: Evolution of surgical treatment for perihilar cholangiocarcinoma: a single-center 34-year review of 574 consecutive resections. Ann Surg 2013;258:129-140.
19.
Edge SB, Byrd DR, Compton CC, Fritz AG, Greene FL, Trotti A, editors: AJCC Cancer Staging Manual. 7th ed. New York: Springer; 2010. 201-225
20.
Agarwal AK, Kalayarasan R, Javed A, Gupta N, Nag HH: The role of staging laparoscopy in primary gall bladder cancer—an analysis of 409 patients: a prospective study to evaluate the role of staging laparoscopy in the management of gallbladder cancer. Ann Surg 2013;258:318-323.
21.
Nishio H, Ebata T, Yokoyama Y, Igami T, Sugawara G, Nagino M: Gallbladder cancer involving the extrahepatic bile duct is worthy of resection. Ann Surg 2011;253:953-960.
22.
Ebata T, Nagino M, Nishio H, Arai T, Nimura Y: Right hepatopancreatoduodenectomy: improvements over 23 years to attain acceptability. J Hepatobiliary Pancreat Surg 2007;14:131-135.
23.
Ishihara S, Horiguchi A, Miyakawa S, Endo I, Miyazaki M, Takada T: Biliary tract cancer registry in Japan from 2008 to 2013. J Hepatobiliary Pancreat Sci 2015. doi: 10.1002/jhbp.314
24.
Eckel F, Schmid RM: Chemotherapy in advanced biliary tract carcinoma: a pooled analysis of clinical trials. Br J Cancer 2007;96:896-902.
25.
Valle J, Wasan H, Palmer DH, Cunningham D, Anthoney A, Maraveyas A, Madhusudan S, Iveson T, Hughes S, Pereira SP, Roughton M, Bridgewater J, ABC-02 Trial Investigators: Cisplatin plus gemcitabine versus gemcitabine for biliary tract cancer. N Engl J Med 2010;362:1273-1281.
26.
Okusaka T, Nakachi K, Fukutomi A, Mizuno N, Ohkawa S, Funakoshi A, Nagino M, Kondo S, Nagaoka S, Funai J, Koshiji M, Nambu Y, Furuse J, Miyazaki M, Nimura Y: Gemcitabine alone or in combination with cisplatin in patients with biliary tract cancer: a comparative multicentre study in Japan. Br J Cancer 2010;103:469-474.
27.
Lamarca A, Benafif S, Ross P, Bridgewater J, Valle JW: Cisplatin and gemcitabine in patients with advanced biliary tract cancer (ABC) and persistent jaundice despite optimal stenting: Effective intervention in patients with luminal disease. Eur J Cancer 2015;51:1694-1703.
28.
Lamarca A, Hubner RA, David Ryder W, Valle JW: Second-line chemotherapy in advanced biliary cancer: a systematic review. Ann Oncol 2014;25:2328-2338.
29.
Komuta M, Govaere O, Vandecaveye V, Akiba J, Van Steenbergen W, Verslype C, Laleman W, Pirenne J, Aerts R, Yano H, Nevens F, Topal B, Roskams T: Histological diversity in cholangiocellular carcinoma reflects the different cholangiocyte phenotypes. Hepatology 2012;55:1876-1888.
30.
Nakanuma Y, Sato Y, Harada K, Sasaki M, Xu J, Ikeda H: Pathological classification of intrahepatic cholangiocarcinoma based on a new concept. World J Hepatol 2010;2:419-427.
31.
Bosman FT, Carneiro F, Hruban RH, Theise ND, editors: WHO Classification of Tumours of the Digestive System 4th ed. Lyon: International Agency for Reseach on Cancer; 2010.
© 2016 S. Karger AG, Basel
2016
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.