Wikipedia

Kolangiokarsinoma: Perbedaan antara revisi

Jelajahi riwayat secara interaktif
← Revisi sebelumnyaRevisi selanjutnya →
Konten dihapus Konten ditambahkan
VisualTeks wiki
Fareleadsm (bicara | kontrib)
153 suntingan
Tidak ada ringkasan suntingan
Fareleadsm (bicara | kontrib)
153 suntingan
Tidak ada ringkasan suntingan
Baris 1:
{{Infobox medical condition (new)
| name = Kolangiokarsinoma
| synonyms = Kanker saluran empedu
| image = Cholangiocarcinoma - very high mag.jpg
| caption = Gambar mikroskopok pada kolangiokarsinoma intrahepatik (gambar sebelah kanan) yang berdekatan dengan sel hati normal (gambar sebelah kiri). Noda H&E.
| field = [[Onkologi]]
| pronounce = {{IPAc-en|k|ə|,|l|æ|n|dʒ|i|ou|,|k|a:r|s|I|'|n|ou|m|ə|}} {{respell|kə-LAN-jee-oh-KAR-sih-NOH-mə}}
| symptoms = [[Nyeri perut]], [[Kulit menguning]], [[Penurunan berat badan]], [[Pruritis]], [[Demam]]
| complications =
| onset = 70 tahun
| duration =
| causes =
| risks = ''[[Primary sclerosing cholangitis]]'', ''[[ulcerative colitis]]'', infeksi cacing hati tertentu, malformasi kongenital pada hati
| diagnosis = Dikonfirmasi dengan pemeriksaan tumor secara mikroskopik
| differential =
| prevention =
| treatment = Pembedahan, kemoterapi, terapi radiasi, prosedur pemasangan ''stent'', transplantasi hati
| medication =
| prognosis =
| frequency = 1-2 dari 100.000 orang per tahun (kejadian di negara Barat)
| deaths =
}}
 
'''Kolangiokarsinoma''' atau dikenal sebagai '''kanker saluran empedu''' adalah jenis kanker yang terbentuk di saluran empedu.<ref>{{Cite web|date=2011-02-02|title=cholangiocarcinoma|url=https://www.cancer.gov/publications/dictionaries/cancer-terms/def/cholangiocarcinoma|website=cancer|language=en|access-date=2022-02-10}}</ref> Beberapa gejala yang timbul pada pengidap kolangiokarsinoma antara lain sakit perut, kulit kekuningan, penurunan berat badan, rasa gatal, dan demam.<ref name=":0">{{Cite web|date=2021-10-08|title=Bile Duct Cancer (Cholangiocarcinoma) Treatment (PDQ®)–Health Professional Version - National Cancer Institute|url=https://www.cancer.gov/types/liver/hp/bile-duct-treatment-pdq|website=cancer|language=en|access-date=2022-02-10}}</ref> Perubahan warna tinja menjadi lebih terang atau urin menjadi lebih gelap juga dapat terjadi.<ref name=":1">{{Cite web|date=2021-08-20|title=Bile Duct Cancer (Cholangiocarcinoma) Treatment (PDQ®)–Patient Version - National Cancer Institute|url=https://www.cancer.gov/types/liver/patient/bile-duct-treatment-pdq|website=www.cancer.gov|language=en|access-date=2022-02-10}}</ref> Kanker saluran empedu lainnya yaitu kanker [[Kantong empedu|kandung empedu]] dan kanker ampula vater.<ref>{{Cite journal|last=Benavides|first=M.|last2=Antón|first2=A.|last3=Gallego|first3=J.|last4=Gómez|first4=M. A.|last5=Jiménez-Gordo|first5=A.|last6=La Casta|first6=A.|last7=Laquente|first7=B.|last8=Macarulla|first8=T.|last9=Rodríguez-Mowbray|first9=J. R.|date=2015-12-01|title=Biliary tract cancers: SEOM clinical guidelines|url=https://doi.org/10.1007/s12094-015-1436-2|journal=Clinical and Translational Oncology|language=en|volume=17|issue=12|pages=982–987|doi=10.1007/s12094-015-1436-2|issn=1699-3055|pmc=PMC4689747|pmid=26607930}}</ref>
 
Baris 32 ⟶ 55:
 
=== Tes darah ===
[[Berkas:Cholangiocarcinoma - high mag.jpg|jmpl|Mikrograf intrahepatik, yaitu di dalam [[hati]], kolangiokarsinoma (gambar sebelah kanan); [[hepatosit]] jinak terlihat (gambar sebelah kiri). Secara histologis, gambar ini menunjukkan kolangiokarsinoma sebagai (1) sel [[saluran empedu]] yang tidak normal (gambar sebelah kiri) memanjang dari [[tumor]] dalam septum interlobular (lokasi anatomi normal saluran empedu) dan (2) tumor yang memiliki stroma desmoplastik berlimpah yang sering terlihat pada kolangiokarsinoma. [[:en:Portal_triad|Portal triad]] (gambar sebelah kiri atas) memiliki saluran empedu yang normal secara histologis. |195x195px]]Tidak ada [[:en:Blood_test|tes darah]] khusus yang dapat dilakukan mendiagnosis kolangiokarsinoma. Pada kondisi kolangiokarsinoma, kadar [[:en:Carcinoembryonic_antigen|serum antigen karsinoembrionik]] (CEA) dan [[:en:CA19-9|CA19-9]] sering kali mengalami peningkatan, tetapi hal tersebut tidak cukup sensitif atau spesifik untuk digunakan sebagai alat skrining umum. Namun, penentuan kadar serum antigen karsinoembrionik (CEA) dan CA19-9  dapat berguna  pada metode pencitraan dalam mendukung diagnosis kolangiokarsinoma.<ref>{{Cite journal|last=Siqueira|first=Eduardo|last2=Schoen|first2=Robert E.|last3=Silverman|first3=William|last4=Martini|first4=John|last5=Rabinovitz|first5=Mordechai|last6=Weissfeld|first6=Joel L.|last7=Elmaagd|first7=Kareem Abu|last8=Madariaga|first8=Juan R.