Thursday, 30 March 2017

Intrahepatic Cholangiocarcinoma in Hodgkin Lymphoma Survivor: Take it or Leave?

Cholangiocarcinoma

Advances in treatment for Hodgkin Lymphoma (HL) have dramatically improved long-term survival and life expectancy. Despite, survivors are prone to develop high-dose radiotherapy late-onset neoplastic complications: the 30 years cumulative incidence of a second malignancy is 30.7% (95% CI, 28.7-32.7).

Among them, solid tumors account for up to 75–80% of all second malignancies, typically located at the edges of prior radiation fields. Primary liver cancer secondary to HL is significantly increased after mixed-modality treatment, with a 2.6 folds Relative-Risk and 0.5 Absolute Excess Risk per 10,000 Person-Years.

When technically resectable, surgery is recognized to be the best curative treatment for primary liver tumors. The downside is that surgery on radiation tissues is highly dangerous leading to poor wound healing, fistula formation, skin necrosis and even death in relation with atrophic tissue inefficient to realize normal healing.

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