Assessing prognosis in cholangiocarcinoma: a review of promising genetic markers and imaging approaches

Introduction: Despite the progress in the treatment of liver cancer, the prognosis of CCA remains poor and the surgical resection remains the only treatment with a potentially curative intent to date. Areas covered: Advances in the knowledge of cholangiocarcinoma regarding the mutational status and radiological of the tumor have been reviewed searching the most updated papers using MEDLINE and EMBASE databases. Recent studies have investigated the mutational status and the imaging features of CCA patients in order to identify new factors correlated with the prognosis in CCA patients who underwent surgical resection. Moreover, the discovery of some gene mutations has led to the development of personalized therapy in CCA patients. Investigation of the mutational profile of CCA patients has been characterized by analysis of the incidence of single-gene mutations, patterns of gene mutations as well as the role of ncRNa alterations. Two innovative radiological sectors (radiomics and radiogenomics), investigating the associations between the imaging features and the molecular profiles, have contributed to knowledge of CCA biology. Expert opinion: The analysis of the mutational profile and application of radiogenomics/radiomics represent promising fields in the identification of new targets toward a more personalized treatment approach for CCA patients.