Viral Hepatitis in Western Patients with Advanced Intrahepatic Cholangiocarcinoma: Retrospective Assessment of Prevalence, Prognostic and Predictive Significance

Roberto Filippi ^1,2, Giovanni Brandi ^3,4, Andrea Casadei-Gardini ⁵

¹Department of Oncology, University of Turin, Torino, Italy.
²Medical Oncology 1U, Azienda Ospedaliero-Universitaria Città della Salute e della Scienza di Torino, Torino, Italy.
³Medical Oncology, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Bologna, Italy.
⁴Department of Medical and Surgical Sciences, University of Bologna, Bologna, Italy.
⁵Department of Oncology, Vita-Salute San Raffaele University, IRCCS San Raffaele Scientific Institute Hospital, Milan, Italy.
⁶Department of Oncology, ASL BI, Ospedale degli Infermi di Biella, Ponderano, Italy.
⁷Medical Oncology Unit, Department of Human Pathology "G. Barresi", University of Messina, Messina, Italy.
⁸Dipartimento di Ricerca Traslazionale e delle Nuove Tecnologie in Medicina e Chirurgia, Università di Pisa, Pisa, Italy.
⁹Interdisciplinary Research Center "Health Science", Scuola Superiore Sant'Anna, Pisa, Italy.
¹⁰Division of Medical Oncology, Ordine Mauriziano Hospital, Torino, Italy.
¹¹Medical Oncology Unit, Ospedale Di Summa-Antonio Perrino, Brindisi, Italy.
¹²Department of Oncology, San Bortolo General Hospital, Vicenza, Italy.
¹³Medical Oncology A, Policlinico Umberto I, La Sapienza Università di Roma, Rome, Italy.
¹⁴Department of Medical Oncology, University Hospital, Cagliari, Italy.
¹⁵Medical Oncology Unit, Ospedali "Santa Maria della Pietà" e "Bartolomeo Eustachio", AST di Macerata, Camerino, Italy.
¹⁶Medical Oncology Unit, IRCCS Istituto Tumori "Giovanni Paolo II", Bari, Italy.

⁰Department of Oncology, University of Turin, Torino, Italy.

Cancer Investigation +

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November 27, 2024

View abstract on PubMed

Summary

Viral hepatitis (VH) impacts intrahepatic cholangiocarcinoma (ICC) outcomes. While not affecting overall survival, HCV-related conditions improved disease control and time-to-progression with chemotherapy.

Area Of Science

Hepatology
Gastroenterology
Oncology

Background

Viral hepatitis (VH), including HBV and HCV, is linked to intrahepatic cholangiocarcinoma (ICC).
Limited Western data exist on VH's role in ICC prognosis and treatment prediction.
Inconsistent VH definitions complicate research and clinical application.

Purpose Of The Study

To investigate the prognostic and predictive value of different viral hepatitis conditions in advanced ICC.
To evaluate the impact of VH on outcomes with first-line chemotherapy (CT1).

Main Methods

Retrospective analysis of 472 advanced ICC cases across multiple centers.
Categorization of patients based on five distinct viral hepatitis conditions.
Assessment of survival and treatment response (disease control, time-to-progression) with CT1 (gemcitabine +/- platinoids).

Main Results

VH prevalence ranged from 9.3% to 25.3% depending on the definition.
No VH condition significantly impacted overall survival; some HBV-related conditions showed worse outcomes.
HCV-related conditions correlated with lower inflammation markers, better disease control, and longer time-to-progression.
Platinoid addition to gemcitabine offered no time-to-progression benefit in VH-positive (specifically HBV-related) patients.

Conclusions

Viral hepatitis status influences treatment response in advanced ICC.
HCV-related conditions may predict a better response to standard chemotherapy.
Further research is warranted to clarify VH's role in ICC management.

Keywords:

HBV/HCV Intrahepatic cholangiocarcinoma biliary tract cancer predictive value prognosis viral hepatitis