Cholangiocellular cholangiocellular carcinoma today.Literature review

Cholangiocarcinoma is a group of malignant tumors with signs of differentiation to bile ducts epithelium direction. There are three anatomical types of cholangiocarcinoma: intrahepatic, portal and distal. These types of tumors are different not only anatomically but have different epidemiology, etiology, pathogenesis and treatment. Morbidity and mortality of cholangiocarcinoma have dramatically increased last few decades whereas survival remains low. Variations of cholangiocarcinoma are caused by different factors of risks in different geographic locations. There is information obtained in last few years about genetic transformations of cells of cholangiocarcinoma; moreover, there are carcinoma-dependent fibroblasts revealed in the stroma of cholangiocarcinoma that are stimulating growth of the tumor. There is substantial progress obtained in the understanding of oncogenesis of intrahepatic and portal cholangiocarcinoma. Patients with intrahepatic cholangiocarcinoma usually undergo resectional surgery and neoadjuvant treatment with liver transplantation serve as a treatment of choice in cases of portal cholangiocarcinoma. This article is a review of the current understanding of the epidemiology, pathogenesis, classification, points of views on the diagnostics and treatment of cholangiocarcinoma.