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Prognosis of Intrahepatic Cholangiocarcinomas with HBV Infection is Better than Those with Hepatolithiasis After R0 Liver Resection: A Propensity Score Matching Analysis

  • Hepatobiliary Tumors
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

The impact of different causative factors of intrahepatic cholangiocarcinoma (ICC) on disease outcome remains largely unknown. This study aimed to evaluate the prognosis of ICC patients with different pathogenic factors after hepatectomy.

Methods

Data of 731 consecutive patients undergoing R0 liver resection for ICC at The Eastern Hepatobiliary Surgery Hospital between 2004 and 2010 were analyzed. These patients were divided into the hepatitis B virus-related (HBV-ICC, n = 519), hepatolithiasis-related (stone-ICC, n = 87), HBV plus hepatolithiasis-related (HBV/stone-ICC, n = 45), and other etiologies-related (other-ICC, n = 80) ICC groups. Propensity score matching (PSM) was used to eliminate the baseline differences between these groups.

Results

In these four groups, the 5-year tumor recurrence and overall survival (OS) rates were 75.4, 90.3, 83.0 and 81.9%, and 32.7, 16.3, 17.7 and 22.6%, respectively. The significant differences in recurrence and OS were identified between the HBV- and stone-ICC groups (both p < 0.001). In these two groups, most of the independent prognostic predictors were similar, but tumor diameter >5 cm was demonstrated as a risk factor in the HBV-ICC patients only, and surgical margin <1 cm and human epidermal growth factor receptor 2-positive were demonstrated as risk factors in the stone-ICC patients only. With PSM, 75 patients in each of the HBV- and stone-ICC cohorts were created, and the 5-year recurrence and OS rates were 69.9 versus 88.6, and 34.6 versus 19.2%, respectively (p = 0.017, 0.027).

Conclusion

Patients with HBV-ICC achieved better outcomes than those with stone-ICC. This prognostic difference was probably associated with biological malignant invasiveness rather than tumor stage.

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Funding

This study was supported by the State Key Project on Infectious Diseases of China (2012ZX10002-016, to Feng Shen), the Natural Science Foundation of Shanghai (12ZR1439700, to Jun Li), and the Medical Guiding Project of Shanghai (201346801, to Jun Li).

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    Authors and Affiliations

    1. Department of Hepatic Surgery, The Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, China

      Qing Wang MD, Jun Li MD, Zhengqing Lei MD, Dong Wu MD, Anfeng Si MD, Kui Wang MD, Yizhou Wang MD, Wan Yee Lau MD & Feng Shen MD

    2. Department of Clinical Database, The Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, China

      Xuying Wan MD

    3. Faculty of Medicine, The Chinese University of Hong Kong, Shatin, Hong Kong

      Wan Yee Lau MD

    4. Department of General Surgery, Central Hospital of ZiBo, ZiBo, Shandong, China

      Qing Wang MD

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    1. Qing Wang MD
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    2. Jun Li MD
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    Correspondence to Feng Shen MD.

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    No potential conflicts of interest were disclosed.

    Additional information

    Qing Wang, Jun Li, and Zhengqing Lei contributed equally to this work.

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    Wang, Q., Li, J., Lei, Z. et al. Prognosis of Intrahepatic Cholangiocarcinomas with HBV Infection is Better than Those with Hepatolithiasis After R0 Liver Resection: A Propensity Score Matching Analysis. Ann Surg Oncol 24, 1579–1587 (2017). https://doi.org/10.1245/s10434-016-5751-9

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    • DOI: https://doi.org/10.1245/s10434-016-5751-9

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