Locoregional Approaches in Cholangiocarcinoma Treatment

SIMPLE SUMMARY: Our current ability to treat cholangiocarcinoma is limited. Surgery to remove the tumor is only possible in a small proportion of cases of the disease due to the tumor’s location or spread to other sites in the body. When surgery is not an option, locoregional therapies that target their treatment to a small region have the potential to slow progression, decrease the size of the tumors, increase overall survival, and in some cases, allow for cure. This review will discuss what locoregional therapies exist, their role is in treatment of cholangiocarcinoma, and their impact on patients. ABSTRACT: Cholangiocarcinoma (CCA) is a rare hepatic malignant tumor with poor prognosis due to late detection and anatomic factors limiting the applicability of surgical resection. Without surgical resection, palliation is the most common approach. In non-surgical cases contained within the liver, locoregional therapies provide the best chance for increased survival and disease control. The most common methods, transarterial chemoembolization and transarterial radioembolization, target tumors by embolizing their blood supply and limiting the tumor’s ability to metabolize. Other treatments induce direct damage via thermal ablation to tumor tissue to mediate their anti-tumor efficacy. Recent studies have begun to explore roles for these therapies outside their previous role of palliation. This review will outline the mechanisms of each of these treatments, along with their effects on overall survival, while comparing these to non-locoregional therapies.