Prognostic impact of hepatitis B or C on intrahepatic cholangiocarcinoma

• Main Authors: Jung Woong Seo, Byung Soo Kwan, Young Koog Cheon, Tae Yoon Lee, Chan Sup Shim, So Young Kwon, Won Hyeok Choe, Byung Chul Yoo, Jeong Min Yoon, Jung Hoon Lee
• Format: Article
• Language: English
• Published: The Korean Association of Internal Medicine 2020-05-01
• Series: The Korean Journal of Internal Medicine
• Subjects: intrahepatic cholangiocarcinoma; hepatitis b virus; hepatitis c virus; survival rate
• Online Access: http://www.kjim.org/upload/pdf/kjim-2018-062.pdf

Background/Aims Intrahepatic cholangiocarcinoma (ICC) is the second-most common primary liver malignancy, arising from the peripheral intrahepatic bile duct epithelium. Hepatitis B virus (HBV) or hepatitis C virus (HCV) may be involved in the development of ICC. We explored the prognostic value of hepatitis virus infection, as well as other prognostic factors affecting survival in patients with ICC. Methods A retrospective chart review was performed for patients diagnosed with ICC between August 2005 and December 2018 at Konkuk University Medical Center. We identified a total of 131 patients with ICC. Overall survival rates of patients with and without hepatitis were determined. Univariate and multivariate analyses were used to estimate factors influencing survival outcomes. Results A total of 17.6% (23/131) of patients were positive for HBV or HCV. Hepatitis B positive ICC patients were significantly younger with higher albumin and higher α-fetoprotein than those without hepatitis viral infections. The median survival of hepatitis-positive and hepatitis-negative groups was 280 and 213 days, respectively. Survival rates were not significantly different between the two groups (p = 0.279). Multivariate analyses indicated that lower serum carbohydrate antigen 19-9 (CA 19-9) (p < 0.001), lower T stage (p = 0.042), the absence of lymph-node metastasis (p = 0.043), and receiving curative surgery (p = 0.033) were independent predictors of better outcomes. Conclusions While hepatitis influenced a number of clinical features in ICC patients, it did not affect survival rate. Prognostic factors influencing survival outcomes with ICC were CA 19-9 level, T stage, the presence of lymph node metastasis, and curative surgery.