|last9=Slivka|first9=Adam|date=2002-07-01|title=Detecting cholangiocarcinoma in patients with primary sclerosing cholangitis|url=https://www.giejournal.org/article/S0016-5107(02)00005-6/abstract|journal=Gastrointestinal Endoscopy|language=English|volume=56|issue=1|pages=40–47|doi=10.1067/mge.2002.125105|issn=0016-5107}}</ref><ref>{{Cite journal|last=Coelho|first=Rosa|last2=Silva|first2=Marco|last3=Rodrigues-Pinto|first3=Eduardo|last4=Cardoso|first4=Hélder|last5=Lopes|first5=Susana|last6=Pereira|first6=Pedro|last7=Vilas-Boas|first7=Filipe|last8=Santos-Antunes|first8=João|last9=Costa-Maia|first9=José|date=2017|title=CA 19-9 as a Marker of Survival and a Predictor of Metastization in Cholangiocarcinoma|url=https://www.karger.com/Article/FullText/452691|journal=GE - Portuguese Journal of Gastroenterology|language=en|volume=24|issue=3|pages=114–121|doi=10.1159/000452691|issn=2341-4545|pmc=PMC5553366|pmid=28848795}}</ref><ref>{{Cite journal|last=Patel|first=Anand H.|last2=Harnois|first2=Denise M.|date=2000|title=The Utility of CA 19-9 in the
Diagnoses of Cholangiocarcinoma in
Patients Without Primary Sclerosing Cholangitis|url=https://www.darmzentrum-bern.ch/fileadmin/darmzentrum/Education/Bible_Class/2019/Gallbladder___Bile_Duct_Cancer/BC_2019-06-19_Milestonepaper_ca19_9.pdf|journal=The American Journal of Gastroeneterology|volume=95|issue=1}}</ref>
Baris 46 ⟶ 69:
=== Patologi ===
[[Berkas:ERCP cholangioca.jpg|jmpl|Gambar [[:en:Endoscopic_retrograde_cholangiopancreatography|ERCP]] dari kolangiokarsinoma, menunjukkan penyempitan saluran empedu dan pelebaran saluran empedu proksimal]]
Secara [[Histologi|histologis]], kolangiokarsinoma secara klasik adalah adenokarsinoma yang berdiferensiasi baik hingga sedang. Imunohistokimia berguna dalam diagnosis dan dapat digunakan untuk membantu membedakan kolangiokarsinoma dari [[karsinoma]] hepatoseluler dan [[metastasis]] [[tumor]] gastrointestinal lainnya.<ref>{{Cite journal|last=Länger|first=F.|last2=v. Wasielewski|first2=R.|last3=Kreipe|first3=H. H.|date=2006-07-01|title=Bedeutung der Immunhistochemie für die Diagnose des Cholangiokarzinoms|url=https://doi.org/10.1007/s00292-006-0836-z|journal=Der Pathologe|language=de|volume=27|issue=4|pages=244–250|doi=10.1007/s00292-006-0836-z|issn=1432-1963}}</ref> KerokanKuretase sitologi yang sering kali dilakukan terkadang tidak terdiagnosisdapat mendiagnosis<ref>{{Cite web|last=Darwin|first=Peter E.|date=2022-01-12|title=Cholangiocarcinoma|url=https://emedicine.medscape.com/article/277393-overview|website=medscape|access-date=22-02-10}}</ref> karena tumor ini biasanya memiliki stroma desmoplastik yang tidak melepaskan sel tumor diagnostik denganmelalui proses kerokanpengkuretan.
 
=== Penentuan stadium ===
Baris 61 ⟶ 84:
 
== Pengobatan ==
Kolangiokarsinoma dianggap sebagai penyakit yang tidak dapat disembuhkan dan bersifat letal kecuali semua tumor dapat sepenuhnya direseksi (diangkat melalui pembedahan). Dalam beberapa kasus, kemampuan tumor untuk dapat dibedah hanya dapat diketahui selama pembedahan berlangsung,<ref>{{Cite journal|last=Su|first=Cheng-Hsi|last2=Tsay|first2=Shyh-Haw|last3=Wu|first3=Cheng-Chung|last4=Shyr|first4=Yi-Ming|last5=King|first5=Kuang-Liang|last6=Lee|first6=Chen-Hsen|last7=Lui|first7=Wing-Yiu|last8=Liu|first8=Tse-Jia|last9=P'eng|first9=Fang-Ku|date=1996-04|title=Factors Influencing Postoperative Morbidity, Mortality, and Survival After Resection for Hilar Cholangiocarcinoma|url=https://journals.lww.com/annalsofsurgery/Abstract/1996/04000/Factors_Influencing_Postoperative_Morbidity,.7.aspx|journal=Annals of Surgery|language=en-US|volume=223|issue=4|pages=384–394|doi=10.1097/00000658-199604000-00007|issn=0003-4932|pmc=PMC1235134|pmid=8633917}}</ref> mayoritas penderita akan menjalani eksplorasi pembedahan kecuali terdapat indikasi yang jelas bahwa terhadap [[tumor]] tidak dapat dilakukan pembedahan.<ref name=":6" /> Namun, [[Mayo Clinic]] telah melaporkan keberhasilan yang signifikan dalam mengobati [[kanker]] [[saluran empedu]] dini dengan [[transplantasi]] [[hati]] menggunakan pendekatan protokol dan kriteria seleksi yang ketat.<ref>{{Cite journal|last=Rosen|first=C. B.|last2=Heimbach|first2=J. K.|last3=Gores|first3=G. J.|date=2008-06-01|title=Surgery for cholangiocarcinoma: the role of liver transplantation|url=https://www.hpbonline.org/article/S1365-182X(15)30051-4/abstract|journal=HPB|language=English|volume=10|issue=3|pages=186–189|doi=10.1080/13651820801992542|issn=1365-182X|pmc=PMC2504373|pmid=18773052}}</ref> [[:en:Adjuvant_therapy|Terapi adjuvan]] diikuti dengan transplantasi hati dapat memiliki peran tertentu dalam pengobatan terhadap tumor yang tidak dapat dibedah pada beberapa kasus tertentu.<ref>{{Cite journal|last=Heimbach|first=Julie K.|last2=Gores|first2=Gregory J.|last3=Haddock|first3=Michael G.|last4=Alberts|first4=Steven R.|last5=Pedersen|first5=Rachel|last6=Kremers|first6=Walter|last7=Nyberg|first7=Scott L.|last8=Ishitani|first8=Michael B.