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Pathological Diagnosis and Surgical Treatment of Cholangiocarcinoma: Current Status and Novel Perspectives

A special issue of Cancers (ISSN 2072-6694).

Deadline for manuscript submissions: 30 October 2026 | Viewed by 529

Editor


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Guest Editor
Department of Hepato-Biliary-Pancreatic Surgery, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
Interests: cholangiocarcinoma; intrahepatic cholangiocarcinoma; hepatobiliary surgery; fluorescence-guided surgery; tumor microenvironment

Special Issue Information

Dear colleagues,

Cholangiocarcinoma (CCA) remains one of the most aggressive malignancies of the hepatobiliary system, characterized by late diagnosis, limited treatment options, and poor prognosis. Recent advances in systemic therapy, particularly the introduction of immune checkpoint inhibitors (ICIs), have opened new horizons, leading to encouraging outcomes, including successful conversion surgeries in initially unresectable cases. Nevertheless, reliable predictive biomarkers for treatment response and long-term outcomes remain insufficiently established.

CCA comprises a heterogeneous group of tumors that arise in both intrahepatic and extrahepatic bile ducts. Intrahepatic cholangiocarcinoma (iCCA) itself can be further subdivided into small-duct and large-duct types, each with distinct clinicopathological and molecular features. This diversity within CCA poses significant challenges to uniform diagnosis and treatment, and may in part explain the slow progress in establishing robust biomarkers and tailored therapeutic strategies.

This Special Issue aims to provide an updated and multidisciplinary overview of the pathological diagnosis, molecular biomarkers, and surgical strategies in CCA, fostering discussion on how pathological and translational insights can guide future therapeutic developments. We welcome original research articles, clinical studies, and comprehensive reviews that explore innovative diagnostic methods, biomarkers for patient stratification, and novel surgical or multimodal treatment approaches.

We look forward to receiving your valuable contributions.

Dr. Masahiko Kinoshita
Guest Editor

Manuscript Submission Information

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Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-anonymized peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Cancers is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2900 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • cholangiocarcinoma
  • intrahepatic cholangiocarcinoma
  • small-duct type
  • large-duct type
  • immune checkpoint inhibitor
  • conversion surgery

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Published Papers (1 paper)

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Research

13 pages, 1194 KB  
Article
Immune Microenvironmental Analysis of Intraductal Papillary Neoplasms of the Bile Duct in Occupational Cholangiocarcinoma: Associations with Tumor Size
by Masahiko Kinoshita, Shoji Kubo, Kimika Kato, Daisuke Inoue, Takuto Yasuda, Kosuke Hatta, Atsushi Sugimoto, Ryota Tanaka, Jun Tauchi, Sadaaki Nishimura, Genki Watanabe, Kohei Nishio, Hiroji Shinkawa, Takeaki Ishizawa and Yasunori Sato
Cancers 2026, 18(16), 2539; https://doi.org/10.3390/cancers18162539 - 7 Aug 2026
Viewed by 240
Abstract
Background/Objectives: Intraductal papillary neoplasm of the bile duct (IPNB) is a premalignant lesion of cholangiocarcinoma. Currently, its tumor immune microenvironment (TIME) remains poorly characterized. Occupational cholangiocarcinoma provides a unique setting wherein multiple IPNBs arise in a background of chronic biliary injury caused by [...] Read more.
Background/Objectives: Intraductal papillary neoplasm of the bile duct (IPNB) is a premalignant lesion of cholangiocarcinoma. Currently, its tumor immune microenvironment (TIME) remains poorly characterized. Occupational cholangiocarcinoma provides a unique setting wherein multiple IPNBs arise in a background of chronic biliary injury caused by organic solvents. This study evaluated TIME alternations in IPNB lesions in occupational cholangiocarcinoma, focusing on histological subclassifications, phenotypes, invasive status, and tumor size. Methods: Thirteen IPNB lesions in six patients with occupational cholangiocarcinoma were immunohistochemically stained for CD8, CD163, programmed death protein 1 (PD-1), and programmed death ligand 1 (PD-L1). CD8-, CD163-, and PD-1-positive cells were counted in the most densely infiltrated areas. PD-L1 expression was assessed using the combined positive score (CPS), and associations with each status were analyzed. Results: Within the occupational IPNB cohort, type 2 IPNBs demonstrated significantly higher CD8, CD163, and PD-1 expression levels than type 1 IPNBs. Invasive lesions showed significantly higher CD8 expression and CPS than noninvasive lesions. Tumor size was positively correlated with CD163 expression (R = 0.504), CD8 expression (R = 0.627), and CPS (R = 0.569) in the TIME. When stratified by tumor size (<10 vs. ≥10 mm), lesions ≥ 10 mm in size demonstrated significantly higher CD163 expression and CPS. Notably, all lesions with CPS ≥1 were ≥10 mm in size. Conclusions: In IPNB arising from occupational cholangiocarcinoma, tumor enlargement is associated with progressive TIME alterations. Lesions ≥ 10 mm in size may represent a threshold at which immunoediting and invasive potential become more prominent. Full article
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