Prognostic impact of hepatitis B virus infection in patients with intrahepatic cholangiocarcinoma.
BACKGROUND
Hepatitis B virus (HBV)-associated intrahepatic cholangiocarcinoma (ICC) was reported to have a favourable prognosis. We investigated the clinicopathological features of patients with HBV-associated ICC and compared post-resection survival outcomes of ICC patients with and without hepatitis B surface antigen (HBsAg) to assess the prognostic impact of HBV infection.


METHODS
A single-institution cohort of 292 patients who underwent macroscopic curative resection for ICC were divided into HBV (n = 37) and non-HBV (n = 255) groups. Their medical records were reviewed retrospectively.


RESULTS
In comparison with the clinicopathological features, patient age, proportion of anatomical resection, perineural invasion and lymph node (LN) metastasis were different between the two groups. Antiviral therapy was administered to 15 (40.5%) and 27 (73.0%) patients before and after surgery, respectively. Univariate analyses revealed that risk factors were tumour size >5 cm, anatomical resection, perineural invasion, lymphovascular invasion and LN metastasis for tumour recurrence and HBV infection, tumour size >5 cm, anatomical resection, perineural invasion, lymphovascular invasion and LN metastasis for patient survival. Multivariate analysis revealed that independent risk factors were tumour size >5 cm, perineural invasion and LN metastasis for both tumour recurrence and patient survival. HBV infection showed statistically marginal significances only in univariate analysis, thus not being an independent risk factor.


CONCLUSIONS
We observed that ICC patients with HBV infection often showed favourable tumour features probably due to early diagnosis, but their post-resection outcomes were not significantly different from those of patients without HBV infection. Therefore, the same treatment and surveillance policies should be applied regardless of HBV serology.
Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Chul-Soo
CS
Ahn
Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Shin
S
Hwang
Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Young-Joo
YJ
Lee
Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Ki-Hun
KH
Kim
Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Deok-Bog
DB
Moon
Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Tae-Yong
TY
Ha
Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Gi-Won
GW
Song
Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
Sung-Gyu
SG
Lee
D000328:Adult; D000368:Aged; D000998:Antiviral Agents / Q000627:therapeutic use; D001650:Bile Duct Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery / Q000821:virology*; D018281:Cholangiocarcinoma / Q000401:mortality / Q000473:pathology / Q000601:surgery / Q000821:virology*; D016001:Confidence Intervals; D016208:Databases, Factual; D018572:Disease-Free Survival; D005260:Female; D006498:Hepatectomy / Q000379:methods / Q000401:mortality; D006509:Hepatitis B / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009361:Neoplasm Invasiveness / Q000473:pathology; D009367:Neoplasm Staging; D011379:Prognosis; D016016:Proportional Hazards Models; D012016:Reference Values; D012189:Retrospective Studies; D018570:Risk Assessment; D016019:Survival Analysis; D016896:Treatment Outcome
D000998:Antiviral Agents
antiviral agent; carcinogenesis; lymphovascular invasion; perineural invasion; recurrence