|last9=Rosen|first9=Charles B.|date=2006-12-27|title=Predictors of Disease Recurrence Following Neoadjuvant Chemoradiotherapy and Liver Transplantation for Unresectable Perihilar Cholangiocarcinoma|url=https://journals.lww.com/transplantjournal/Fulltext/2006/12270/Predictors_of_Disease_Recurrence_Following.34.aspx|journal=Transplantation|language=en-US|volume=82|issue=12|pages=1703–1707|doi=10.1097/01.tp.0000253551.43583.d1|issn=0041-1337}}</ref> Terapi lokoregional termasuk kemoembolisasi transarterial (TACE), radioembolisasi transarterial (TARE), dan terapi ablasi memiliki peran dalam varian intrahepatik kolangiokarsinoma untuk memberikan [[perawatan paliatif]] atau penyembuhan potensial pada penderita kolangiokarsinoma yang bukan kandidat layak untuk dibedah.<ref>{{Cite journal|last=Kuhlmann|first=Jan B.|last2=Blum|first2=Hubert E.|date=2013-05|title=Locoregional therapy for cholangiocarcinoma|url=https://journals.lww.com/co-gastroenterology/Abstract/2013/05000/Locoregional_therapy_for_cholangiocarcinoma.15.aspx|journal=Current Opinion in Gastroenterology|language=en-US|volume=29|issue=3|pages=324–328|doi=10.1097/MOG.0b013e32835d9dea|issn=0267-1379}}</ref>
 
=== Kemoterapi adjuvan dan terapi radiasi ===
Jika [[tumor]] dapat diangkat melalui [[pembedahan]], penderita akan menerima [[kemoterapi]] [[:en:Adjuvant_therapy|adjuvan]] atau [[terapi radiasi]] setelah operasi untuk meningkatkan kemungkinan penyembuhan. Jika margin jaringan negatif (yaitu tumor telah dieksisi total), terapikemoterapi ajuvanadjuvan tidak dapat dipasti manfaatnya. Hasil positif<ref>{{Cite journal|last=Todoroki|first=Takeshi|last2=Ohara|first2=Kiyoshi|last3=Kawamoto|first3=Toru|last4=Koike|first4=Naoto|last5=Yoshida|first5=Sadao|last6=Kashiwagi|first6=Hironobu|last7=Otsuka|first7=Masaaki|last8=Fukao|first8=Katashi|date=2000-02-01|title=Benefits of adjuvant radiotherapy after radical resection of locally advanced main hepatic duct carcinoma|url=https://www.redjournal.org/article/S0360-3016(99)00472-1/abstract|journal=International Journal of Radiation Oncology, Biology, Physics|language=English|volume=46|issue=3|pages=581–587|doi=10.1016/S0360-3016(99)00472-1|issn=0360-3016|pmid=10701737}}</ref><ref>{{Cite journal|last=Alden|first=Mark E.|last2=Mohiuddin|first2=Mohammed|date=1994-03-01|title=The impact of radiation dose in combined external beam and intraluminal IR-192 brachytherapy for bile duct cancer|url=https://www.redjournal.org/article/0360-3016(94)90115-5/abstract|journal=International Journal of Radiation Oncology, Biology, Physics|language=English|volume=28|issue=4|pages=945–951|doi=10.1016/0360-3016(94)90115-5|issn=0360-3016|pmid=8138448}}</ref> dan negatif<ref name=":7" /><ref>{{Cite journal|last=Gonzalez|first=D.Gonziilez|last2=Gouma|first2=D.J.|last3=Rauws|first3=E.A.J.|last4=Gulik|first4=T.M. van|last5=Bosma|first5=A.|last6=Koedooder|first6=C.|date=1999|title=Role of radiotherapy, in particular intraluminal brachytherapy, in the treatment
of proximal bile duct carcinoma|url=https://www.annalsofoncology.org/article/S0923-7534(20)31148-0/pdf|journal=Annals of Oncology|volume=10|issue=4}}</ref><ref>{{Cite journal|last=Pitt|first=Henry A.|last2=Nakeeb|first2=Attila|last3=Abrams|first3=Ross A.|last4=Coleman|first4=JoAnn|last5=Piantadosi|first5=Steven|last6=Yeo|first6=Charles J.|last7=Lillemoe|first7=Keith D.|last8=Cameron|first8=John L.|date=1995-06|title=Perihilar Cholangiocarcinoma Postoperative Radiotherapy Does Not Improve Survival|url=https://journals.lww.com/annalsofsurgery/Abstract/1995/06000/Perihilar_Cholangiocarcinoma_Postoperative.17.aspx|journal=Annals of Surgery|language=en-US|volume=221|issue=6|pages=788–802|doi=10.1097/00000658-199506000-00017|issn=0003-4932|pmc=PMC1234714|pmid=7794082}}</ref> dari terapi radiasi adjuvan telah dilaporkan dan tidak ada uji coba terkontrol acak prospektif yang telah dilakukan pada Maret 2007. Kemoterapi adjuvan tampaknya tidak efektif pada orang dengan tumor yang direseksi total. <ref>{{Cite journal|last=Takada|first=Tadahiro|last2=Amano|first2=Hodaka|last3=Yasuda|first3=Hideki|last4=Nimura|first4=Yuji|last5=Matsushiro|first5=Takashi|last6=Kato|first6=Hiroyuki|last7=Nagakawa|first7=Takukazu|last8=Nakayama|first8=Toshimichi|date=2002|title=Is postoperative adjuvant chemotherapy useful for gallbladder carcinoma?|url=https://onlinelibrary.wiley.com/doi/abs/10.1002/cncr.10831|journal=Cancer|language=en|volume=95|issue=8|pages=1685–1695|doi=10.1002/cncr.10831|issn=1097-0142}}</ref>Peran kemoradioterapi kombinasi dalam pengobatan terhadap kolangiokarsinoma masih belum jelas. Namun, jika margin jaringan tumor positif, menunjukkan bahwa tumor tidak sepenuhnya diangkat melalui pembedahan, maka terapi adjuvan dengan radiasi dan kemungkinan kemoterapi umumnya direkomendasikan berdasarkan data yang tersedia.
