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The University of Michigan Comprehensive Cancer Center

Hepatobiliary cancers are common worldwide and highly lethal. Hepatocellular carcinoma is the most common hepatobiliary malignancy and the seventh most common cancer worldwide. Gallbladder cancer is the most common biliary tract malignancy, accounting for approximately 5000 newly diagnosed cases in the United States. Cholangiocarcinomas are diagnosed throughout the biliary tree and are usually classified as intrahepatic or extrahepatic. Intrahepatic cholangiocarcinomas arise from intrahepatic small-duct radicals, whereas extrahepatic cholangiocarcinomas encompass hilar carcinomas (including Klatskin's tumors). These guidelines discuss these subtypes of hepatobiliary cancer and the epidemiology, pathology, etiology, staging, diagnosis, and treatment of each subtype.

For the most recent version of the guidelines, please visit NCCN.org

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The University of Michigan Comprehensive Cancer Center

Over the past 20 years, increasing attention has been paid to quality-of-life issues in oncology. As the hospice movement has grown in this country, palliative care has developed into an integral part (rather than the antithesis) of comprehensive cancer care. Palliative care must be integrated earlier into the continuum of cancer care, and palliative, symptom-modifying therapy should be provided simultaneously with disease-modifying therapy from diagnosis. The goal of the NCCN palliative care guidelines is to help assure that each patient with cancer experiences the best possible quality of life throughout the illness trajectory. These guidelines are intended to help oncology teams provide the best care possible for their patients with incurable cancer.

For the most recent version of the guidelines, please visit NCCN.org

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The University of Michigan Comprehensive Cancer Center

The incidence of primary malignant brain tumors is increasing, especially in the elderly, and metastatic disease to the central nervous system (CNS) occurs even more frequently (an incidence about 10 times that of primary brain tumors). In fact, estimates are that 20% to 40% of patients with systemic cancer will develop brain metastases. Primary and metastatic brain tumors are heterogeneous, with varied outcomes and management strategies. This marked heterogeneity means that prognostic features and treatment options must be carefully reviewed for each patient. As these guidelines note, the involvement of an interdisciplinary team is key in the appropriate management of these patients. Important updates to the guidelines include the addition of systemic chemotherapy as a salvage therapy treatment option for local recurrence and limited metastatic lesions and its deletion as an option for multiple metastatic lesions.

For the most recent version of the guidelines, please visit NCCN.org