Patients with chronic liver disease (CLD) present with cholangiocarcinoma (CCA) at earlier stages and experience improved survival rates compared to non-CLD patients.

• CLD patients had a higher frequency of early-stage disease (57% localized vs. 43% in non-CLD) and more often qualified for curative-intent surgery (60% vs. 48%).
• Median overall survival was longer for CLD patients (12.2 months vs. 11.1 months, HR 0.88).

Surgeons should consider implementing structured surveillance for high-risk CLD patients to facilitate earlier diagnosis and potentially improve surgical outcomes.