Treatment options include liver resection or transplantation and radiation therapy. Although, the general prognosis is poor, with low 5year survival rates of usually less than 20 % , a 65 % cure rate may be achieved in some cases with perihilar cholangiocarcinoma that were treated with neoadjuvant therapy followed up by liver surgery [22]. There is increasing evidence that early diagnosis leading to liver resection can substantially improved the patient’s chances of survival and quality of life. However, strategies for determining the main population at risk and thus for developing an effective screening program remain to be developed.