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

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.

The significance of cirrhosis in cases with intra-hepatic cholangiocarcinoma: A SEER-based retrospective cohort study

“…The HR of cirrhosis in our research is higher than 1, suggesting that cirrhosis itself is a risk factor, which was consistent with ndings by Wang J et al(2) and Wei T et al (14). Comparable long-term survival was acquired between cases with cirrhosis and those without cirrhosis even after matching, suggesting that the survival impact of cirrhosis is limited among IHCC cases and the actual factors determining the overall prognosis is the tumor stage, which has also been validated in previous publications (2,14).…”

“…For patients with liver malignancies, cases with cirrhosis often could only tolerate a smaller range of surgical resection, share a lower chance of achieving the clear surgical margin, and therefore share a poorer prognosis. The signi cance of cirrhosis in cases with IHCC has been systematically evaluated by Wang J et al based on the public Surveillance, Epidemiology, and End Results (SEER) database (2). Their results indicated that cirrhosis was not associated with a worse prognosis in cases with IHCC even after propensity score matching (PSM) (2).…”

“…The signi cance of cirrhosis in cases with IHCC has been systematically evaluated by Wang J et al based on the public Surveillance, Epidemiology, and End Results (SEER) database (2). Their results indicated that cirrhosis was not associated with a worse prognosis in cases with IHCC even after propensity score matching (PSM) (2). Their study was performed based on an aged cohort (SEER databases, 2021).…”