Background: Cholangiocarcinomas are highly lethal and rare cancers that account for approximately 3% of all gastrointestinal cancers in the United States. The incidence in the United States is 8 per 100,000. Data from the SEER program suggest 15% of all liver diagnosed cancers are intrahepatic cholangiocarcinoma. Approximately 1/3 of patients are under age 65 at diagnosis. The majority of patients are over 70 years of age. The 5-year survival is estimated to be from 2% to 30%. The purpose of this comprehensive review of literature was to establish evidence-based guidelines for nurses and physicians caring for patients diagnosed with cholangiocarcinoma. The specific aims were to assist physicians and nurses in implementing evidence-based care through an understanding of cholangiocarcinoma patients undergoing, surgery, chemotherapy, radiation therapy, or a clinical trial, and to be able to manage symptoms of biliary obstruction, and toxicities from treatment.
Methods: A collaboration of nursing professionals from major academic cancer centers in the United States and United Kingdom identified concepts of care to develop Clinical Nursing Practice Guidelines. This included a comprehensive literature review utilizing scientific and medical databases, submission of institutional practices, group consensus on content, an evidence-based scoring system, and approval by the Cholangiocarcinoma Medical Advisory Board.
Results: Evidence-based guidelines for nursing practice were developed which included: care of the patient receiving chemotherapy and radiation, caring for patients with treatment toxicities including radiation and chemotherapy, care of the patient preparing for treatment on a clinical trial, and care of the patient preparing for liver transplant.
Conclusions: Evidence-based guidelines will provide a knowledge base and guidance for nurses and physicians caring for patients with cholangiocarcinoma internationally. It also allows for identification of evidence gaps for future research and improvement of quality.
