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Diagnosis and Treatment of Cholangiocarcinoma

^a Division of Hepatobiliary Surgery and Liver Transplantation, Department of Surgery, ^b Department of Oncology, and ^c Department of Cancer Biology, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, Tennessee, USA

Correspondence: Ravi S. Chari, M.D., Division of Hepatobiliary Surgery and Liver Transplantation, Suite 801 Oxford House, 1313 21st Avenue South, Vanderbilt University Medical Center, Nashville, Tennessee 37232-4753, USA. Telephone: 615-936-2573; Fax: 615-936-0435; e-mail: ravi.chari{at}vanderbilt.edu

Cholangiocarcinoma presents a formidable diagnostic and treatment challenge. The majority of patients present with unresectable disease and have a survival of less than 12 months following diagnosis. Progress has been made by the appropriate selection of patients for treatment options including resection, with the routine use of more aggressive resections in order to achieve margin-negative resections. This has resulted in longer survival times for these patients. Neoadjuvant and adjuvant therapies have, for the most part, not improved survival in patients with this tumor, and new strategies are needed to improve this line of therapy. The prognosis for unresectable patients is poor, and palliative measures should be aimed at increasing quality of life first and increasing survival second.

Key Words. Cholangiocarcinoma • Biliary tract cancer • Bile duct tumor • Biliary obstruction

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