=== Pengobatan penyakit lebih lanjut ===
Mayoritas kasus pada kolangikarsinoma bersifat tidak dapat dilakukan pembedahan (tidak dapat dioperasi).<ref name=":11">{{Cite journal|last=Vauthey|first=Jean-Nicolas|last2=Blumgart|first2=Leslie H.|date=1994-05|title=Recent Advances in the Management of Cholangiocarcinomas|url=http://www.thieme-connect.de/DOI/DOI?10.1055/s-2007-1007302|journal=Seminars in Liver Disease|language=en|volume=14|issue=02|pages=109–114|doi=10.1055/s-2007-1007302|issn=0272-8087}}</ref> Dalam hal ini, penderita umumnya diobati dengan [[kemoterapi]] [[Perawatan paliatif|paliatif]], dengan atau tanpa [[radioterapi]]. Kemoterapi telah ditunjukkan dalam uji coba terkontrol secara acak untuk meningkatkan kualitas hidup dan memperpanjang kelangsungan hidup pada orang dengan kolangiokarsinoma yang tidak dapat dibedah.<ref>{{Cite journal|last=Glimelius|first=B.|last2=Hoffman|first2=K.|last3=Sjödén|first3=P.-O.|last4=Jacobsson|first4=G.|last5=Sellström|first5=H.|last6=Enander|first6=L.-K.|last7=Linné|first7=T.|last8=Svensson|first8=C.|date=1996-08|title=Chemotherapy improves survival and quality of life in advanced pancreatic and biliary cancer|url=https://doi.org/10.1093/oxfordjournals.annonc.a010676|journal=Annals of Oncology|volume=7|issue=6|pages=593–600|doi=10.1093/oxfordjournals.annonc.a010676|issn=0923-7534}}</ref> Tidak ada rejimenpanduan kemoterapi tunggal yang digunakan secara universal, dan pendaftaran dalam uji klinis sering direkomendasikan bila memungkinkan. Agen kemoterapi yang digunakan untuk mengobati kolangiokarsinoma termasuk [[:en:5-fluorouracil|5-fluorouracil]] dengan [[:en:Leucovorin|leucovorin]],<ref>{{Cite journal|last=Choi|first=Chul Won|last2=Choi|first2=Keun|last3=Seo|first3=Jae Hong|last4=Kim|first4=Byung Soo|last5=Kim|first5=Jae Seon|last6=Kim|first6=Chang Duk|last7=Um|first7=Soon Ho|last8=Kim|first8=Jun Suk|last9=Kim|first9=Yeul Hong|date=2000-08|title=Effects of 5-Fluorouracil and Leucovorin in the Treatment of Pancreatic–Biliary Tract Adenocarcinomas|url=https://journals.lww.com/amjclinicaloncology/Abstract/2000/08000/Effects_of_5_Fluorouracil_and_Leucovorin_in_the.23.aspx|journal=American Journal of Clinical Oncology|language=en-US|volume=23|issue=4|pages=425–428|doi=10.1097/00000421-200008000-00023|issn=0277-3732}}</ref> [[:en:Gemcitabine|gemcitabine]] sebagai agen tunggal,<ref>{{Cite journal|last=Park|first=Jong-Sung|last2=Oh|first2=Sung-Yong|last3=Kim|first3=Sung-Hyun|last4=Kwon|first4=Hyuk-Chan|last5=Kim|first5=Jae-Seok|last6=Jin-Kim|first6=Hyo|last7=Kim|first7=Young-Hoon|date=2005-02-01|title=Single-agent Gemcitabine in the Treatment of Advanced Biliary Tract Cancers: a Phase II Study|url=https://doi.org/10.1093/jjco/hyi021|journal=Japanese Journal of Clinical Oncology|volume=35|issue=2|pages=68–73|doi=10.1093/jjco/hyi021|issn=0368-2811}}</ref> atau gemcitabine dan [[cisplatin]],<ref>{{Cite journal|last=Giuliani|first=F.|last2=Gebbia|first2=V.|last3=Maiello|first3=E.|last4=Borsellino|first4=N.|last5=Bajardi|first5=E.|last6=Colucci|first6=G.|date=2006-06|title=Gemcitabine and cisplatin for inoperable and/or metastatic biliary tree carcinomas: a multicenter phase II study of the Gruppo Oncologico dell'Italia Meridionale (GOIM)|url=https://doi.org/10.1093/annonc/mdl956|journal=Annals of Oncology|volume=17|pages=vii73–vii77|doi=10.1093/annonc/mdl956|issn=0923-7534}}</ref> [[:en:Irinotecan|irinotecan]],<ref>{{Cite journal|last=Bhargava|first=Pankaj|last2=Jani|first2=Chirag R.|last3=Savarese|first3=Diane M. F.|last4=O’donnell|first4=Judith L.|last5=Stuart|first5=Keith E.|last6=Lima|first6=Caio Max S. Rocha|date=2003|title=Gemcitabine and Irinotecan in Locally Advanced or Metastatic Biliary Cancer: Preliminary Report|url=https://www.cancernetwork.com/view/gemcitabine-and-irinotecan-locally-advanced-or-metastatic-biliary-cancer-preliminary-report|journal=Oncology|volume=17|issue=9}}</ref> atau [[capecitabine]].<ref>{{Cite journal|last=Knox|first=Jennifer J.|last2=Hedley|first2=David|last3=Oza|first3=Amit|last4=Feld|first4=Ron|last5=Siu|first5=Lillian L.|last6=Chen|first6=Eric|last7=Nematollahi|first7=Mahsan|last8=Pond|first8=Gregory R.