Cholangiocarcinoma with Resectable Disease: Treatment After Surgical Resection

This protocol applies to patients with cholangiocarcinoma confirmed as resectable (operable) on imaging and staging who have undergone — or are completing — curative-intent surgery.

Clinical Scenario

Resectable disease on imaging and staging identifies the patient group for whom surgery offers a potential cure. Surgical resection is the only therapeutic option — other than liver transplantation in a small, highly selected subset — that can achieve curative outcomes in cholangiocarcinoma.

R0 resection, achieving complete removal with negative resection margins, is the only curative treatment available. Once surgery has been performed, the immediate clinical question is what structured post-surgical therapy should follow.

Previous Treatment Step

The preceding step was curative surgical resection at a high-volume centre — targeting a complete R0 resection with negative margins. This protocol defines the treatment approach that comes after surgical resection has been carried out.

Post-Surgical Treatment Approach

Following surgical resection for cholangiocarcinoma, an adjuvant chemotherapy-based approach is part of the structured management strategy — but the specific agent, course details, and complete regimen are set out in the full protocol.

Instant Access to Structured Evidence-Based Regimens

References

DOI: 10.1136/gutjnl-2023-330029

R0 resection is the only curative treatment available.
Surgical resection is the only therapeutic option (other than liver transplantation for a small proportion of selected patients) that offers a potential cure for CCA.
Patients who have undergone surgical resection for CCA should be considered for 24 weeks of adjuvant chemotherapy (currently capecitabine).

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