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Long-Term Recurrence-Free and Overall Survival Differ Based on Common, Proliferative, and Inflammatory Subtypes After Resection of Intrahepatic Cholangiocarcinoma

2022Journal article Open access
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dc.contributor.authorAlaimo, L
dc.contributor.authorMoazzam, Z
dc.contributor.authorEndo, Y
dc.contributor.authorLima, H
dc.contributor.authorRuzzenente, A
dc.contributor.authorGuglielmi, A
dc.contributor.authorAldrighetti, L
dc.contributor.authorWeiss, M
dc.contributor.authorBauer, T
dc.contributor.authorAlexandrescu, S
dc.contributor.authorPoultsides, G
dc.contributor.authorMaithel, S
dc.contributor.authorPinto Marques, H
dc.contributor.authorMartel, G
dc.contributor.authorPulitano, C
dc.contributor.authorShen, F
dc.contributor.authorCauchy, F
dc.contributor.authorKoerkamp, B
dc.contributor.authorEndo, I
dc.contributor.authorPawlik, T
dc.date.accessioned2024-08-22T13:56:27Z
dc.date.available2024-08-22T13:56:27Z
dc.date.issued2022
dc.description.abstractIntroduction: While generally associated with poor prognosis, intrahepatic cholangiocarcinoma (ICC) can have a heterogeneous presentation and natural history. We sought to identify specific ICC subtypes that may be associated with varied long-term outcomes and patterns of recurrence after liver resection. Methods: Patients who underwent curative-intent resection for ICC from 2000 to 2020 were identified from a multi-institutional database. Hierarchical cluster analysis characterized three ICC subtypes based on morphology (i.e., tumor burden score [TBS]) and biology (i.e., preoperative neutrophil-to-lymphocyte ratio [NLR] and CA19-9 levels). Results: Among 598 patients, the cluster analysis identified three ICC subtypes: Common (n = 300, 50.2%) (median, TBS: 4.5; NLR: 2.4; CA19-9: 38.0 U/mL); Proliferative (n = 246, 41.1%) (median, TBS: 8.8; NLR: 2.9; CA19-9: 71.2 U/mL); Inflammatory (n = 52, 8.7%) (median, TBS: 5.4; NLR: 12.6; CA19-9: 26.7 U/mL). Median overall survival (OS) (Common: 72.0 months; Proliferative: 31.4 months; Inflammatory: 22.9 months) and recurrence-free survival (RFS) (Common: 21.5 months; Proliferative: 11.9 months; Inflammatory: 9.0 months) varied considerably among the different ICC subtypes (all p < 0.001). Even though patients with Inflammatory ICC had more favorable T-(T1/T2, Common: 84.4%; Proliferative: 80.6%; Inflammatory: 86.5%) and N-(N0, Common: 14.0%; Proliferative: 20.7%; Inflammatory: 26.9%) disease, the Inflammatory subtype was associated with a higher incidence of intra- and extrahepatic recurrence (Common: 15.8%; Proliferative: 24.2%; Inflammatory: 28.6%) (all p = 0.01). Conclusions: Cluster analysis identified three distinct subtypes of ICC based on TBS, NLR, and CA19-9. ICC subtype was associated with RFS and OS and predicted worse outcomes among patients. Despite more favorable T- and N-disease, the Inflammatory ICC subtype was associated with worse outcomes ICC subtype should be considered in the prognostic stratification of patients.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationAnn Surg Oncol . 2023 Mar;30(3):1392-1403.pt_PT
dc.identifier.doi10.1245/s10434-022-12795-4pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.17/5002
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherSpringerpt_PT
dc.subjectHCC CIRpt_PT
dc.subjectHumanspt_PT
dc.subjectBile Duct Neoplasms* / pathologypt_PT
dc.subjectBile Duct Neoplasms* / surgerypt_PT
dc.subjectBile Ducts, Intrahepatic / pathologypt_PT
dc.subjectCA-19-9 Antigenpt_PT
dc.subjectCholangiocarcinoma* / pathologypt_PT
dc.subjectFollow-Up Studiespt_PT
dc.subjectHepatectomypt_PT
dc.subjectNeoplasm Recurrence, Local / pathologypt_PT
dc.subjectPrognosispt_PT
dc.subjectNeoplasm Recurrence, Local / surgerypt_PT
dc.titleLong-Term Recurrence-Free and Overall Survival Differ Based on Common, Proliferative, and Inflammatory Subtypes After Resection of Intrahepatic Cholangiocarcinomapt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage1403pt_PT
oaire.citation.issue3pt_PT
oaire.citation.startPage1392pt_PT
oaire.citation.titleAnnals of Surgical Oncologypt_PT
oaire.citation.volume30pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

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