{"id":"https://openalex.org/W7204476265","doi":"https://doi.org/10.21037/cco-2026-0042","title":"Locoregional therapies for intrahepatic cholangiocarcinoma: a stage-stratified, biology-informed multidisciplinary framework\u2014a narrative review","display_name":"Locoregional therapies for intrahepatic cholangiocarcinoma: a stage-stratified, biology-informed multidisciplinary framework\u2014a narrative review","publication_year":2026,"publication_date":"2026-08-01","ids":{"openalex":"https://openalex.org/W7204476265","doi":"https://doi.org/10.21037/cco-2026-0042","pmid":"https://pubmed.ncbi.nlm.nih.gov/42713690"},"language":"en","primary_location":{"id":"doi:10.21037/cco-2026-0042","doi":"https://doi.org/10.21037/cco-2026-0042","is_oa":true,"landing_page_url":"https://doi.org/10.21037/cco-2026-0042","pdf_url":null,"source":{"id":"https://openalex.org/S2764664221","display_name":"Chinese Clinical Oncology","issn_l":"2304-3865","issn":["2304-3865","2304-3873"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","jufo-1","ki-jl-1","medline","norway-1"],"host_organization":"https://openalex.org/P4310321814","host_organization_name":"AME Publishing Company","host_organization_lineage":["https://openalex.org/P4310321814"],"host_organization_lineage_names":["AME Publishing Company"],"type":"journal"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Chinese Clinical Oncology","raw_type":"journal-article"},"volume":null,"type":"review","indexed_in":["crossref","doaj","pubmed"],"open_access":{"is_oa":true,"oa_status":"diamond","oa_url":"https://doi.org/10.21037/cco-2026-0042","any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5082787521","display_name":"Jonathan Tefera","orcid":"https://orcid.org/0000-0001-9038-8579","observed_orcids":["https://orcid.org/0000-0001-9038-8579"]},"institutions":[{"id":"https://openalex.org/I32971472","display_name":"Yale University","ror":"https://ror.org/03v76x132","country_code":"US","type":"education","lineage":["https://openalex.org/I32971472"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Jonathan Tefera","raw_affiliation_strings":["Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT, USA"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT, USA","institution_ids":["https://openalex.org/I32971472"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5020745931","display_name":"David C. Madoff","orcid":"https://orcid.org/0000-0003-3461-437X","observed_orcids":["https://orcid.org/0000-0003-3461-437X"]},"institutions":[{"id":"https://openalex.org/I32971472","display_name":"Yale University","ror":"https://ror.org/03v76x132","country_code":"US","type":"education","lineage":["https://openalex.org/I32971472"]}],"countries":["US"],"is_corresponding":true,"raw_author_name":"David C. Madoff","raw_affiliation_strings":["Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT, USA; Department of Medicine, Section of Medical Oncology, Yale School of Medicine, New Haven, CT, USA; Department of Surgery, Section of Surgical Oncology, Yale School of Medicine, New Haven, CT, USA"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Department of Radiology and Biomedical Imaging, Yale School of Medicine, New Haven, CT, USA; Department of Medicine, Section of Medical Oncology, Yale School of Medicine, New Haven, CT, USA; Department of Surgery, Section of Surgical Oncology, Yale School of Medicine, New Haven, CT, USA","institution_ids":["https://openalex.org/I32971472"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":1,"corresponding_author_ids":["https://openalex.org/A5020745931"],"corresponding_institution_ids":["https://openalex.org/I32971472"],"apc_list":null,"apc_paid":null,"fwci":0.0,"has_fulltext":false,"cited_by_count":0,"citation_normalized_percentile":{"value":0.63965201,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":null,"biblio":{"volume":"15","issue":"4","first_page":"61","last_page":"61"},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T11364","display_name":"Cholangiocarcinoma and Gallbladder Cancer