Neoadjuvant Therapy Protocol and Liver Transplantation in Combination With Pancreatoduodenectomy for the Treatment of Hilar Cholangiocarcinoma Occurring in a Case of Primary Sclerosing Cholangitis: Case Report With a More Than 8-Year Disease-Free Survival

Abstract: Cholangiocarcinoma has historically represented a major contraindication to liver transplantation at many centers because of its high recurrence rate and low disease-free survival rate, even after radical surgery. Novel neoadjuvant therapy protocols combined with demolitive surgery and liver transplantation seem to achieve successful results in terms of overall and disease-free survivals. Surgery frequently seems to be unsatisfactory only for patients also suffering from chronic cirrhosis or end-stage liver disease. We have reported a case of hilar cholangiocarcinoma occurring in a case of primary sclerosing cholangitis treated with neoadjuvant radiochemotherapy and endoscopic brachytherapy, followed by liver transplantation combined with pancreatoduodenectomy, who has survived free of disease for >8 years.