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. 2017:2017:6543423.
doi: 10.1155/2017/6543423. Epub 2017 Nov 12.

Prognostic Impact of Cirrhosis in Patients with Intrahepatic Cholangiocarcinoma following Hepatic Resection

Seogsong Jeong  1 , Lei Gao  2 , Ying Tong  1 , Lei Xia  1 , Ning Xu  1 , Meng Sha  1 , Jianjun Zhang  1 , Xiaoni Kong  1 , Jinyang Gu  1 , Qiang Xia  1
Affiliations

Prognostic Impact of Cirrhosis in Patients with Intrahepatic Cholangiocarcinoma following Hepatic Resection

Seogsong Jeong et al. Can J Gastroenterol Hepatol. 2017.

Abstract

Background: Prognostic impact of cirrhosis in patients with intrahepatic cholangiocarcinoma (ICC) upon hepatic resection remains unclear due to lack of studies in the literature.

Methods: A total of 106 resected patients with ICC were reviewed, including 25 patients (23.6%) with cirrhosis and 81 noncirrhotic patients (76.4%). Subgroups of cirrhotic patients with and without hepatitis B virus (HBV) infection were studied.

Results: The impact of cirrhosis on the overall survival (OS) (hazard ratio [HR], 0.901; 95% confidence interval [CI], 0.510 to 1.592; P = 0.720) and the relapse-free survival (RFS) (HR, 0.889; 95% CI, 0.509 to 1.552; P = 0.678) revealed no statistical significance. Furthermore, HBV-associated cirrhotic patients and the other cirrhotic patients demonstrated no statistical difference on survival outcomes (1 yr OS, 60.0% versus 70.0%; 5 yr OS, 10.0% versus 0%; P = 0.744; 1 yr RFS, 53.3% versus 30.0%; 5 yr RFS, 10.0% versus 0%; P = 0.279). In patients with cirrhosis, tumor size larger than 5 cm was found to be the foremost factor that was independently associated with poor prognosis.

Conclusion: The presence of liver cirrhosis did not significantly affect prognosis of patients with ICC after resection. Downstaging modality may be in need for patients with ICC underlying cirrhosis, which remains to be validated in future studies.

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Figures

Figure 1
Figure 1
Survival outcomes of the patients with and without cirrhosis. Shown are the impact of cirrhosis on the OS (Panel (a)) and RFS (Panel (b)) of the entire cohort. The data revealed that the presence of cirrhosis showed no association with the OS (HR, 0.882; 95% CI, 0.501 to 1.552; P = 0.664) and RFS (HR, 0.869; 95% CI, 0.499 to 1.513; P = 0.619) of the patients.
Figure 2
Figure 2
Survival curves of the patients according to the presence of HBV infection and cirrhosis. Shown are the survival curves of the HBV-associated cirrhotic patients (Group 1), HBV-associated noncirrhotic patients (Group 2), HBV-negative cirrhotic patients (Group 3), and HBV-negative noncirrhotic patients (Group 4) on the OS (Panel (a)) and RFS (Panel (b)). The curves demonstrated no significant between-group differences except for Group 2 and Group 4 in the RFS (P = 0.011). The most favorable prognosis was found in Group 2 (1-yr OS, 66.7%; 5-yr OS, 16.7%; median survival for OS, 37 months; 1-yr RFS, 55.6%; 5-yr RFS, 16.7%; median survival for RFS, 24 months) and Group 4 showed the worst prognosis (1-yr OS, 44.4%; 5-yr OS, 11.1%; median survival for OS, 10.5 months; 1-yr RFS, 29.6%; 5-yr RFS, 10.4%; median survival for RFS, 3 months).
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