Update on Cholangiocarcinoma

Cholangiocarcinoma remains a challenge both in terms of diagnosis and treatment. Due to the lack of a useful screening test and often clinically silent early course, disease stage is often advanced at the time of diagnosis. Surgical resection remains the only potentially curative treatment option and recurrence rates are high; however, liver transplantation has recently resulted in promising outcomes in certain groups of patients with intrahepatic and perihilar cholangiocarcinoma. For patients in whom surgery is not an option, chemotherapy with gemcitabine and cisplatin is the first-line treatment. An array of locoregional management options exists, which includes transarterial embolization, hepatic arterial chemotherapy infusion, ablation, and radiation therapy. High-quality data from randomized controlled trials for these treatments remains limited, however, and additional study is needed.