Point-of-Care Clinical Guide: Cholangiocarcinoma

Abstract

Cholangiocarcinoma is a neoplasm arising from the epithelial lining of the biliary tree; the cholangiocytes. Cholangiocarcinoma encompasses three types based on anatomical location: intrahepatic (IHCC), extrahepatic (EHCC), and hilar (HiCC) type; with the hilar type being the most common. Although cholangiocarcinoma is a rare tumor, its incidence is rising worldwide. Late presentation of the disease contributes to the poor prognosis and occurs due to subtle symptoms that often initially go unrecognized. Although surgical resection remains the best available option for cholangiocarcinoma, late presentation can limit surgical resection as an option, stressing the need for alternative interventions. Current therapeutic options include resection, liver transplantation, systematic chemotherapy, radiotherapy, and liver directed therapies. Palliative care is a valuable tool for those entering a non-curative paradigm in order to potentially minimize symptoms and improve the patient’s quality of life. In this chapter, we discuss factors most commonly associated with disease development, available treatments, and anticipated outcomes for cholangiocarcinoma.