The presence of metabolic diseases could determine outcomes for patients with cholangiocarcinoma (CCA), according to a study recently published in Cancer Medicine.

“This study evidenced a high prevalence of metabolic (dysfunction)-associated fatty liver disease (MAFLD) in iCCA, suggesting its potential contribution to disease etiology,” the authors wrote.

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This observational study aimed to understand the role of body composition alterations in the outcomes of patients with CCA after liver resection.

The study’s findings revealed some noteworthy associations between body composition and patient outcomes. Notably, sarcopenia, a condition characterized by loss of muscle mass, was linked to postoperative morbidity.

Patients with sarcopenia experienced higher rates of intraoperative transfusions and more severe complications (Clavien-Dindo ≥ 3b). A postoperative comprehensive complication index was also significantly higher in these patients.

Furthermore, the researchers observed that patients with myosteatosis, a condition involving muscle infiltration by fat, had inferior overall survival compared to those without this alteration. The survival difference was notable, with a median survival of 33 months for patients with myosteatosis versus 23 months for those without.

The study also highlighted the prevalence of MAFLD in patients with iCCA, indicating a potential link between MAFLD and disease development. Patients with MAFLD were found to have a higher incidence of visceral, sarcopenic, and subcutaneous obesity. Moreover, this group exhibited a longer time-to-recurrence compared to those without MAFLD.

However, despite these associations, multivariable Cox regression analysis indicated that only clinical parameters, such as at least 65 years of age and fresh frozen plasma transfusions, were independently prognostic for overall survival. While body composition alterations showed strong associations with certain outcomes, they did not emerge as independent prognostic factors in this study.

Body composition alterations are commonly observed in individuals with cancer or chronic liver disease, but their prognostic significance has remained unclear for various cancer types. To address this knowledge gap, the researchers performed a computer tomography-based body composition assessment on 173 patients with CCA from Europe and North America who underwent curative-intent liver resection.

The analysis focused on several key body composition parameters, including muscle mass and composition, as well as the quantity of subcutaneous and visceral adipose tissue. The researchers also investigated the prevalence of myosteatosis, sarcopenic obesity, (secondary) sarcopenia, and both visceral and subcutaneous obesity, correlating these findings with clinicopathological data.


Lurje I, Uluk D, Pavicevic S, et al. Body composition is associated with disease aetiology and prognosis in patients undergoing resection of intrahepatic cholangiocarcinoma. Cancer Med. Published online July 26, 2023. doi:10.1002/cam4.6374.