Cholangiocarcinoma: Treatment, outcomes, and nutrition overview for oncology nurses

BACKGROUND: Cholangiocarcinoma is a cancer that arises from the bile ducts inside or outside of the liver. Although it is a rare cancer, cholangiocarcinoma appears to be rising in incidence in the United States and worldwide. OBJECTIVES: The diagnosis of cholangiocarcinoma frequently presents with biliary emergencies from diagnosis through treatment. The lethality of this cancer stems, in part, from challenges with supportive care during treatment. This article provides an overview of intrahepatic and extrahepatic cholangiocarcinoma, including identification of risk factors, differences in treatment approaches, palliation of symptoms, and insight into commonly asked questions. METHODS: A comprehensive review of the current literature regarding incidence, prevalence, and treatment of cholangiocarcinoma was conducted. FINDINGS: Nursing literature regarding cholangiocarcinoma is scarce. Studies that focus on nursing care, symptom management, and nursing management of patients with biliary obstruction are needed. Nutrition and palliative care management of patients with cholangiocarcinoma are key areas of nursing management.

[1]  B. Blechacz.  Cholangiocarcinoma: Current Knowledge and New Developments , 2016, Gut and liver.

[2]  A. Keeling,et al.  A review of percutaneous transhepatic biliary drainage at a tertiary referral centre. , 2016, Clinical radiology.

[3]  Lipika Goyal,et al.  Multi-Institutional Phase II Study of High-Dose Hypofractionated Proton Beam Therapy in Patients With Localized, Unresectable Hepatocellular Carcinoma and Intrahepatic Cholangiocarcinoma. , 2016, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[4]  K. Boberg,et al.  Expert consensus document: Cholangiocarcinoma: current knowledge and future perspectives consensus statement from the European Network for the Study of Cholangiocarcinoma (ENS-CCA) , 2016, Nature Reviews Gastroenterology &Hepatology.

[5]  Andrew X. Zhu,et al.  Forty-Year Trends in Cholangiocarcinoma Incidence in the U.S.: Intrahepatic Disease on the Rise , 2016, The oncologist.

[6]  J. Echeverri,et al.  Liver transplantation for cholangiocarcinoma: Current status and new insights. , 2015, World journal of hepatology.

[7]  Charles R. Thomas,et al.  SWOG S0809: A Phase II Intergroup Trial of Adjuvant Capecitabine and Gemcitabine Followed by Radiotherapy and Concurrent Capecitabine in Extrahepatic Cholangiocarcinoma and Gallbladder Carcinoma. , 2015, Journal of clinical oncology : official journal of the American Society of Clinical Oncology.

[8]  J. Mancias,et al.  Stereotactic Body Radiotherapy (SBRT) for Intrahepatic and Hilar Cholangiocarcinoma , 2015, Journal of Cancer.

[9]  Angelo Caruso,et al.  Cholangiocarcinoma and malignant bile duct obstruction: A review of last decades advances in therapeutic endoscopy. , 2015, World journal of gastrointestinal endoscopy.

[10]  R. Plentz,et al.  Clinical presentation, risk factors and staging systems of cholangiocarcinoma. , 2015, Best practice & research. Clinical gastroenterology.

[11]  W. Jang,et al.  Outcomes of stereotactic body radiotherapy for unresectable primary or recurrent cholangiocarcinoma , 2014, Radiation oncology journal.

[12]  Jian-yu Hao,et al.  Retrospective evaluation of endoscopic stenting of combined malignant common bile duct and gastric outlet-duodenum obstructions , 2014, Experimental and therapeutic medicine.

[13]  T. Pawlik,et al.  Guidelines for the diagnosis and management of intrahepatic cholangiocarcinoma. , 2014, Journal of hepatology.

[14]  G. Gores,et al.  Pathogenesis, diagnosis, and management of cholangiocarcinoma. , 2013, Gastroenterology.

