What follow-up protocols should be in place for patients treated for cholangiocarcinoma to monitor for recurrence?

Follow-up protocols for patients treated for cholangiocarcinoma to monitor for disease recurrence are not explicitly detailed in the provided UK NICE guidelines. However, by analogy with other gastrointestinal cancers such as oesophago-gastric cancer, routine clinical follow-up or radiological surveillance solely for the detection of recurrent disease is generally not recommended if the patient is asymptomatic and there is no evidence of residual disease after curative treatment.

Therefore, for cholangiocarcinoma, in the absence of specific NICE guidance, it is reasonable to avoid routine surveillance imaging or clinical follow-up solely aimed at detecting recurrence in asymptomatic patients post-treatment, unless symptoms or clinical findings suggest recurrence.

Follow-up should instead focus on symptom assessment and clinical evaluation, with investigations guided by clinical indications rather than routine surveillance.