肝内胆管癌（ICC）的分期很复杂，国际癌症组织对于如何最合适地选择非转移性疾病患者进行手术切除尚未达成共识。导致疾病更高级的因素包括较大的肿瘤大小、多发性肿瘤、血管侵犯（门静脉或动脉）、胆道侵犯、局部肝结构受累、浆膜侵犯和区域淋巴结转移。对于选择接受手术的患者，有充分证据表明，R0 切除可带来生存获益。估计肝切除术后肝功能衰竭和术后残余肝功能的风险至关重要，并且可能会阻止一些肿瘤负荷严重的患者接受手术。该疾病的许多血清和胆汁生物标志物可以帮助检测接受手术切除的患者的复发情况。为促进更好的手术结果而进行的全身和局部新辅助治疗在改善可切除性和总体生存率方面取得了不同的结果。需要进行更多的研究来确定最佳的新辅助治疗方法并评估哪些患者将从这些策略中受益最多。针对肿瘤分子分析发现的基因突变和蛋白质畸变的疗法可能为未来的新辅助治疗提供更多选择。

The staging of intrahepatic cholangiocarcinoma (ICC) is complex, and there is no consensus among international cancer groups on how to most appropriately select candidates with nonmetastatic disease for surgical resection. Factors contributing to a higher stage of disease include larger tumor size, multiple tumors, vascular invasion (either portal venous or arterial), biliary invasion, involvement of local hepatic structures, serosal invasion, and regional lymph node metastases. For patients selected to undergo surgery, it is well-documented that R0 resection translates to a survival benefit. Estimating the risk of post-hepatectomy liver failure and post-surgical residual liver function is vital and may preclude some patients with significant tumor burden from undergoing surgery. Numerous serum and biliary biomarkers of the disease can help detect recurrence in patients undergoing surgical resection. Systemic and locoregional neoadjuvant treatments to facilitate better surgical outcomes have yielded mixed results regarding improving resectability and overall survival. Additional research is needed to identify optimal neoadjuvant treatment approaches and to evaluate which patients will benefit most from these strategies. Therapies targeting genetic mutations and protein aberrations found by tumor molecular profiling may offer additional options for future neoadjuvant treatment.