|last9=Zhang|first9=Jessica|date=2005-04-01|title=Combining Gemcitabine and Capecitabine in Patients With Advanced Biliary Cancer: A Phase II Trial|url=https://ascopubs.org/doi/10.1200/JCO.2005.51.008|journal=Journal of Clinical Oncology|volume=23|issue=10|pages=2332–2338|doi=10.1200/JCO.2005.51.008|issn=0732-183X}}</ref> Dalam sebuah studi, dinyatakan adanya manfaat dari [[:en:Erlotinib|erlotinib]] inhibitor tirosin kinase pada penderita kolangiokarsinoma tingkat lanjut.<ref>{{Cite journal|last=Philip|first=Philip A.|last2=Mahoney|first2=Michelle R.|last3=Allmer|first3=Cristine|last4=Thomas|first4=James|last5=Pitot|first5=Henry C.|last6=Kim|first6=George|last7=Donehower|first7=Ross C.|last8=Fitch|first8=Tom|last9=Picus|first9=Joel|date=2006-07-01|title=Phase II Study of Erlotinib in Patients With Advanced Biliary Cancer|url=https://ascopubs.org/doi/10.1200/JCO.2005.05.3579|journal=Journal of Clinical Oncology|volume=24|issue=19|pages=3069–3074|doi=10.1200/JCO.2005.05.3579|issn=0732-183X}}</ref> Terapi radiasi diamati mampu memperpanjang kelangsungan hidup pada orang dengan kolangiokarsinoma ekstrahepatik yang direseksi,<ref>{{Cite journal|last=Beltrán|first=Marta Bonet|last2=Allal|first2=Abdelkarim S.|last3=Gich|first3=Ignasi|last4=Solé|first4=Josep M.|last5=Carrió|first5=Ignasi|date=2012-04-01|title=Is adjuvant radiotherapy needed after curative resection of extrahepatic biliary tract cancers? A systematic review with a meta-analysis of observational studies|url=https://www.cancertreatmentreviews.com/article/S0305-7372(11)00080-6/abstract|journal=Cancer Treatment Reviews|language=English|volume=38|issue=2|pages=111–119|doi=10.1016/j.ctrv.2011.05.003|issn=0305-7372|pmid=21652148}}</ref> dan beberapa laporan tentang penggunaannya pada kolangiokarsinoma yang tidak dapat direseksi menunjukkan peningkatan kelangsungan hidup, tetapi jumlahnya kecil.<ref name=":3" />
 
Infigratinib (Truseltiq) adalah [[:en:Tyrosine_kinase_inhibitor|penghambat tirosin kinase]] dari [[:en:Fibroblast_growth_factor_receptor|reseptor ''growth factor fibroblast'']] (FGFR) yang telah disetujui untuk penggunaan medis di [[Amerika Serikat]] pada Mei 2021.<ref name=":12">{{Cite web|last=Inc|first=BridgeBio Pharma|date=2021-05-28|title=BridgeBio Pharma’s Affiliate QED Therapeutics and Partner Helsinn Group Announce FDA Approval of TRUSELTIQ™ (infigratinib) for Patients with Cholangiocarcinoma|url=https://www.globenewswire.com/news-release/2021/05/28/2238443/0/en/BridgeBio-Pharma-s-Affiliate-QED-Therapeutics-and-Partner-Helsinn-Group-Announce-FDA-Approval-of-TRUSELTIQ-infigratinib-for-Patients-with-Cholangiocarcinoma.html|website=GlobeNewswire News Room|language=en|access-date=2022-02-11}}</ref> Infigranatinib diindikasikan untuk pengobatan penderita kolangiokarsinoma stadium lanjut atau metastasis yang sebelumnya diobati secara lokal di mana menyimpan fusi atau terjadi penataan ulang terhadap FGFR2.<ref name=":12" />
Baris 76 ⟶ 99:
Untuk kasus kolangiokarsinoma yang dapat bedah, kemungkinan penyembuhan bervariasi tergantung pada lokasi [[tumor]] dan apakah tumor dapat diangkat seluruhnya, atau hanya sebagian. Kolangiokarsinoma distal (yang timbul dari saluran empedu umum) umumnya diobati dengan pembedahan dengan [[:en:Whipple_procedure|prosedur Whipple]] di mana tingkat kelangsungan hidup jangka panjang berkisar dari 15 hingga 25%, meskipun dalam satu penelitian melaporkan kelangsungan hidup lima tahun 54% untuk penderita tanpa keterlibatan [[kelenjar getah bening]].<ref>{{Cite journal|last=Nakeeb|first=Attila|last2=Pitt|first2=Henry A.|last3=Sohn|first3=Taylor A.|last4=Coleman|first4=JoAnn|last5=Abrams|first5=Ross A.|last6=Piantadosi|first6=Steven|last7=Hruban|first7=Ralph H.|last8=Lillemoe|first8=Keith D.|last9=Yeo|first9=Charles J.|date=1996-10|title=Cholangiocarcinoma: A Spectrum of Intrahepatic, Perihilar, and Distal Tumors|url=https://journals.lww.com/annalsofsurgery/Abstract/1996/10000/Cholangiocarcinoma__A_Spectrum_of_Intrahepatic,.5.aspx|journal=Annals of Surgery|language=en-US|volume=224|issue=4|pages=463–475|doi=10.1097/00000658-199610000-00005|issn=0003-4932|pmc=PMC1235406|pmid=8857851}}</ref><ref>{{Cite journal|last=Jang|first=Jin-Young|last2=Kim|first2=Sun-Whe|last3=Park|first3=Do Joong|last4=Ahn|first4=Young Joon|last5=Yoon|first5=Yoo-Seok|last6=Choi|first6=Min Gew|last7=Suh|first7=Kyung-Suk|last8=Lee|first8=Kuhn Uk|last9=Park|first9=Yong-Hyun|date=2005-01|title=Actual Long-term Outcome of Extrahepatic Bile Duct Cancer After Surgical Resection|url=https://journals.lww.com/annalsofsurgery/Abstract/2005/01000/Actual_Long_term_Outcome_of_Extrahepatic_Bile_Duct.11.aspx|journal=Annals of Surgery|language=en-US|volume=241|issue=1|pages=77–84|doi=10.1097/01.sla.0000150166.94732.88|issn=0003-4932|pmc=PMC1356849|pmid=15621994}}</ref><ref>{{Cite journal|last=Bortolasi|first=Luca|last2=Burgart|first2=Lawrence J.