[15]  Celia P. Corona-Villalobos,et al.  Multidisciplinary approaches to intrahepatic cholangiocarcinoma , 2013, Cancer.

[16]  S. Devesa,et al.  Biliary tract cancer incidence in the United States—Demographic and temporal variations by anatomic site , 2013, International journal of cancer.

[17]  A. Loukas,et al.  The tumorigenic liver fluke Opisthorchis viverrini--multiple pathways to cancer. , 2012, Trends in parasitology.

[18]  Johnny C. Hong,et al.  Efficacy of neoadjuvant chemoradiation, followed by liver transplantation, for perihilar cholangiocarcinoma at 12 US centers. , 2012, Gastroenterology.

[19]  H. Thomas,et al.  Rising trends in cholangiocarcinoma: is the ICD classification system misleading us? , 2012, Journal of hepatology.

[20]  H. Masuoka,et al.  Transplantation for cholangiocarcinoma. , 2011, Clinics in liver disease.

[21]  R. Sloan,et al.  The Influence of Symptoms, Social Support, Uncertainty, and Coping on Health-Related Quality of Life Among Cholangiocarcinoma Patients in Northeast Thailand , 2011, Cancer nursing.

[22]  F. Contaldo,et al.  Nutritional screening and early treatment of malnutrition in cancer patients , 2011, Journal of cachexia, sarcopenia and muscle.

[23]  P. Ghaneh,et al.  Drainage and bypass procedures for palliation of malignant diseases of the upper gastrointestinal tract. , 2010, Clinical oncology (Royal College of Radiologists (Great Britain)).

[24]  P. Malfertheiner,et al.  Cisplatin plus gemcitabine versus gemcitabine for biliary tract cancer , 2010, Expert review of gastroenterology & hepatology.

[25]  G. Gores,et al.  Liver transplantation for cholangiocarcinoma , 2010, Transplant international : official journal of the European Society for Organ Transplantation.

[26]  D. Cunningham,et al.  Cisplatin plus gemcitabine versus gemcitabine for biliary tract cancer. , 2010, The New England journal of medicine.

[27]  Yun Yen,et al.  NCCN clinical practice guidelines in oncology: hepatobiliary cancers. , 2009, Journal of the National Comprehensive Cancer Network : JNCCN.

[28]  M. Nagino,et al.  The Value of Bile Replacement During External Biliary Drainage: An Analysis of Intestinal Permeability, Integrity, and Microflora , 2004, Annals of surgery.

[29]  K. O'Connor,et al.  Cholangiocarcinoma: a nursing perspective. , 2001, Clinical Journal of Oncology Nursing.

[30]  R. A. Norton,et al.  Bile duct cancer , 1990, CA: a cancer journal for clinicians.

[31]  J. Kutner,et al.  NCCN Guidelines ® Insights Palliative Care , Version 2 . 2017 Featured Updates to the NCCN Guidelines , 2017 .

[32]  Juliana Alvares Duarte Bonini Campos,et al.  Cáncer Malnutrition in patients with gastrointestinal cancer : effectiveness of different diagnostic methods , 2015 .

[33]  B. Njei.  Intrahepatic cholangiocarcinoma: are we doing the right thing? , 2014, Gastrointestinal cancer research : GCR.

[34]  R. Parks,et al.  Epidemiology of Cholangiocarcinoma and Gallbladder Carcinoma , 2014 .

[35]  L. Fabris,et al.  Cholangiocarcinoma in Italy: A national survey on clinical characteristics, diagnostic modalities and treatment. Results from the "Cholangiocarcinoma" committee of the Italian Association for the Study of Liver disease. , 2011, Digestive and liver disease : official journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver.

[36]  Hai-rim Shin,et al.  Comparison of incidence of intrahepatic and extrahepatic cholangiocarcinoma--focus on East and South-Eastern Asia. , 2010, Asian Pacific journal of cancer prevention : APJCP.

[37]  F. Ottery.  Cancer cachexia: prevention, early diagnosis, and management. , 1994, Cancer practice.