Impact of cirrhosis on long-term survival outcomes of patients with intrahepatic cholangiocarcinoma

Cancer Med. 2022 Oct;11(19):3633-3642. doi: 10.1002/cam4.4740. Epub 2022 Apr 12.

Abstract

Background: The correlation between cirrhosis and the long-term oncological outcome in intrahepatic cholangiocarcinoma (ICC) is debatable, and this study aimed to explore the impact of cirrhosis on the long-term prognosis of patients with ICC.

Methods: A total of 398 ICC patients were identified in the Surveillance, Epidemiology, and End Results (SEER) database from 2000 to 2018. The diagnosis of cirrhosis was based on the Ishak fibrosis score provided by the SEER database. Propensity score matching (PSM) and inverse probability of treatment weighting (IPTW) analysis were performed to minimize the potential confounders. Overall survival (OS) and cancer-specific survival (CSS) were observed, and the Cox regression model was used to select potential factors that affect the prognosis of the patients with ICC.

Results: Of the included patients, there were 142 patients and 256 patients in the cirrhotic and noncirrhotic groups, respectively. Additionally, 299 of 398 patients (75.1%) died following a median follow-up of 19 months (interquartile range [IQR], 7, 43). The OS and CSS indicated advantage trend in the noncirrhotic group than the cirrhotic group in either the original cohort (OS: 17 vs 12 months, p = 0.023; CSS: 26 vs 15 months, p = 0.004) or the PSM (OS: 17 vs 12 months, p = 0.52; CSS: 22 vs 14 months, p = 0.15) or IPTW (OS: 20 vs 13 months, p = 0.163; CSS: 22 vs 15 months, p = 0.059) cohorts. Subgroup analyses displayed that the prognosis of patients who experienced surgery for ICC in the noncirrhotic group was better than that of the cirrhotic group with regard to OS and CSS.

Conclusions: Collectively, it seems that the noncirrhotic patients have similar relative OS but better CSS compared with that of the cirrhotic patients.

Keywords: SEER database; cirrhosis; intrahepatic cholangiocarcinoma (ICC); prognosis; propensity score matching (PSM).

MeSH terms

  • Bile Duct Neoplasms* / pathology
  • Bile Ducts, Intrahepatic / pathology
  • Cholangiocarcinoma* / pathology
  • Humans
  • Liver Cirrhosis / complications
  • Liver Cirrhosis / pathology
  • Prognosis