It accounts for approximately 15% of liver cancer worldwide [2].
This cancer can be classified into three major groups, i.e., intrahepatic, perihilar and distal extrahepatic cholangiocarcinoma.
Intrahepatic type is the most common case of cholangiocarcinoma in Thailand and infestation of Opisthorchis viverrini has been classified as a definite risk factor of the disease [3].
The lack of early detection and limited therapeutic options are major problems for controlling this type of cancer.
At present, surgical resection of detectable tumors leads to an improvement in the 5-year survival rate.
Adjunctive therapy with chemotherapeutic agents has been shown to improve local control, provide palliation, and prolong survival [4].
Even those with operable tumor, the recurrence rate is extremely high, with a 5-year survival rate of less than 40% [5, 6].
Chemotherapeutic treatment of cholangiocarcinoma is largely ineffective; the standard chemotherapeutic agent, 5-fluorouracil (5-FU) always produces low clinical response rate [6, 7, 8].
Advanced surgical techniques in conjunction with alternative chemotherapeutic option with promising activity are required to improve the survival of patients.
Cholangiocarcinoma is considered to be a multidrug and radio-resistant tumor and still require new approach of treatments [9].