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. 2023 Feb 22;30(3):2613-2624.
doi: 10.3390/curroncol30030199.

Bone Metastases from Intrahepatic Cholangiocarcinoma Confer Worse Prognosis

Ingrid Garajová  1 , Fabio Gelsomino  2 , Massimiliano Salati  2 , Francesco Leonardi  1 , Stefania De Lorenzo  3 , Alessandro Granito  4 , Francesco Tovoli  4
Affiliations

Bone Metastases from Intrahepatic Cholangiocarcinoma Confer Worse Prognosis

Ingrid Garajová et al. Curr Oncol. .

Abstract

Background: Metastatic intrahepatic cholangiocarcinoma still has a dismal prognosis. The aim of our study was to investigate the prognostic role of bone metastases in patients affected by intrahepatic cholangiocarcinoma.

Methods: A total of 186 metastatic intrahepatic cholangiocarcinoma patients were retrospectively reviewed. Clinicopathologic and survival data were collected and reviewed, in particular overall survival, progression-free survival after first-line treatment and time from end of first-line therapy to cancer death.

Results: Around 11% of intrahepatic cholangiocarcinoma patients developed bone metastases. This subgroup of patients showed no differences in progression-free survival to first-line chemotherapy but had a shorter median overall survival of 4 months compared to the group with liver involvement only (p = 0.03). If treated, the outcome for ECOG PS 2 patients with bone metastases was worse in comparison to patients with liver involvement only with poor performance status (p = 0.003). The presence of bone metastases, poor performance status and no subsequent second-line treatment was associated with a worse outcome in multivariate analysis.

Conclusions: Patients with intrahepatic carcinoma and bone metastases with poor ECOG performance status might be treated with best supportive care and not active chemotherapy treatment, the decisions which have to be shared with patients.

Keywords: bone metastases; cholangiocarcinoma; intrahepatic; outcome; survival.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
OS in Group C, in comparison to Group B (p = 0.234) and in comparison to Group A (p = 0.03). Median OS in Group A was 11 months (95% CI 8.3–13.6 months), in Group B was 7 months (95% CI 5.1–8.9 months) and in Group C was 4 months (95% CI 1.0–8.3 months).
Figure 2
Figure 2
PFS did not differ between the three groups of patients (Group A vs. Group C with p = 0.44, Group B vs. Group C with p = 0.47, Group A vs. Group B with p = 0.68). Median PFS for all three groups was 4 months (95% CI 3.4–4.6 months).
Figure 3
Figure 3
Second-line treatment and OS: better OS for ICC patients who underwent second-line treatment in Group A, p < 0.001 (a), Group B, p < 0.001 (b) and Group C, p < 0.001 (c).
Figure 4
Figure 4
TTD with statistically significant difference between Group A and Group C (p = 0.016) and Group A and Group B (p = 0.007). Median TTD in Group A was 6 months (95% CI 4.2–7.8 months), in Group B was 2 months (95% CI 1.0–3.1 months) and in Group C was 1 months (95% CI 1.0–2.1 months).
Figure 5
Figure 5
OS according to ECOG PS before first-line therapy initiation. The median OS for ECOG PS 0 group was 14 months (95% CI 10.7–17.3 months), in comparison to ECOG PS 3 with median OS of 2 months (95% CI 1.0–3.8 months).
Figure 6
Figure 6
OS for ECOG PS 2 patients, with a statistically significant difference in OS between Group A and Group C (p = 0.003) and between Group A and B (p = 0.04).
See this image and copyright information in PMC

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