Cirrhosis is not an independent prognostic factor for survival in patients with intrahepatic cholangiocarcinoma (iCCA), according to a new study published in BMC Gastroenterology.

The effect of cirrhosis on overall survival in iCCA is not clear. 

Read more about the prognosis of CCA

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In the present study, a team of researchers from the United States led by Atif Hussein, MD, from Memorial Healthcare System in Hollywood, California assessed whether there was any difference in survival outcomes between patients with iCCA who had concomitant cirrhosis and those who did not.

The researchers analyzed data from 3644 patients with iCCA who were diagnosed between 2004 and 2017. Of these, 1052 (28.9%) patients had cirrhosis.

“Although . . . univariate analyses . . . showed a survival advantage for noncirrhotic patients, there was no statistically significant association found between cirrhosis and survival status or long-term survival when multivariate analysis was used,” the authors reported.

The highest median overall survival was observed in patients with cirrhosis and a stage 1 tumor at 132 months. This was 73.7 months in patients without cirrhosis. 

The survival time of iCCA patients with stage 4 disease and cirrhosis was half that of patients without cirrhosis.

“Our data thus indicates that the presence of cirrhosis is not an independent prognostic factor for survival,” the researchers wrote.

CCA is a heterogeneous group of rare malignant tumors originating from cells of the biliary tree. There are 3 different subtypes: intrahepatic, perihilar, and distal. 

iCCA is located inside the hepatic parenchyma and can occur at any location in the intrahepatic biliary tree. Prognosis is the worst among patients diagnosed with this type of tumor, and those with unresectable tumors typically live for around 2 years postdiagnosis.

Cirrhosis is the result of long-term liver damage preventing the organ from functioning properly. The Ishak fibrosis score is used to define cirrhosis, with a score of 5 reflecting incomplete cirrhosis and a score of 6 indicating definite cirrhosis.


Thakral N, Gonzalez T, Nano O, Shin SH, Samuels S, Hussein A. Cirrhosis in intrahepatic cholangiocarcinoma: prognostic importance and impact on survival. BMC Gastroenterol. Published online May 13, 2023. doi:10.1186/s12876-023-02710-w