Surgical resection provides the best hope but is suitable in only a few cases. Patients with small localized tumors may have prolonged survival after resection, but the diagnosis is usually established late, and death often occurs within a few months. The tumor is not radiosensitive, and chemotherapy is usually unsuccessful, even when hepatic artery infusion or chemoembolization is used. It remains to be proven whether routine screening of high-risk individuals can lower mortality from the disease. Moderately good long-term survival rates have been reported after liver transplantation, but this may largely reflect selection bias for patients with relatively small localized tumors.
Most experts remain wary of transplantation for malignancy.
It usually occurs in young adults and has no association with preexisting cirrhosis, HBV or HCV, or other known risk factors. The prognosis is better than for hepatocellular carcinoma, and some patients survive several years after tumor resection. Cholangiocarcinoma, a tumor arising from biliary epithelium, is common in China, where underlying infestation with liver flukes is believed partially responsible. Elsewhere, it is less common than hepatocellular carcinoma. Histologic overlap between the two may occur.