A Single-arm Study of Gemcitabine, Cisplatin, and Nab-Paclitaxel as Neoadjuvant Therapy for Resectable Oncologically High-Risk IHCC in Korea

Inclusion Criteria:

1. Diagnosis of intrahepatic cholangiocarcinoma
2. Oncologic high-risk disease at the time of enrollment defined as T-stage ≥ Ib (Ib - IV) Solitary lesion \> 5 cm
3. Multifocal tumors or satellite lesions present confined to the same lobe of the liver as the dominant lesion but still technically resectable
4. Presence of major vascular invasion but still technically resectable
5. Suspicious or involved regional lymph nodes (N1)
6. No distant extrahepatic disease (M0)
7. High-quality cross-sectional imaging (CT or MRI) performed within 4 weeks prior to enrollment
8. Adults \>18 years of age
9. Able to give informed consent
10. Able to adhere to study visit schedule and other protocol requirements
11. ECOG performance status of 0-1
12. Absolute neutrophil count ≥ 1500/mm3 13Platelet count ≥ 100,000/mm3

14.Albumin ≥3 g/dl

Exclusion Criteria:

* Serum creatinine \> 1.5x upper limit of normal
* Serum total bilirubin \> 1.5x upper limit of normal
* Presence of active infection
* Pregnant and/or breastfeeding
* Active other primary malignancy
* Concurrent severe and/or uncontrolled medication conditions which could compromise participation in study such as unstable angina, MI within 6 months, unstable symptomatic arrhythmia, symptomatic CHF, serious active or uncontrolled infection after inadequate biliary drainage if tumor obstructing bile duct.