|last3=Tsiotos|first3=Gregory G.|last4=León|first4=Enrique Luque-de|last5=Sarr|first5=Michael G.|date=2000|title=Adenocarcinoma of the Distal Bile Duct|url=https://www.karger.com/Article/FullText/18798|journal=Digestive Surgery|language=english|volume=17|issue=1|pages=36–41|doi=10.1159/000018798|issn=0253-4886|pmid=10720830}}</ref><ref>{{Cite journal|last=Fong|first=Y|last2=Blumgart|first2=L H|last3=Lin|first3=E|last4=Fortner|first4=J G|last5=Brennan|first5=M F|date=1996-12-01|title=Outcome of treatment for distal bile duct cancer|url=https://doi.org/10.1002/bjs.1800831217|journal=British Journal of Surgery|volume=83|issue=12|pages=1712–1715|doi=10.1002/bjs.1800831217|issn=0007-1323}}</ref> Kolangiokarsinoma intrahepatik (yang timbul dari saluran empedu di dalam hati) biasanya diobati dengan [[hepatektomi]] parsial. Berbagai seri penelitian telah melaporkan perkiraan kelangsungan hidup setelah operasi mulai dari 22 hingga 66%. Hasil tersebut dapat bergantung pada keterlibatan kelenjar getah bening dan kelengkapan operasi.<ref>{{Cite journal|last=Nakeeb|first=Attila|last2=Pitt|first2=Henry A.|last3=Sohn|first3=Taylor A.|last4=Coleman|first4=JoAnn|last5=Abrams|first5=Ross A.|last6=Piantadosi|first6=Steven|last7=Hruban|first7=Ralph H.|last8=Lillemoe|first8=Keith D.|last9=Yeo|first9=Charles J.|date=1996-10|title=Cholangiocarcinoma: A Spectrum of Intrahepatic, Perihilar, and Distal Tumors|url=https://journals.lww.com/annalsofsurgery/Abstract/1996/10000/Cholangiocarcinoma__A_Spectrum_of_Intrahepatic,.5.aspx|journal=Annals of Surgery|language=en-US|volume=224|issue=4|pages=463–475|doi=10.1097/00000658-199610000-00005|issn=0003-4932|pmc=PMC1235406|pmid=8857851}}</ref><ref>{{Cite journal|last=Lieser|first=Mark J.|last2=Barry|first2=M. Kevin|last3=Rowland|first3=Charles|last4=Ilstrup|first4=Duane M.|last5=Nagorney|first5=David M.|date=1998-04-01|title=Surgical management of intrahepatic cholangiocarcinoma: A 31-year experience|url=https://doi.org/10.1007/PL00009949|journal=Journal of Hepato-Biliary-Pancreatic Surgery|language=en|volume=5|issue=1|pages=41–47|doi=10.1007/PL00009949|issn=1436-0691}}</ref><ref>{{Cite journal|last=Valverde|first=Alain|last2=Bonhomme|first2=Nicolas|last3=Farges|first3=Olivier|last4=Sauvanet|first4=Alain|last5=Flejou|first5=Jean F.|last6=Belghiti|first6=Jacques|date=1999-07-01|title=Resection of intrahepatic cholangiocarcinoma: a Western experience|url=https://doi.org/10.1007/s005340050094|journal=Journal of Hepato-Biliary-Pancreatic Surgery|language=en|volume=6|issue=2|pages=122–127|doi=10.1007/s005340050094|issn=1436-0691}}</ref><ref>{{Cite journal|last=Nakagohri|first=Toshio|last2=Asano|first2=Takehide|last3=Kinoshita|first3=Hirotoshi|last4=Kenmochi|first4=Takashi|last5=Urashima|first5=Tetsuro|last6=Miura|first6=Fumihiko|last7=Ochiai|first7=Takenori|date=2003-03-01|title=Aggressive Surgical Resection for Hilar-invasive and Peripheral Intrahepatic Cholangiocarcinoma|url=https://doi.org/10.1007/s00268-002-6696-7|journal=World Journal of Surgery|language=en|volume=27|issue=3|pages=289–293|doi=10.1007/s00268-002-6696-7|issn=1432-2323}}</ref><ref>{{Cite journal|last=Weber|first=S|date=2001-10|title=Intrahepatic Cholangiocarcinoma: resectability, recurrence pattern, and outcomes|url=https://doi.org/10.1016/S1072-7515(01)01016-X|journal=Journal of the American College of Surgeons|volume=193|issue=4|pages=384–391|doi=10.1016/s1072-7515(01)01016-x|issn=1072-7515}}</ref> Kolangiokarsinoma perihilar (yang terjadi di dekat tempat keluarnya [[saluran empedu]] dari [[hati]]) paling tidak mungkin dapat dioperasi. Ketika pembedahan memungkinkan, tumor umumnya diperlakukan dengan pendekatan agresif yang sering kali termasuk pengangkatan kantong empedu dan kemungkinan bagian dari hati. Pada pasien dengan tumor perihilar yang dapat dioperasi, tingkat kelangsungan hidup 5 tahun yang dilaporkan berkisar antara 20 hingga 50%.