Studies","score":0.9990000128746033,"subfield":{"id":"https://openalex.org/subfields/2746","display_name":"Surgery"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T11364","display_name":"Cholangiocarcinoma and Gallbladder Cancer Studies","score":0.9990000128746033,"subfield":{"id":"https://openalex.org/subfields/2746","display_name":"Surgery"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10073","display_name":"Hepatocellular Carcinoma Treatment and Prognosis","score":0.0003000000142492354,"subfield":{"id":"https://openalex.org/subfields/2721","display_name":"Hepatology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T12460","display_name":"Pediatric Hepatobiliary Diseases and Treatments","score":0.00019999999494757503,"subfield":{"id":"https://openalex.org/subfields/2746","display_name":"Surgery"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/intrahepatic-cholangiocarcinoma","display_name":"intrahepatic cholangiocarcinoma","score":1.0},{"id":"https://openalex.org/keywords/locoregional-therapy","display_name":"locoregional therapy","score":0.9829999804496765},{"id":"https://openalex.org/keywords/unresectable-liver-cancer","display_name":"unresectable liver cancer","score":0.8569999933242798},{"id":"https://openalex.org/keywords/portal-vein-embolization","display_name":"portal vein embolization","score":0.9599999785423279},{"id":"https://openalex.org/keywords/liver-venous-deprivation","display_name":"liver venous deprivation","score":0.9290000200271606},{"id":"https://openalex.org/keywords/percutaneous-ablation","display_name":"percutaneous ablation","score":0.8709999918937683},{"id":"https://openalex.org/keywords/transarterial-chemoembolization","display_name":"transarterial chemoembolization","score":0.9190000295639038},{"id":"https://openalex.org/keywords/radioembolization","display_name":"radioembolization","score":0.9850000143051147},{"id":"https://openalex.org/keywords/hepatic-arterial-infusion-chemotherapy","display_name":"hepatic arterial infusion chemotherapy","score":0.9010000228881836},{"id":"https://openalex.org/keywords/stereotactic-body-radiation-therapy","display_name":"stereotactic body radiotherapy","score":0.9950000047683716},{"id":"https://openalex.org/keywords/multimodal-treatment","display_name":"multimodal therapy","score":0.5199999809265137},{"id":"https://openalex.org/keywords/chemoimmunotherapy","display_name":"chemoimmunotherapy","score":0.7049999833106995},{"id":"https://openalex.org/keywords/downstaging","display_name":"downstaging","score":0.5180000066757202},{"id":"https://openalex.org/keywords/surgical-resection-eligibility","display_name":"surgical resection eligibility","score":0.42100000381469727}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.9717000126838684},{"id":"https://openalex.org/C2779343474","wikidata":"https://www.wikidata.org/wiki/Q3109175","display_name":"Context (archaeology)","level":2,"score":0.5738000273704529},{"id":"https://openalex.org/C126838900","wikidata":"https://www.wikidata.org/wiki/Q77604","display_name":"Radiology","level":1,"score":0.4625000059604645},{"id":"https://openalex.org/C2779399171","wikidata":"https://www.wikidata.org/wiki/Q1483951","display_name":"Malignancy","level":2,"score":0.4607999920845032},{"id":"https://openalex.org/C2776035437","wikidata":"https://www.wikidata.org/wiki/Q1144114","display_name":"Embolization","level":2,"score":0.4359000027179718},{"id":"https://openalex.org/C2780813298","wikidata":"https://www.wikidata.org/wiki/Q2071287","display_name":"Percutaneous","level":2,"score":0.42820000648498535},{"id":"https://openalex.org/C2908647359","wikidata":"https://www.wikidata.org/wiki/Q2625603","display_name":"Population","level":2,"score":0.3978999853134155},{"id":"https://openalex.org/C185926286","wikidata":"https://www.wikidata.org/wiki/Q1929812","display_name":"Systemic therapy","level":4,"score":0.39739999175071716},{"id":"https://openalex.org/C2778019345","wikidata":"https://www.wikidata.org/wiki/Q1148337","display_name":"Hepatocellular