Klatskin tumor: characteristics, symptoms, treatment, prognosis

According to the statistics of the world medical community, cholangiocarcinoma accounts for about 2% of all types of cancer, as well as up to 10% of the total number of cases of liver cancer and bile ducts. In this case, the diagnosis of this type of tumor is very low: only 1.5-2%. The tumor of Klatskin is named after the pathologist Gerald Klatskin, a doctor from America. In 1965, working at Yale University, he, based on 13 cases of the disease, described all the characteristics of this ailment.

Cholangiocarcinoma, or cancer of the liver and bile ducts

The tumor of Klatskin is a rather dangerous disease. For this neoplasm is characterized by slow growth and later development of metastases. Due to untimely diagnosis and the inability to perform surgical removal, the disease has high rates of death. The diagnosis in most cases is made at the last stages of development of formations, which excludes surgical intervention. The development of metastases is directly affected by the liver, gates of the liver, regional lymph nodes, as well as the abdominal cavity. The tumor grows from the liver epithelium cells. The disease is formed mainly after 50 years, but every year the age of patients decreases. Men are slightly more likely to be affected than women.

Possible causes of tumor

The causes of the formation of cholangiocarcinoma of the liver are not known exactly. But the scientists found out the factors, the influence of which increases the risk of neoplasm development. If there is a history of primary sclerotizing cholangitis in patients in 40 cases out of 100, Klatskin's disease may form. A tumor is formed with a frequency of 25 cases out of 100 on the basis of hereditary diseases, such as Caroli's disease. Inflammatory reaction due to intrahepatic parasites can provoke neoplasm.

Harmful habits that affect liver health: smoking, alcohol dependence, improper diet, leading to obesity are undeniable factors for the progression of the disease. The presence of cholelithiasis increases the likelihood of a tumor. At risk people who are exposed to long-term exposure to toxins and harmful substances. Viral infections, mainly hepatitis, contribute to the development of cancers.

Symptoms of cholangiocarcinoma

Since malignant tumors in the liver are difficult to diagnose, you need to listen to your body for early detection of Klatskin's disease. A tumor can be characterized by symptoms such as:

• The main symptom of the disease is mechanical jaundice;
• A constant sensation of itching;
• Pulling pain in the upper right side of the abdomen;
• Loss of appetite and, as a result, a sharp decrease in weight;
• Physical exhaustion, characteristic of tumor formations;
• The increased temperature of a Klatskin tumor also occurs;
• Changes in the color of urine and stool (urine darkens, and the stool becomes light).

Symptoms manifest unexpectedly and progress. Mechanical jaundice occurs in 90 cases out of 100 and is one of the frequent signs of a disease such as Klatskin's tumor. The patients' opinions sometimes differ. Some patients note the addition of itching, pain and a sharp loss in weight. Such manifestations are caused by late stages of malignant formations. But others do not feel practically any deviations in the state of health or associate the symptoms that appear with other ailments.

Diagnosis of Klatskin's tumor

To establish the diagnosis, a number of clinical studies are carried out, which with accuracy can tell about the presence of Klatskin's disease. The tumor is clearly visible during screening on an ultrasound machine. This is a fairly economical, harmless and easily accessible method. With the help of spiral computed tomography, it is easy to detect irregularities in the operation of the gallbladder, to see damage to the liver and lymph nodes. The use of MRI (magnetic resonance imaging), with the introduction of contrast fluid in the liver, allows to determine with high accuracy the state of liver tissue and the degree of narrowing of the bile ducts in the diagnosis of the Klatskin tumor. The photo shows all parts of the liver and bile ducts.

X-ray and X-ray examination shows problems with bile-excreting pathways. In the course of diagnosis, a contrast agent is introduced, which allows one to see the outflow of bile. Biochemical blood tests will help to identify the level of enzymes and bilirubin. Analyzes for the detection of oncological bodies may also be prescribed: CA 199, CA 125.

Quite often, tumor processes reach the hepatic artery and portal vein that feed blood to the liver. Before the surgical intervention, it is very important to determine the stage of neoplasm, in order to clarify whether the disease has spread to the blood vessels. In some cases, such diagnosis is difficult and then the question of the scale of resection is solved during a surgical operation.

Methods of treatment of neoplasms

In the absence of treatment in patients, in most cases, life expectancy averages 6 months after determining the exact diagnosis. At an early stage, Klatskin's disease is rarely detected. The tumor is treatable at the last stages rather ineffectively.

Surgical intervention is one of the main ways to treat a tumor. But due to late diagnosis, the operation has a low survival threshold (on average 20%). To achieve a positive effect, a complete removal of the damaged part of the bile ducts is used, together with the removal of one lobe of the liver, in order to avoid infection of the blood vessels.

Surgical operation is possible in several cases:

• The formation did not affect the circulatory system of the liver; In this case, it is possible to remove the site or the entire fraction of the damaged liver;
• The formation did not affect the bile duct of one or both lobes of the liver.

The disease is considered to be unoperable when the tumor enters the blood vessels of the liver or into the cholagogic ducts of both its lobes.

Palliative methods of treatment

In inoperable cases or as an additional therapy, palliative care is used .

Such methods include:

• Drainage of the biliary tract;
• chemotherapy;
• radiation therapy;
• Bypass surgery;
• Photodynamic therapy;
• Irradiation with highly focused ultrasound.

When combining several treatment methods in conjunction with early diagnosis, life expectancy can be increased from 10 months to 5 years.

Prognosis after treatment

Due to the fact that the processes of tumor formation in the liver are rather slow, the life expectancy ranges from one and a half to five years. The complete removal of the damaged areas allows to increase the life expectancy with accurate and timely diagnosis of Klatskin's disease. The tumor found inside the liver has disappointing predictions. This is one of the worst indicators observed in patients with inoperable formations with metastases. Such patients can only rely on the drainage of the biliary tract. If inside the liver is diagnosed a tumor of Klatskin, the life expectancy of the ill sometimes does not exceed several weeks.

The cause of death, oddly enough, is not metastases, but the attendant complications. These include:

• Cirrhosis of the liver caused by an irregular outflow of bile;
• Infections leading to the formation of abscesses;
• General atrophy of the body and malfunction of immunity;
• Purulent-inflammatory processes.

Preventive measures

For the prevention of neoplastic diseases of the liver and bile ducts, it is necessary to adhere to proper nutrition, not to abuse alcohol and to prevent the infection of parasites. If you have a history of disease, which is positioned as a risk factor, then you should conduct timely treatment and systematic examination for early detection of abnormalities in the work of biliary organs. It is also necessary to exclude the influence of harmful substances, for example in the workplace.

Finally

Modern diagnostic equipment can detect tumor processes in the liver and bile ducts, as well as determine the degree of complexity of surgical intervention. The use of new methods for rapid resolution of the problem, transplantation and additional therapeutic measures leads to an improvement in the quality and longevity of patients.