Microvascular invasion plays a key role in the prognosis of intrahepatic cholangiocarcinoma following curative resection, a new study published in BMC Cancer found. Independent risk factors for the occurrence of microvascular invasion include age, gamma-glutamyl transpeptidase (GGT), and preoperative image tumor number.

Intrahepatic cholangiocarcinoma is a malignancy that originates in the bile ducts within the liver. The most common and effective treatment approach for the disease is hepatectomy. 

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However, prognosis following surgery is still poor. It is, therefore, important to identify factors affecting prognosis to better stratify patients and ensure they receive the best possible treatment and care after surgery, including postoperative adjuvant therapy. 

Here, a team of researchers from China retrospectively collected the clinicopathological data of 704 patients with intrahepatic cholangiocarcinoma who underwent curative resection in 13 hospitals to explore whether microvascular invasion, a crucial risk factor for the prognosis of hepatocellular carcinoma, is also important for the postoperative prognosis of intrahepatic cholangiocarcinoma. The researchers also wanted to identify preoperative indicators that could help predict microvascular invasion.

Their results showed that Child-Pugh grade—a measure of chronic liver disease severity—and microvascular invasion were independent risk factors of overall survival in intrahepatic cholangiocarcinoma after curative resection. Independent risk factors for recurrence-free survival included major hepatectomy and microvascular invasion. Based on these findings, the team developed a prediction model for the prognosis of intrahepatic cholangiocarcinoma.

The researchers concluded that microvascular invasion plays a vital role in the prognosis of intrahepatic cholangiocarcinoma. They added that a multicenter retrospective study or a prospective study with a larger number of patients is necessary to further confirm this finding and validate the value of the prediction model proposed in this study.

Microvascular invasion is the presence of tumor cells in portal veins, large capsule vessels, or vascular spaces lined by endothelial cells. 

Reference

Chen Y, Liu H, Zhang J, et al. Prognostic value and predication model of microvascular invasion in patients with intrahepatic cholangiocarcinoma: a multicenter study from China. BMC Cancer. 2021;21(1):1299. doi:10.1186/s12885-021-09035-5