carcinoma","level":2,"score":0.39010000228881836},{"id":"https://openalex.org/C197934379","wikidata":"https://www.wikidata.org/wiki/Q2047938","display_name":"Adverse effect","level":2,"score":0.3804999887943268},{"id":"https://openalex.org/C3020000205","wikidata":"https://www.wikidata.org/wiki/Q2412849","display_name":"Narrative review","level":2,"score":0.3765000104904175},{"id":"https://openalex.org/C2779185275","wikidata":"https://www.wikidata.org/wiki/Q2267963","display_name":"Selective internal radiation therapy","level":3,"score":0.3653999865055084},{"id":"https://openalex.org/C141071460","wikidata":"https://www.wikidata.org/wiki/Q40821","display_name":"Surgery","level":1,"score":0.36410000920295715},{"id":"https://openalex.org/C2777075537","wikidata":"https://www.wikidata.org/wiki/Q929737","display_name":"Liver disease","level":2,"score":0.3630000054836273},{"id":"https://openalex.org/C167135981","wikidata":"https://www.wikidata.org/wiki/Q2146302","display_name":"Retrospective cohort study","level":2,"score":0.3513000011444092},{"id":"https://openalex.org/C2779984678","wikidata":"https://www.wikidata.org/wiki/Q2145898","display_name":"Response Evaluation Criteria in Solid Tumors","level":4,"score":0.3481000065803528},{"id":"https://openalex.org/C509974204","wikidata":"https://www.wikidata.org/wiki/Q180507","display_name":"Radiation therapy","level":2,"score":0.34689998626708984},{"id":"https://openalex.org/C168563851","wikidata":"https://www.wikidata.org/wiki/Q1436668","display_name":"Randomized controlled trial","level":2,"score":0.3418000042438507},{"id":"https://openalex.org/C535046627","wikidata":"https://www.wikidata.org/wiki/Q30612","display_name":"Clinical trial","level":2,"score":0.32280001044273376},{"id":"https://openalex.org/C188816634","wikidata":"https://www.wikidata.org/wiki/Q2113324","display_name":"Prospective cohort study","level":2,"score":0.3197000026702881},{"id":"https://openalex.org/C140608501","wikidata":"https://www.wikidata.org/wiki/Q7318358","display_name":"Review article","level":2,"score":0.31709998846054077},{"id":"https://openalex.org/C2778014663","wikidata":"https://www.wikidata.org/wiki/Q17149193","display_name":"Microwave ablation","level":3,"score":0.3003000020980835},{"id":"https://openalex.org/C189708586","wikidata":"https://www.wikidata.org/wiki/Q1504425","display_name":"Systematic review","level":3,"score":0.29760000109672546},{"id":"https://openalex.org/C2776231280","wikidata":"https://www.wikidata.org/wiki/Q623031","display_name":"Liver cancer","level":3,"score":0.2921999990940094},{"id":"https://openalex.org/C121608353","wikidata":"https://www.wikidata.org/wiki/Q12078","display_name":"Cancer","level":2,"score":0.2831000089645386},{"id":"https://openalex.org/C61434518","wikidata":"https://www.wikidata.org/wiki/Q932510","display_name":"General surgery","level":1,"score":0.27549999952316284},{"id":"https://openalex.org/C2777377203","wikidata":"https://www.wikidata.org/wiki/Q1809554","display_name":"Radiofrequency ablation","level":3,"score":0.27410000562667847},{"id":"https://openalex.org/C146357865","wikidata":"https://www.wikidata.org/wiki/Q1123245","display_name":"Stage (stratigraphy)","level":2,"score":0.27059999108314514},{"id":"https://openalex.org/C2775908122","wikidata":"https://www.wikidata.org/wiki/Q3070621","display_name":"External beam radiotherapy","level":4,"score":0.2639000117778778},{"id":"https://openalex.org/C2778902805","wikidata":"https://www.wikidata.org/wiki/Q322177","display_name":"Ablation","level":2,"score":0.25870001316070557},{"id":"https://openalex.org/C2777202286","wikidata":"https://www.wikidata.org/wiki/Q9609","display_name":"Vein","level":2,"score":0.2556999921798706},{"id":"https://openalex.org/C2776131983","wikidata":"https://www.wikidata.org/wiki/Q436572","display_name":"Catheter ablation","level":3,"score":0.2540999948978424},{"id":"https://openalex.org/C4441509","wikidata":"https://www.wikidata.org/wiki/Q6418787","display_name":"Multimodal