Surgery benefits patients with stage 2 intrahepatic cholangiocarcinoma (iCCA) but not those with stage 3B disease, found a new study published in the Journal of Clinical Medicine.
Among patients with stage 2 disease, prognosis is significantly worse in the case of multiple tumors compared to a single tumor with vascular invasion and almost similar to that of stage 3B disease, the study reported.
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However, when the proportion of patients undergoing surgery is similar, prognosis is also similar between patients with stage 2 disease with multiple tumors and with a solitary tumor, the authors noted.
Therefore, increasing the proportion of surgical treatment in patients with stage 2 disease and multiple tumors can improve overall disease prognosis, they added.
To clarify the role of surgery in stage 2 iCCA, a team of researchers from China assessed the differences in overall survival between patients with stage 2 iCCA with solitary tumors and vascular invasion, and those with stage 2 disease with multiple tumors with or without vascular invasion. The researchers performed 2 propensity score-matching analyses, 1 with surgical treatment and 1 without.
The team analyzed a total of 667 patients with stage 2 iCCA and 778 patients with stage 3B disease.
After propensity score-matching analysis with surgical treatment, the researchers saw no difference in survival among patients with stage 2 disease, under the hypothetical condition that the proportion of patients undergoing surgery was the same. However, when they considered the actual surgical proportion, the researchers saw that overall survival was significantly worse among patients with multiple tumors, whether or not vascular invasion was present compared to those with solitary tumors with vascular invasion.
Overall survival was similar between patients with stage 2 disease and multiple tumors and those with stage 3B disease regardless of surgical treatment.
Based on these findings, the researchers concluded that overall survival for stage 2 iCCA with multiple tumors will approach that of stage 2 disease with a single tumor and vascular invasion if surgical proportion is gradually increased.
Reference
Luo S, Wu L, Li M, et al. Validation of the prognostic role for surgical treatment in stage II intrahepatic cholangiocarcinoma: a SEER population-based study. JCM. Published online January 14, 2023. doi:10.3390/jcm12020675
