Cancer risk in primary sclerosing cholangitis: Epidemiology, prevention, and surveillance strategies.
Cancer risk in primary sclerosing cholangitis: Epidemiology, prevention, and surveillance strategies.
World J Gastroenterol. 2019 Feb 14;25(6):659-671
Authors: Fung BM, Lindor KD, Tabibian JH
Abstract
Primary sclerosing cholangitis (PSC) is a rare cholestatic liver disease characterized by progressive fibroinflammatory destruction of the intra- and/or extrahepatic biliary ducts. While its features and disease course can be variable, most patients with PSC have concurrent inflammatory bowel disease and will eventually develop liver cirrhosis and end-stage liver disease, with liver transplantation representing the only potentially curative option. Importantly, PSC is associated with a significantly increased risk of malignancy compared to the general population, mainly cholangiocarcinoma, gallbladder carcinoma, hepatocellular carcinoma, and colorectal cancer, with nearly 50% of deaths in patients with PSC being due to cancer. Therefore, robust surveillance strategies are needed, though uncertainty remains regarding how to best do so. In this review, we discuss the epidemiology, prevention, and surveillance of cancers in patients with PSC. Where evidence is limited, we present pragmatic approaches based on currently available data and expert opinion.
PMID: 30783370 [PubMed - in process]
Source: World Journal of Gastroenterology : WJG - Category: Gastroenterology Authors: Fung BM, Lindor KD, Tabibian JH Tags: World J Gastroenterol Source Type: research
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