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Update on the Diagnosis and Treatment of Cholangiocarcinoma

  • Liver (S Cotler and E Kallwitz, Section Editors)
  • Published:
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Abstract

Purpose of Review

Cholangiocarcinoma is a rare biliary adenocarcinoma associated with poor outcomes. Cholangiocarcinoma is subdivided into extrahepatic and intrahepatic variants. Intrahepatic cholangiocarcinoma is then further differentiated into (1) peripheral mass-forming tumors and (2) central periductal infiltrating tumors. We aimed to review the currently known risk factors, diagnostic tools, and treatment options, as well as highlight the need for further clinical trials and research to improve overall survival rates.

Recent Findings

Cholangiocarcinoma has seen significant increase in incidence rates over the last several decades. Most patients do not carry the documented risk factors, which include infections and inflammatory conditions, but cholangiocarcinoma typically forms in the setting of cholestasis and chronic inflammation. Management strategies include multispecialty treatments, with consideration of surgical resection, systemic chemotherapy, and targeted radiation therapy. Surgically resectable disease is the only curable treatment option, which may involve liver transplantation in certain selected cases. Referrals to centers of excellence, along with enrollment in novel clinical trials are recommended for patients with unresectable or recurrent disease.

Summary

This article provides an overview of cholangiocarcinoma and discusses the current diagnosis and treatment options. While incidence is increasing and more risk factors are being discovered, much more work remains to improve outcomes of this ominous disease.

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Acknowledgements

We appreciate the assistance of Andrew Bowman, MD PhD – Department of Radiology, Mayo Clinic for providing the Fig. 2 images.

Fig. 2
figure 2

Management of cholangiocarcinoma in cirrhosis. CA carbohydrate antigen, CEA carcinoembryonic antigen, CT computed tomography, IV intravenous, MRI magnetic resonance imaging, PET positron emission tomography, TIPS transjugular intrahepatic portosystemic shunt

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Authors and Affiliations

  1. Grand Strand Medical Center, Myrtle Beach, SC, 29572, USA

    Bryan Doherty & Vinod E. Nambudiri

  2. Division of Gastroenterology and Hepatology, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, USA

    William C. Palmer

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  1. Bryan Doherty
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Correspondence to William C. Palmer.

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Bryan Doherty and William Palmer declare no conflict of interest.

Vinod Nambudiri receives textbook royalties from McGraw Hill.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is a part of the Topical Collection on Liver

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Doherty, B., Nambudiri, V.E. & Palmer, W.C. Update on the Diagnosis and Treatment of Cholangiocarcinoma. Curr Gastroenterol Rep 19, 2 (2017). https://doi.org/10.1007/s11894-017-0542-4

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