Comprehensive review of Cholangiocarcinoma

Cholangiocarcinoma (CCA), a malignant neoplasm originating from the biliary epithelium, represents the second most common primary hepatic tumor, accounting for 10–15% of hepatobiliary malignancies. This scientific session aimed to provide a comprehensive overview of CCA, encompassing its epidemiology, risk factors, pathogenesis, clinical presentation, diagnostic approaches, and management strategies. CCA is broadly classified into intrahepatic, perihilar, and distal types, each with unique clinical implications. Risk factors include primary sclerosing cholangitis, liver fluke infection, bile duct cysts, and chronic liver diseases, which contribute to chronic inflammation and malignant transformation of cholangiocytes.
Diagnosis of CCA remains challenging due to its often late presentation and nonspecific symptoms. Advancements in imaging techniques, including MRI and MRCP, combined with tumor markers such as CA 19-9, have improved diagnostic accuracy. However, histopathological confirmation remains essential. Treatment strategies depend on the tumor’s location and stage. Surgical resection offers the only potential cure but is feasible in a limited number of patients. In unresectable cases, chemotherapy, radiotherapy, and emerging targeted therapies are employed to prolong survival and improve quality of life. Liver transplantation is considered in select early-stage perihilar CCA cases under stringent criteria.
The session emphasized the importance of early detection, multidisciplinary management, and continued research into novel therapeutic approaches. Awareness and education on the risk factors and symptoms of CCA are crucial in improving patient outcomes. Overall, this session served as a valuable platform for enhancing clinical understanding and fostering collaborative efforts in the fight against cholangiocarcinoma.