<ref>{{Cite journal|last=Burke|first=Edmund C.|last2=Jarnagin|first2=William R.|last3=Hochwald|first3=Steven N.|last4=Pisters|first4=Peter W. T.|last5=Fong|first5=Yuman|last6=Blumgart|first6=Leslie H.|date=1998-09|title=Hilar Cholangiocarcinoma: Patterns of Spread, the Importance of Hepatic Resection for Curative Operation, and a Presurgical Clinical Staging System|url=https://journals.lww.com/annalsofsurgery/Abstract/1998/09000/Hilar_Cholangiocarcinoma__Patterns_of_Spread,_the.11.aspx|journal=Annals of Surgery|language=en-US|volume=228|issue=3|pages=385–394|doi=10.1097/00000658-199809000-00011|issn=0003-4932|pmc=PMC1191497|pmid=9742921}}</ref><ref>{{Cite journal|last=Tsao|first=Jane I.|last2=Nimura|first2=Yuji|last3=Kamiya|first3=Junichi|last4=Hayakawa|first4=Naokazu|last5=Kondo|first5=Satoshi|last6=Nagino|first6=Masato|last7=Miyachi|first7=Masahiko|last8=Kanai|first8=Michio|last9=Uesaka|first9=Katsuhiko|date=2000-08|title=Management of Hilar Cholangiocarcinoma: Comparison of an American and a Japanese Experience|url=https://journals.lww.com/annalsofsurgery/Abstract/2000/08000/Management_of_Hilar_Cholangiocarcinoma__Comparison.3.aspx|journal=Annals of Surgery|language=en-US|volume=232|issue=2|pages=166–174|doi=10.1097/00000658-200008000-00003|issn=0003-4932|pmc=PMC1421125|pmid=10903592}}</ref><ref>{{Cite journal|last=Chamberlain|first=Ronald S.|last2=Blumgart|first2=Leslie H.|date=2000-01-01|title=Hilar Cholangiocarcinoma: A Review and Commentary|url=https://doi.org/10.1007/s10434-000-0055-4|journal=Annals of Surgical Oncology|language=en|volume=7|issue=1|pages=55–66|doi=10.1007/s10434-000-0055-4|issn=1534-4681}}</ref><ref>{{Cite journal|last=Washburn|first=W. Kenneth|last2=Lewis|first2=W. David|last3=Jenkins|first3=Roger L.|date=1995-03-01|title=Aggressive Surgical Resection for Cholangiocarcinoma|url=https://doi.org/10.1001/archsurg.1995.01430030040006|journal=Archives of Surgery|volume=130|issue=3|pages=270–276|doi=10.1001/archsurg.1995.01430030040006|issn=0004-0010}}</ref><ref>{{Cite journal|last=Rea|first=David J.|last2=Munoz-Juarez|first2=Manuel|last3=Farnell|first3=Michael B.|last4=Donohue|first4=John H.|last5=Que|first5=Florencia G.|last6=Crownhart|first6=Brian|last7=Larson|first7=Dirk|last8=Nagorney|first8=David M.|date=2004-05-05|title=Major Hepatic Resection for Hilar Cholangiocarcinoma: Analysis of 46 Patients|url=https://doi.org/10.1001/archsurg.139.5.514|journal=Archives of Surgery|volume=139|issue=5|pages=514–525|doi=10.1001/archsurg.139.5.514|issn=0004-0010}}</ref>
 
[[Prognosis]] mungkin lebih buruk bagi pengidap ''[[:en:Primary_sclerosing_cholangitis|primary sclerosing cholangitis]]'' yang mengembangkan kolangiokarsinoma, kemungkinan karena kanker tidak terdeteksi sampai stadium lanjut.<ref name=":8" /> Beberapa bukti menunjukkan bahwa hasil mungkin membaik dengan pendekatan bedah yang lebih intensif dan [[:en:Adjuvant_therapy|terapi adjuvan]].<ref>{{Cite journal|last=Nakeeb|first=Attila|last2=Tran|first2=Khoi Q.|last3=Black|first3=Michael J.|last4=Erickson|first4=Beth A.|last5=Ritch|first5=Paul S.|last6=Quebbeman|first6=Edward J.|last7=Wilson|first7=Stuart D.|last8=Demeure|first8=Michael J.|last9=Rilling|first9=William S.|date=2002-10-01|title=Improved survival in resected biliary malignancies|url=https://www.surgjournal.com/article/S0039-6060(02)00133-2/abstract|journal=Surgery|language=English|volume=132|issue=4|pages=555–564|doi=10.1067/msy.2002.127555|issn=0039-6060|pmid=12407338}}</ref>
 
== Epidemiologi ==
[[Berkas:Liver tumor types in adults by relative incidence.png|jmpl|Jenis tumor pada hati yang banyak terjadi pada orang dewasa di Amerika Serikat, dengan kolangiokarsinoma ada pada peringkat atas<ref>{{Cite web|last=Themes|first=U. F. O.|date=2016-12-27|title=Masses of the Liver|url=https://basicmedicalkey.com/masses-of-the-liver-2/|website=Basicmedical Key|language=en-US|access-date=2022-02-10}}</ref>]]Kolangiokarsinoma adalah bentuk [[kanker]] yang relatif jarang terjadi. Setiap tahun, sekitar 2.000 hingga 3.000 kasus baru didiagnosis di [[Amerika Serikat]], yang berarti 1-2 kasus per 100.000 orang dilaporkan per tahun.<ref>{{Cite journal|last=Landis|first=S. H.|last2=Murray|first2=T.|last3=Bolden|first3=S.|last4=Wingo|first4=P. A.