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Table 1. Literature review of studies in the last 10 years with patients with iCCA subject to LT

Overall survival
Authors 5 yr DFS (%)
Study design Year n NAT Comments
(%) 1 yr 3 yr 5 yr
[80]
Valin et al. Retrospective 2013 10 No - 80 60 24
Sapisochin et al. [48] Retrospective 2014 298 8 TACE 29% 79% 61% 45% very early survival
very 3 RFA 100%, 73% and 73%
early 2 PEI
[81]
Lindnér et al. Retrospective 2015 5 - - - 60% - no details on long-
term outcomes
[82]
Facciuto et al. Retrospective 2015 32 69% 44% 71% - 57% only four biopsy-
12 TACE proven iCCA
1 RFA
6 RFA + TACE
1 SRBT
1 TACE + SRBT
Vilchez et al. [47] Retrospective 2016 440 no - 79% 58% 47%
[60]
Takahashi et al. Retrospective 2016 13 no - - - -
Sapisochin et al. [49] Retrospective 2016 48 48 82% very 93% 84% 65% Very early
15 very 15 very early early
early 39% 79% 50% 45% Advanced
advanced
[83]
Jung et al. Retrospective 2017 16 10 TACE 21.9 81.3 52,4 52,4
1 RFA
1 LR
2 LR + RFA
[66]
Lunsford et al. Prospective 2018 6 GEM-CIS 50 100 83.3 83.3
single arm
[84]
Lee et al. Retrospective 2018 44 no - 78.6 - 54.5
De Martin et al. [61] Retrospective 2020 49 62% 75 90 76 67
[85]
Krasnodębski et al. Retrospective 2020 8 - 28,6 75 37,5 25
[67]
MacMillan et al. Prospective 2021 18 GEM-CIS - 90% 61% 49
single arm 3 LR
4 SRBT
4 locoregional*
[65]
Ito et al. Prospective 2021 31 1- patients GEM-CIS + 42 80 60 49
single arm SRBT and TACE
iCCA: Intrahepatic Cholangiocarcinoma; LT: Liver Transplantation; DFS: Disease-free survival; OS: overall survival; TACE: Transarterial
Chemoembolization; PEI: percutaneous ethanol injection; RFA: Radiofrequency Ablation; LR: Liver resection; SBRT: Stereotactic Body radiation
Therapy; GEM-CIS: Gemcitabine-Cisplatin; NAT: Neoadjuvant therapies. Locoregional therapies*: TACE, Transarterial radioembolization, RFA,
and electroporation. Not specified in the manuscript.

lymph node dissection along with the explant. Given worldwide donor scarcity, it is of paramount
importance to rule out lymph node involvement in order to avoid futile procedures.

Bridging/neoadjuvant therapies for LT in Intrahepatic Cholangiocarcinoma
The ever-growing and cumulative experience and trials have led to great advances in transplant oncology.
Particularly regarding hepatocellular carcinoma (HCC), the most common primary malignancy of the liver,
there are many studies that show benefit for cirrhotic patients with HCC, when correctly studied and
[52]
[59]
[58]
stratified. Milan criteria , UCSF and BCLC staging system are different methods used to stratify
cirrhotic patients with HCC, and determine the best treatment for each scenario. Patients with HCC and a
BCLC staging score of “A” (tumors within Milan criteria in cirrhotic child A/Super A patients) have a clear
indication for LT. However, due to donor shortage and “good” health status, these patients often suffer
disease progression and migrate to a higher BCLC class due to either tumor growth or metastases while on
the waitlist, missing the opportunity for a LT. Due to this issue, there have been many advances regarding
neoadjuvant treatments (NAT) for patients with HCC who await a LT. “ Bridging” therapies refer to these