A Comparative Study of Clinical Features and Survival Outcomes in Intrahepatic Cholangiocarcinoma Patients With and
Hongling Wang1, Xingwu Zhu2, Xiaoliang Yang3
1Department of General Surgery, Jiading District Central Hospital Affiliated Shanghai University of Medicine & Health Sciences, Shanghai, China.
Backgrounds:
Previous studies have established an association between hepatitis B virus (HBV) infection and an elevated risk of intrahepatic cholangiocarcinoma (ICC); the prognostic implications of HBV infection in patients with ICC remain inadequately characterized.
Methods:
Between January 2003 and December 2013, consecutive patients with histologically confirmed ICC who underwent curative-intent liver resection were retrospectively enrolled. Patients were stratified into two cohorts based on HBV status: HBV-positive (defined as HBsAg and/or HBV DNA positivity) and HBV-negative (both HBsAg and HBV DNA negative). Clinical characteristics and survival outcomes were systematically compared between the groups.
Results:
A total of 1842 patients were included in the analysis, comprising 839 (45.5%) in the HBV-positive group and 1003 (54.5%) in the HBV-negative group. Compared with HBV-negative patients, those with HBV infection were more likely to be male (76.4% vs. 58.4%), had a higher prevalence of underlying liver cirrhosis (39.4% vs. 6.0%) and macrovascular invasion (12.6% vs. 8.2%), and exhibited lower rates of lymph node metastasis (3.7% vs. 12.0%) and perineural invasion (1.9% vs. 7.1%). The HBV-positive group demonstrated superior median overall survival (41 months vs. 27 months) and significantly higher overall survival rates at 1, 3, and 5 years. However, no significant difference in disease-free survival was observed between the two groups.
Conclusion:
HBV-associated ICC exhibited distinct tumor biology more similar to hepatocellular carcinoma, and patients with HBV-associated ICC exhibited improved overall survival compared to their HBV-negative counterparts.