|date=1998-01-01|title=Cancer statistics, 1998|url=https://doi.org/10.3322/canjclin.48.1.6|journal=CA: A Cancer Journal for Clinicians|volume=48|issue=1|pages=6–29|doi=10.3322/canjclin.48.1.6|issn=0007-9235}}</ref> Dalam suatu seri [[otopsi]] telah melaporkan prevalensi 0,01% hingga 0,46%.<ref name=":11" /><ref>{{Cite web|date=2015-04-02|title=Cancer Statistics - National Cancer Institute|url=https://www.cancer.gov/about-cancer/understanding/statistics|website=www.cancer.gov|language=en|access-date=2022-02-11}}</ref> Terdapat [[prevalensi]] yang lebih tinggi dari kolangiokarsinoma di [[Asia]], yang telah dikaitkan dengan infestasi [[parasit]] kronis endemik. Insiden kolangiokarsinoma meningkat seiring bertambahnya usia dan penyakit ini sedikit lebih sering terjadi pada pria daripada wanita (dimungkinkan karena tingkat ''[[:en:Primary_sclerosing_cholangitis|primary sclerosing cholangitis]]'' sebagai faktor risiko utama tingkat kejadinnyakejadianya lebih tinggi pada pria).<ref name=":10" /> Prevalensi dari kolangiokarsinoma pada orang dengan ''[[:en:Primary_sclerosing_cholangitis|primary sclerosing cholangitis]]'' adalah sebesar 30%, berdasarkan studi otopsi.<ref name=":8" />
 
Berbagai penelitian telah mendokumentasikan peningkatan yang stabil dalam insiden kolangiokarsinoma intrahepatik. Peningkatan tersebut telah terlihat di [[Amerika Utara]], [[Eropa]], [[Asia]], dan [[Australia]].<ref>{{Cite journal|last=Patel|first=Tushar|date=2002-05-03|title=Worldwide trends in mortality from biliary tract malignancies|url=https://doi.org/10.1186/1471-2407-2-10|journal=BMC Cancer|volume=2|issue=1|pages=10|doi=10.1186/1471-2407-2-10|issn=1471-2407|pmc=PMC113759|pmid=11991810}}</ref><ref>{{Cite journal|last=Patel|first=T|date=2001-06|title=Increasing incidence and mortality of primary intrahepatic cholangiocarcinoma in the United States|url=https://doi.org/10.1053/jhep.2001.25087|journal=Hepatology|volume=33|issue=6|pages=1353–1357|doi=10.1053/jhep.2001.25087|issn=0270-9139}}</ref><ref>{{Cite journal|last=Shaib|first=Yasser H.|last2=Davila|first2=Jessica A.|last3=McGlynn|first3=Kathryn|last4=El-Serag|first4=Hashem B.|date=2004-03-01|title=Rising incidence of intrahepatic cholangiocarcinoma in the United States: a true increase?|url=https://www.journal-of-hepatology.eu/article/S0168-8278(03)00627-5/abstract|journal=Journal of Hepatology|language=English|volume=40|issue=3|pages=472–477|doi=10.1016/j.jhep.2003.11.030|issn=0168-8278}}</ref><ref>{{Cite journal|last=West|first=J.|last2=Wood|first2=H.|last3=Logan|first3=R. F. A.|last4=Quinn|first4=M.|last5=Aithal|first5=G. P.|date=2006-06|title=Trends in the incidence of primary liver and biliary tract cancers in England and Wales 1971–2001|url=https://www.nature.com/articles/6603127|journal=British Journal of Cancer|language=en|volume=94|issue=11|pages=1751–1758|doi=10.1038/sj.bjc.6603127|issn=1532-1827|pmc=PMC2361300|pmid=16736026}}</ref><ref name=":13">{{Cite journal|last=Khan|first=Shahid A.|last2=Taylor-Robinson|first2=Simon D.|last3=Toledano|first3=Mireille B.|last4=Beck|first4=Angus|last5=Elliott|first5=Paul|last6=Thomas|first6=Howard C.|date=2002-12-01|title=Changing international trends in mortality rates for liver, biliary and pancreatic tumours|url=https://www.journal-of-hepatology.eu/article/S0168-8278(02)00297-0/abstract|journal=Journal of Hepatology|language=English|volume=37|issue=6|pages=806–813|doi=10.1016/S0168-8278(02)00297-0|issn=0168-8278}}</ref><ref>{{Cite journal|last=Welzel|first=Tania M.|last2=McGlynn|first2=Katherine A.|last3=Hsing|first3=Ann W.|last4=O'Brien|first4=Thomas R.|last5=Pfeiffer|first5=Ruth M.|date=2006-06-21|title=Impact of Classification of Hilar Cholangiocarcinomas (Klatskin Tumors) on the Incidence of Intra- and Extrahepatic Cholangiocarcinoma in the United States|url=https://doi.org/10.1093/jnci/djj234|journal=JNCI: Journal of the National Cancer Institute|volume=98|issue=12|pages=873–875|doi=10.1093/jnci/djj234|issn=0027-8874}}</ref>Alasan peningkatan terjadinya kolangiokarsinoma belum bisa dijelaskan. Metode diagnostik yang lebih baik mungkin dapat membantu, tetapi prevalensi faktor risiko potensial untuk kolangiokarsinoma, seperti infeksi [[HIV]] juga telah mengalami peningkatan.<ref name=":9" />
Diperoleh dari "https://wiki-indonesia.club/wiki/Kolangiokarsinoma"