therapy","level":2,"score":0.25209999084472656},{"id":"https://openalex.org/C143998085","wikidata":"https://www.wikidata.org/wiki/Q162555","display_name":"Oncology","level":1,"score":0.25209999084472656}],"mesh":[{"descriptor_ui":"D000099142","descriptor_name":"Radioembolization, Therapeutic","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D001650","descriptor_name":"Bile Duct Neoplasms","qualifier_ui":"Q000473","qualifier_name":"pathology","is_major_topic":true},{"descriptor_ui":"D001650","descriptor_name":"Bile Duct Neoplasms","qualifier_ui":"Q000628","qualifier_name":"therapy","is_major_topic":true},{"descriptor_ui":"D003131","descriptor_name":"Combined Modality Therapy","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D006801","descriptor_name":"Humans","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D009367","descriptor_name":"Neoplasm Staging","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D018281","descriptor_name":"Cholangiocarcinoma","qualifier_ui":"Q000473","qualifier_name":"pathology","is_major_topic":true},{"descriptor_ui":"D018281","descriptor_name":"Cholangiocarcinoma","qualifier_ui":"Q000628","qualifier_name":"therapy","is_major_topic":true}],"locations_count":2,"locations":[{"id":"doi:10.21037/cco-2026-0042","doi":"https://doi.org/10.21037/cco-2026-0042","is_oa":true,"landing_page_url":"https://doi.org/10.21037/cco-2026-0042","pdf_url":null,"source":{"id":"https://openalex.org/S2764664221","display_name":"Chinese Clinical Oncology","issn_l":"2304-3865","issn":["2304-3865","2304-3873"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","jufo-1","ki-jl-1","medline","norway-1"],"host_organization":"https://openalex.org/P4310321814","host_organization_name":"AME Publishing Company","host_organization_lineage":["https://openalex.org/P4310321814"],"host_organization_lineage_names":["AME Publishing Company"],"type":"journal"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Chinese Clinical Oncology","raw_type":"journal-article"},{"id":"pmid:42713690","doi":null,"is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/42713690","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Chinese clinical oncology","raw_type":"Journal Article"}],"best_oa_location":{"id":"doi:10.21037/cco-2026-0042","doi":"https://doi.org/10.21037/cco-2026-0042","is_oa":true,"landing_page_url":"https://doi.org/10.21037/cco-2026-0042","pdf_url":null,"source":{"id":"https://openalex.org/S2764664221","display_name":"Chinese Clinical Oncology","issn_l":"2304-3865","issn":["2304-3865","2304-3873"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","jufo-1","ki-jl-1","medline","norway-1"],"host_organization":"https://openalex.org/P4310321814","host_organization_name":"AME Publishing Company","host_organization_lineage":["https://openalex.org/P4310321814"],"host_organization_lineage_names":["AME Publishing Company"],"type":"journal"},"license":"cc-by-nc-nd","license_id":"https://openalex.org/licenses/cc-by-nc-nd","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Chinese Clinical Oncology","raw_type":"journal-article"},"sustainable_development_goals":[{"display_name":"Good health and well-being","score":1.0,"id":"https://metadata.un.org/sdg/3"}],"sustainable_development_goals_aurora":[],"study_designs":[],"awards":[],"funders":[],"has_content":{"grobid_xml":false,"pdf":false},"content_urls":null,"referenced_works_count":0,"referenced_works":[],"related_works":[],"abstract_inverted_index":{"BACKGROUND":[0],"AND":[1,167],"OBJECTIVE:":[2],"Intrahepatic":[3],"cholangiocarcinoma":[4],"(iCCA)":[5],"is":[6,25,86,293,301],"an":[7],"aggressive":[8],"primary":[9],"liver":[10,35,176],"malignancy":[11],"with":[12,19,121,171,206,236,253,322,335],"rising":[13],"global":[14],"incidence;":[15],"most":[16,328],"patients":[17,205],"present":[18],"unresectable":[20,70],"disease,":[21],"and":[22,52,76,79,139,144,158,228,280,320],"intrahepatic":[23],"recurrence":[24],"common":[26],"after":[27],"curative-intent":[28],"surgery.":[29],"Locoregional":[30],"therapies":[31],"(LRTs),":[32],"including":[33],"future":[34],"remnant":[36],"(FLR)":[37],"augmentation,":[38],"percutaneous":[39],"ablation,":[40],"transarterial":[41,44],"chemoembolization":