The Korean Journal of Medicine

The Korean Association of Internal Medicine (대한내과학회)
권호 표지

The epidemiology and risk factors of hilar cholangiocarcinoma

간문부 담관암의 역학과 위험 요소

  • Ryu, Ji-Kon (Department of Internal Medicine, Seoul National University College of Medicine)
  • 류지곤 (서울대학교 의과대학 내과학교실)
  • Published : 2010.12.01
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Abstract

A hilar cholangiocarcinoma is a cholangiocarcinoma occurring at the confluence of the right and left hepatic bile ducts which is called as Klatskin tumor. Because hilar cholangiocarcinoma is the most common form of extrahepatic bile duct cancer (EBDC), the epidemiology and risk factors of hilar cholangiocarcinoma are similar to those of EBDC. In Korea, overall incidence of EBDC is 5.1/100,000 individuals without a significant change during past 10 years. Most of cases occur in patients over the age of 50 and the incidence is 1.78 times higher in men than women. The etiology of EBDC has not been clearly defined. A number of pathologic conditions, however, resulting in either acute or chronic biliary tract epithelial injury may predispose to malignant change. Chronic biliary tract parasitic infection, such as Clonorchis sinensis and Opisthorchis viverrini, has been identified as a risk factor of EBDC and hilar cholangiocarcinoma. Other clear risk factors of EBDC are primary sclerosing cholangitis and choledochal cyst. However, there are no enough evidences whether primary sclerosing cholangitis and choledochal cyst are the definite risk factors of hilar cholangiocarcinoma or not.

