Adjuvant Treatment After Surgical Resection of Localised Extrahepatic Cholangiocarcinoma

This protocol applies to patients with localised (non-metastatic) extrahepatic cholangiocarcinoma (eCCA) who have undergone, or are candidates for, complete surgical resection with negative margins (R0). Surgical resection is the primary curative intervention in this population, and management after resection is the central clinical question addressed here.

All patients with non-metastatic eCCA should be evaluated for surgical resection where a complete R0 resection is feasible with acceptable postoperative mortality. Once resection has been performed — regardless of tumour stage, nodal status, or final margin result — the focus moves to the post-resection treatment plan.

Following resection of invasive eCCA, adjuvant systemic therapy is recommended across patient subgroups. In selected individual patients — particularly where the resection margin situation warrants it — additional treatment modalities may also be considered on a case-by-case basis.

The complete regimen, agent selection, sequencing, and patient-specific criteria are detailed in the full structured protocol.