[42],"(TACE),":[43],"radioembolization":[45],"(TARE),":[46],"hepatic":[47,272],"arterial":[48,273],"infusion":[49,274],"chemotherapy":[50,256],"(HAIC),":[51],"stereotactic":[53],"body":[54],"radiotherapy":[55],"(SBRT),":[56],"are":[57,338],"increasingly":[58],"applied":[59],"across":[60],"the":[61,125,180,259,268,327],"disease":[62,192],"continuum.":[63],"This":[64],"narrative":[65],"review":[66],"focuses":[67],"primarily":[68],"on":[69,136],"iCCA,":[71],"while":[72],"also":[73],"addressing":[74],"surgical-adjunct":[75],"downstaging":[77],"roles,":[78],"aims":[80],"to":[81,190,200,225,295,310,340],"clarify":[82],"how":[83],"each":[84],"modality":[85],"best":[87],"integrated":[88],"within":[89],"modern":[90,323],"multimodal":[91],"management.":[92],"METHODS:":[93],"We":[94],"performed":[95,133],"a":[96,214,288],"focused":[97],"literature":[98],"search":[99],"of":[100,182,262,271,313],"PubMed/MEDLINE":[101],"for":[102,134,217,240,250],"English-language":[103],"publications":[104],"from":[105,258,307],"January":[106],"2000":[107],"through":[108],"March":[109],"2026,":[110],"combining":[111],"population":[112],"terms":[113,123],"(\"cholangiocarcinoma\",":[114],"\"intrahepatic":[115],"cholangiocarcinoma\",":[116],"\"iCCA\",":[117],"\"biliary":[118],"tract":[119],"cancer\")":[120],"intervention":[122],"covering":[124],"principal":[126],"locoregional":[127],"modalities.":[128],"Supplementary":[129],"targeted":[130,140],"searches":[131],"were":[132,163],"context":[135],"epidemiology,":[137],"systemic":[138,255,278,324],"therapy,":[141],"biology,":[142],"imaging,":[143],"current":[145,159],"guidelines.":[146],"Randomized":[147],"trials,":[148],"prospective":[149,248,299],"cohort":[150],"studies,":[151],"large":[152],"multicenter":[153],"retrospective":[154,285],"series,":[155],"systematic":[156],"reviews,":[157],"clinical":[160],"practice":[161],"guidelines":[162],"prioritized.":[164],"KEY":[165],"CONTENT":[166],"FINDINGS:":[168],"FLR":[169],"augmentation":[170],"portal":[172],"vein":[173],"embolization":[174],"or":[175,209,220,243],"venous":[177],"deprivation":[178],"expands":[179],"pool":[181],"surgical":[183],"candidates":[184],"but":[185,298],"requires":[186],"careful":[187],"interval":[188],"management":[189],"limit":[191],"progression.":[193],"Thermal":[194],"ablation":[195],"can":[196],"yield":[197],"outcomes":[198],"comparable":[199,231],"repeat":[201],"resection":[202],"in":[203,233],"selected":[204,234],"small":[207],"recurrent":[208],"solitary":[210],"lesions;":[211],"SBRT":[212],"offers":[213],"non-invasive":[215],"option":[216],"centrally":[218],"located":[219],"perihilar":[221],"tumors":[222],"not":[223],"amenable":[224],"ablation.":[226],"TACE":[227],"TARE":[229,237],"achieve":[230],"survival":[232,289],"patients,":[235],"often":[238],"preferred":[239],"infiltrative,":[241],"unilobar,":[242],"portal-vein-compromised":[244],"disease.":[245],"The":[246],"strongest":[247],"evidence":[249],"LRT":[251,292],"integration":[252,321],"first-line":[254,296],"comes":[257],"MISPHEC":[260],"trial":[261,270],"concomitant":[263],"Y-90":[264],"SIRT":[265],"plus":[266,277],"gemcitabine/cisplatin,":[267,279],"PUMP-2":[269],"pump":[275],"floxuridine":[276],"pooled":[281],"comparative":[282],"analyses.":[283],"Emerging":[284],"data":[286],"suggest":[287],"benefit":[290],"when":[291],"added":[294],"chemoimmunotherapy,":[297],"confirmation":[300],"awaited.":[302],"CONCLUSIONS:":[303],"LRTs":[304],"have":[305],"evolved":[306],"salvage":[308],"interventions":[309],"integral":[311],"components":[312],"multidisciplinary":[314],"iCCA":[315],"care.":[316],"Stage-stratified,":[317],"biology-informed":[318],"selection":[319],"backbones":[325],"offer":[326],"promising":[329,342],"path":[330],"forward.":[331],"Prospective,":[332],"modality-stratified":[333],"trials":[334],"standardized":[336],"endpoints":[337],"needed":[339],"translate":[341],"signals":[343],"into":[344],"evidence-based":[345],"practice.":[346]},"counts_by_year":[],"updated_date":"2026-09-29T14:09:16.559479","created_date":"2026-08-28T00:00:00"}
