Multidisciplinary Approach of Malignant Tumors of the Biliary Tree

Biliary tract carcinomas are aggressive tumors that arise from epithelial cells of bile ducts. They present several difficulties in their clinical management. A late initial diagnosis (fre quently in the form of locally advanced disease), jaundice, cholangitis, or poor perfor- mance status of patients are some of the medical issues that arise in this setting. Another clinical limitation is the lack of robust evidence for many of the standard procedures in this particular scenario. Biliary tumors are lethal tumors, and most of them present in the form of advanced disease or during late evolution. However, we are witnessing some exciting changes in clinical management of tumors of the biliary tract, such as the development of new radiological techniques and novel interventional radiology procedures, the emergence of new radiotherapy modalities, the establishment of standardized chemotherapy regimens, the advance in molecular knowledge, and the development of new treatments directed against therapeutic targets. On the other hand, the most important step for advancing the treatment of these complex diseases is the appearance of multi- disciplinary management teams integrating qualified specialists to resolve appropriate treatment challenges. In this chapter, we summarize the most relevant advances in clini- cal management and new oncologic treatment in biliary tract carcinomas.