Cirrhosis in intrahepatic cholangiocarcinoma: prognostic importance and impact on survival
Abstract Context Cholangiocarcinoma (CCA), a malignancy of the biliary tract epithelium is of increasing importance due to its rising incidence worldwide. There is a lack of data on cirrhosis in intrahepatic CCA (iCCA) and how it affects overall survival and prognosis. Objectives The primary objecti...
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| Format: | Article |
| Language: | English |
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BMC
2023-05-01
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| Series: | BMC Gastroenterology |
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| Online Access: | https://doi.org/10.1186/s12876-023-02710-w |
| _version_ | 1797827499561844736 |
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| author | Nimish Thakral Teresita Gonzalez Olger Nano Sang-Ha Shin Shenae Samuels Atif Hussein |
| author_facet | Nimish Thakral Teresita Gonzalez Olger Nano Sang-Ha Shin Shenae Samuels Atif Hussein |
| author_sort | Nimish Thakral |
| collection | DOAJ |
| description | Abstract Context Cholangiocarcinoma (CCA), a malignancy of the biliary tract epithelium is of increasing importance due to its rising incidence worldwide. There is a lack of data on cirrhosis in intrahepatic CCA (iCCA) and how it affects overall survival and prognosis. Objectives The primary objective of this study was to examine if there were differences in survival outcomes between iCCA patients with concomitant cirrhosis and those without cirrhosis. Methods The National Cancer Database (NCDB) was used to identify and study patients with iCCA from 2004 to 2017. The presence of cirrhosis was defined using CS Site-Specific Factor 2 where 000 indicated no cirrhosis and 001 indicated the presence of cirrhosis. Descriptive statistics were utilized for patient demographics, disease staging, tumor, and treatment characteristics. Kaplan-Meier (KM) method with log-rank test and a multivariate logistic regression model was used to assess if the presence of cirrhosis in iCCA was associated with survival status and long-term survival (60 or more months after diagnosis). Results There were 33,160 patients with CCA in NCDB (2004–2017), of which 3644 patients were diagnosed with iCCA. One thousand fifty-two patients (28.9%) had cirrhosis as defined by Ishak Fibrosis score 5–6 on biopsy and 2592 patients (71.1%) did not meet the definition for cirrhosis. Although in univariate analyses using KM/log-rank tests showed a survival advantage for non-cirrhotic patients, there was no statistically significant association found between cirrhosis and survival status (OR = 0.82, p = 0.405) or long-term survival (OR = 0.98, p = 0.933) when multivariate analysis was used. iCCA patients with cirrhosis and Stage 1 tumor had the highest median OS (132 months) vs 73.7 months in the non-cirrhotic arm, while patients with stage IV disease who had cirrhosis had half the survival time of those without. Our data thus indicates that the presence of cirrhosis is not an independent prognostic factor for survival. |
| first_indexed | 2024-04-09T12:49:18Z |
| format | Article |
| id | doaj.art-48f311df006c49bea090a33c233cf185 |
| institution | Directory Open Access Journal |
| issn | 1471-230X |
| language | English |
| last_indexed | 2024-04-09T12:49:18Z |
| publishDate | 2023-05-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Gastroenterology |
| spelling | doaj.art-48f311df006c49bea090a33c233cf1852023-05-14T11:18:47ZengBMCBMC Gastroenterology1471-230X2023-05-0123111210.1186/s12876-023-02710-wCirrhosis in intrahepatic cholangiocarcinoma: prognostic importance and impact on survivalNimish Thakral0Teresita Gonzalez1Olger Nano2Sang-Ha Shin3Shenae Samuels4Atif Hussein5Department of Hepatology, University of KentuckyMemorial Healthcare SystemMemorial Healthcare SystemMemorial Healthcare SystemMemorial Healthcare SystemMemorial Healthcare SystemAbstract Context Cholangiocarcinoma (CCA), a malignancy of the biliary tract epithelium is of increasing importance due to its rising incidence worldwide. There is a lack of data on cirrhosis in intrahepatic CCA (iCCA) and how it affects overall survival and prognosis. Objectives The primary objective of this study was to examine if there were differences in survival outcomes between iCCA patients with concomitant cirrhosis and those without cirrhosis. Methods The National Cancer Database (NCDB) was used to identify and study patients with iCCA from 2004 to 2017. The presence of cirrhosis was defined using CS Site-Specific Factor 2 where 000 indicated no cirrhosis and 001 indicated the presence of cirrhosis. Descriptive statistics were utilized for patient demographics, disease staging, tumor, and treatment characteristics. Kaplan-Meier (KM) method with log-rank test and a multivariate logistic regression model was used to assess if the presence of cirrhosis in iCCA was associated with survival status and long-term survival (60 or more months after diagnosis). Results There were 33,160 patients with CCA in NCDB (2004–2017), of which 3644 patients were diagnosed with iCCA. One thousand fifty-two patients (28.9%) had cirrhosis as defined by Ishak Fibrosis score 5–6 on biopsy and 2592 patients (71.1%) did not meet the definition for cirrhosis. Although in univariate analyses using KM/log-rank tests showed a survival advantage for non-cirrhotic patients, there was no statistically significant association found between cirrhosis and survival status (OR = 0.82, p = 0.405) or long-term survival (OR = 0.98, p = 0.933) when multivariate analysis was used. iCCA patients with cirrhosis and Stage 1 tumor had the highest median OS (132 months) vs 73.7 months in the non-cirrhotic arm, while patients with stage IV disease who had cirrhosis had half the survival time of those without. Our data thus indicates that the presence of cirrhosis is not an independent prognostic factor for survival.https://doi.org/10.1186/s12876-023-02710-wCholangiocarcinomaIntrahepatic cholangiocarcinomaCirrhosisPrognostic factorPalliative care |
| spellingShingle | Nimish Thakral Teresita Gonzalez Olger Nano Sang-Ha Shin Shenae Samuels Atif Hussein Cirrhosis in intrahepatic cholangiocarcinoma: prognostic importance and impact on survival BMC Gastroenterology Cholangiocarcinoma Intrahepatic cholangiocarcinoma Cirrhosis Prognostic factor Palliative care |
| title | Cirrhosis in intrahepatic cholangiocarcinoma: prognostic importance and impact on survival |
| title_full | Cirrhosis in intrahepatic cholangiocarcinoma: prognostic importance and impact on survival |
| title_fullStr | Cirrhosis in intrahepatic cholangiocarcinoma: prognostic importance and impact on survival |
| title_full_unstemmed | Cirrhosis in intrahepatic cholangiocarcinoma: prognostic importance and impact on survival |
| title_short | Cirrhosis in intrahepatic cholangiocarcinoma: prognostic importance and impact on survival |
| title_sort | cirrhosis in intrahepatic cholangiocarcinoma prognostic importance and impact on survival |
| topic | Cholangiocarcinoma Intrahepatic cholangiocarcinoma Cirrhosis Prognostic factor Palliative care |
| url | https://doi.org/10.1186/s12876-023-02710-w |
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