Keywords

References

  1. Nakeeb A, Pitt HA, Sohn TA, Coleman J, Abrams RA, Piantadosi S, Hruban RH, Lillemoe KD, Yeo CJ, Cameron JL. Cholangiocarcinoma: a spectrum of intrahepatic, perihilar, and distal tumors. Ann Surg 224:463-473, 1996 https://doi.org/10.1097/00000658-199610000-00005
  2. Klatskin G. Adenocarcinoma of the hepatic duct at its bifurcation within the porta hepatis: an unusual tumor with distinctive clinical and pathological features. Am J Med 38:241-256, 1965 https://doi.org/10.1016/0002-9343(65)90178-6
  3. Kuwayti K, Baggenstoss AH, Stauffer MH, Priestley JT. Carcinoma of the major intrahepatic and the extrahepatic bile ducts exclusive of the papilla of Vater. Surg Gynecol Obstet 104:357-366, 1957
  4. Kim CD. Epidemiology of cholangiocarcinoma. In: Chung JB, ed. Cholangiocarcinoma. 1st ed. Seoul, Koon Ja Publishing Inc, 2009
  5. Khan SA, Toledano MB, Taylor-Robinson SD. Epidemiology, risk factors, and pathogenesis of cholangiocarcinoma. HPB (Oxford) 10:77-82, 2008 https://doi.org/10.1080/13651820801992641
  6. Shaib YH, Davila JA, McGlynn K, El-Serag HB. Rising incidence of intrahepatic cholangiocarcinoma in the United States: a true increase? J Hepatol 40:472-477, 2004 https://doi.org/10.1016/j.jhep.2003.11.030
  7. Carriaga MT, Henson DE. Liver, gallbladder, extrahepatic bile ducts, and pancreas. Cancer 75(1 Suppl):171-190, 1995 https://doi.org/10.1002/1097-0142(19950101)75:1+<171::AID-CNCR2820751306>3.0.CO;2-2
  8. Shin HR, Oh JK, Lim MK, Shin A, Kong HJ, Jung KW, Won YJ, Park S, Park SJ, Hong ST. Descriptive epidemiology of cholangiocarcinoma and clonorchiasis in Korea. J Korean Med Sci 25:1011-1016, 2010 https://doi.org/10.3346/jkms.2010.25.7.1011
  9. Lun ZR, Gasser RB, Lai DH, Li AX, Zhu XQ, Yu XB, Fang YY. Clonorchiasis: a key foodborne zoonosis in China. Lancet Infect Dis 5:31-41, 2005 https://doi.org/10.1016/S1473-3099(04)01252-6
  10. Bouvard V, Baan R, Straif K, Grosse Y, Secretan B, El Ghissassi F, Benbrahim-Tallaa L, Guha N, Freeman C, Galichet L, Cogliano V. A review of human carcinogens: part B. biological agents. Lancet Oncol 10:321-322, 2009 https://doi.org/10.1016/S1470-2045(09)70096-8
  11. Shin HR, Oh JK, Masuyer E, Curado MP, Bouvard V, Fang YY, Wiangnon S, Sripa B, Hong ST. Epidemiology of cholangiocarcinoma: an update focusing on risk factors. Cancer Sci 101:579-585, 2010 https://doi.org/10.1111/j.1349-7006.2009.01458.x
  12. Abbas G, Lindor KD. Cholangiocarcinoma in primary sclerosing cholangitis. J Gastrointest Cancer 40:19-25, 2009 https://doi.org/10.1007/s12029-009-9085-8
  13. Boberg KM, Bergquist A, Mitchell S, Pares A, Rosina F, Broome U, Chapman R, Fausa O, Egeland T, Rocca G, Schrumpf E. Cholangiocarcinoma in primary sclerosing cholangitis: risk factors and clinical presentation. Scand J Gastroenterol 37:1205-1211, 2002 https://doi.org/10.1080/003655202760373434
  14. Burak K, Angulo P, Pasha TM, Egan K, Petz J, Lindor KD. Incidence and risk factors for cholangiocarcinoma in primary sclerosing cholangitis. Am J Gastroenterol 99:523-526, 2004 https://doi.org/10.1111/j.1572-0241.2004.04067.x
  15. Lazaridis KN, Gores GJ. Primary sclerosing cholangitis and cholangiocarcinoma. Semin Liver Dis 26:42-51, 2006
  16. Tashiro S, Imaizumi T, Ohkawa H, Okada A, Katoh T, Kawaharada Y, Shimada H, Takamatsu H, Miyake H, Todani T. Pancreaticobiliary maljunction: retrospective and nationwide survey in Japan. J Hepatobiliary Pancreat Surg 10:345-351, 2003 https://doi.org/10.1007/s00534-002-0741-7
  17. Chen MF. Peripheral cholangiocarcinoma (cholangiocellular carcinoma): clinical features, diagnosis and treatment. J Gastroenterol Hepatol 14:1144-1149, 1999 https://doi.org/10.1046/j.1440-1746.1999.01983.x
  18. Su CH, Shyr YM, Lui WY, P'Eng FK. Hepatolithiasis associated with cholangiocarcinoma. Br J Surg 84:969-973, 1997 https://doi.org/10.1002/bjs.1800840717
  19. Zhou YM, Yin ZF, Yang JM, Li B, Shao WY, Xu F, Wang YL, Li DQ. Risk factors for intrahepatic cholangiocarcinoma: a case-control study in China. World J Gastroenterol 14:632-635, 2008 https://doi.org/10.3748/wjg.14.632
  20. El-Serag HB, Engels EA, Landgren O, Chiao E, Henderson L, Amaratunge HC, Giordano TP. Risk of hepatobiliary and pancreatic cancers after hepatitis C virus infection: a population-based study of U.S.veterans. Hepatology 49:116-123, 2009 https://doi.org/10.1002/hep.22606
  21. Lipshutz GS, Brennan TV, Warren RS. Thorotrast-induced liver neoplasia: a collective review. J Am Coll Surg 195:713-718, 2002 https://doi.org/10.1016/S1072-7515(02)01287-5
  22. Welzel TM, Graubard BI, El-Serag HB, Shaib YH, Hsing AW, Davila JA, McGlynn KA. Risk factors for intrahepatic and extrahepatic cholangiocarcinoma in the United States: a population- based case-control study. Clin Gastroenterol Hepatol 5:1221-1228, 2007 https://doi.org/10.1016/j.cgh.2007.05.020
  23. Tao LY, He XD, Qu Q, Cai L, Liu W, Zhou L, Zhang SM. Risk factors for intrahepatic and extrahepatic cholangiocarcinoma: a case-control study in China. Liver Int 30:215-221, 2010 https://doi.org/10.1111/j.1478-3231.2009.02149.x