Comparison of clinicopathological characteristics between cirrhotic and non‑cirrhotic patients with intrahepatic cholangiocarcinoma: A large‑scale retrospective study

Yuan,Lei; Luo,Xianwu; Lu,Xinyuan; Yi,Bin; Chu,Kaijian; Cai,Quanyu; Jiang,Xiaoqing

doi:10.3892/mco.2017.1387

Comparison of clinicopathological characteristics between cirrhotic and non‑cirrhotic patients with intrahepatic cholangiocarcinoma: A large‑scale retrospective study

Authors:
- Lei Yuan
- Xianwu Luo
- Xinyuan Lu
- Bin Yi
- Kaijian Chu
- Quanyu Cai
- Xiaoqing Jiang
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Affiliations: The First Department of Biliary Surgery, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai 200438, P.R. China, Department of Pathology, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai 200438, P.R. China, Department of Medical Imaging, Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai 200438, P.R. China
Published online on: August 22, 2017 https://doi.org/10.3892/mco.2017.1387
Pages: 615-622

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Abstract

The effect of cirrhosis on the characteristics of intrahepatic cholangiocarcinoma (ICC) has not been fully elucidated. The purpose of this study was to investigate how cirrhosis affects the clinicopathological characteristics and survival of surgically treated ICC patients. A total of 1,312 ICC patients surgically treated between January 2007 and December 2011 at a single institution were retrospectively reviewed and the clinicopathological data were compared between cirrhotic and non‑cirrhotic patients. Univariate and multivariate analyses were performed to identify significant and independent prognostic factors in this cohort. A total of 302 patients (23.0%) were cirrhotic. Compared with cirrhotic patients, the tumors in non‑cirrhotic patients were usually larger, less differentiated, and more likely to have lymphatic metastasis, vascular and perineural invasion. Following resection, cirrhotic patients achieved a longer survival compared with non‑cirrhotic patients (16.0 vs. 13.0 months, respectively; P<0.038). Multivariate analysis demonstrated that hepatitis B virus infection and cirrhosis were independent favorable prognostic factors, while the presence of cholelithiasis, elevated carbohydrate antigen 19‑9 and carcinoembryonic antigen levels, multiple tumors, lymphatic metastasis, vascular invasion and positive surgical margin status were independent unfavorable prognostic factors. Overall, the clinicopathological characteristics of ICC patients with and without cirrhosis differed significantly. Compared with cirrhotic patients, in whom the biological behavior of ICC was similar to that of HCC, non‑cirrhotic patients exhibited higher‑risk pathological characteristics, lower curative resection rate and worse survival.

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