Tumor invasion front morphology: a novel prognostic factor for intrahepatic cholangiocarcinoma

To explore the prognostic value of the morphology of tumor invasion front (TIF) in Intrahepatic Cholangiocarcinoma (ICC).

Seventy-four ICC patients with complete clinicopathological data and follow-up information were enrolled in our study. The most typical morphology of TIF of each case will be classified as low-grade group or high-grade group after evaluation by two pathologists. The clinicopathological characteristics, disease-free survival (DFS), and overall survival (OS) were compared between the two groups.

A total of 26 (35.3%) patients were assigned to low-grade group, while 48 (64.7%) patients were assigned to high-grade group. High-grade group was associated with higher CA19-9 (p=0.032), poor differentiation (p=0.050), larger tumor diameter (p=0.016), advanced T staging (p=0.048), and higher incidence of lymph node (LN) metastasis (0.014). No significant associations were found in demographic and clinical characteristics between the two groups. On multivariable analysis, high-grade group was a significant independent predictor of worse DFS (HR=0.433, 95% CI=0.235-0.800, p=0.002) and OS (HR=0.363, 95% CI=0.187-0.704, p=0.003).

High-grade morphology of TIF was an independent prognostic factor of ICC.