Hypervascularity of intrahepatic cholangiocarcinoma (ICC) was associated with longer recurrence-free survival (RFS) and better survival after recurrence, a study published online in HPB found.

CT scans are used by hepatobiliary (HPB) surgeons as critical tools to diagnose, evaluate, and predict prognosis in ICC. This retrospective study looked at the CT scan results of 147 patients who had undergone curative resection surgery from March 2001 to July 2017.

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Although there are many potential options for treating ICC, surgical resection with curative intent remains the most effective one. However, due to the vague presentation of the symptoms of the disease, most patients are only diagnosed at an advanced stage of the disease and are thus ineligible for curative resection surgery. Only about a third of patients are eligible for surgical resection with curative intent.

Researchers studied the tumor vascularity features — such as hypovascularity, rim-enhancement, and hypervascularity  — on the CT scans. They then looked into possible links between the vascularity of recurrent ICC and the survival rate after recurrence. 

Of the 147 patients enrolled in the study, 101 (68.7%) experienced ICC recurrence after a follow-up of a median of 36.1 months. The examination of the hepatic CT scans shows that the hypervascularity of the ICC was associated with better RFS [rim-enhanced image hazard ratio (HR), 3.893; 95% confidence interval (CI), 1.700–8.915, P =.001; hypovascular image HR, 6.241; 95% CI, 2.670–14.586, P <.001]. In addition, the hypervascular recurrent ICC was also significantly linked to better survival after recurrence (log-rank test, P < .001).

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This finding is significant because it suggests that hypervascularity of ICC shown on CT images may indicate a better prognosis, thus better informing decision-making in care. HPB surgeons should consider this “noninvasive, accessible, and useful prognostic index” when treating patients with ICC, the study authors wrote. 


Park H, Jang H, Lee D, et al. Prognostic impact of tumor vascularity on CT in resectable intrahepatic cholangiocarcinoma. HPB. Published online July 12, 2021. doi:10.1016/j.hpb.2021.06.424

Chan KM, Tsai CY, Yeh CN, et al. Characterization of intrahepatic cholangiocarcinoma after curative resection: outcome, prognostic factor, and recurrence. BMC Gastroenterol. 2018;18(180). https://doi.org/10.1186/s12876-018-0912-x