Image-Guided Ablation for Cholangiocarcinoma: Current Evidence and Future Directions

Abstract Though the incidence of intrahepatic cholangiocarcinoma (ICC) is rare compared with other malignancies, its prevalence is increasing significantly worldwide. Intrahepatic cholangiocarcinoma is an aggressive tumor, typically presenting at an advanced stage and showing resistance to treatments. The primary cause of mortality is liver failure related to tumor progression with associated parenchymal loss and vascular or biliary compromise. Currently, surgical resection remains the primary curative approach, yet less than 20% of patients are eligible for such treatment, and postoperative rate of recurrence are high. In this context, locoregional therapies such as percutaneous thermal ablation have been shown to be safe and effective for patients with unresectable or recurrent ICCs. This review discusses the clinical application of ablation techniques, as it relates to patient selection and tumor characteristics for the treatment of ICC.