Clinical and pathological features and prognostic analysis of early-onset intrahepatic cholangiocarcinoma
10.3760/cma.j.cn112139-20250122-00041
- VernacularTitle:早发型肝内胆管癌的临床病理学特征及预后分析
- Author:
Delong QIN
1
;
Yue TANG
;
Zonglong LI
;
Jialu CHEN
;
Zhimin GENG
;
Chuandong SUN
;
Hong WU
;
Yinghe QIU
;
Tianqiang SONG
;
Xianhai MAO
;
Yu HE
;
Zhangjun CHENG
;
Wenlong ZHAI
;
Jingdong LI
;
Xiao LIANG
;
Ruixin LIN
;
Di TANG
;
Zhaohui TANG
;
Zhiwei QUAN
Author Information
1. 上海交通大学医学院附属新华医院普外科，上海 200092
- Publication Type:Journal Article
- Keywords:
Bile duct diseases;
Bile ducts,intrahepatic;
Early-onset tumor;
Clinical characteristics;
Survival analysis
- From:
Chinese Journal of Surgery
2025;63(6):500-507
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To explore the clinical and pathological features and survival outcomes of patients with early-onset intrahepatic cholangiocarcinoma (EOICC).Methods:This is a multicenter, retrospective cohort study. Data of 1 160 intrahepatic cholangiocarcinoma patients undergoing radical resection in 14 tertiary Grade A hospitals in China from January 2010 to November 2021 were retrospectively collected. The cohort included 632 males and 528 females, aged( M (IQR)) 61 (14) years (range: 22 to 93 years). ICC aged ≤50 years at the time of diagnosis was defined as EOICC and >50 years as late-onset intrahepatic cholangiocarcinoma (LOICC). Of these, there were 247 cases in the EOICC group and 913 cases in the LOICC. The clinical and pathological characteristics of both groups were analyzed and compared using the independent sample t-test, Mann-Whitney U test or Kaplan-Meier method. Univariate and multivariate Cox regression models for patient outcomes were constructed and forest graphed. Results:Compared with the patients in the LOICC group, patients in the EOICC group had lower carcinoembryonic antigen levels (2.5(4.0) μg/L vs. 3.1(5.2)μg/L, U=124 899, P=0.009) and CA19-9 level (63.4(524.7)U/ml vs. 77.9(611.3)U/ml, U=120 320, P=0.013), higher levels of ALT (29(35)U/L vs. 24(26)U/L, U=101 214, P=0.013), a lower score of the Eastern US Cooperative Oncology Group (0 score patients: 54.7% vs. 44.1%, χ2=12.472, P=0.014), higher TNM stage ( χ2=11.807, P=0.038), and proportion of lymph node dissection (62.3% vs. 54.1%, χ2=5.355, P=0.021). Patients in the two groups in sex, first diagnosis symptoms, intrahepatic bile duct stone history, nail protein, albumin, total bilirubin, transaminase, liver function Child-Pugh grade, T stage, stage, N stage, preoperative laparoscopic exploration proportion, tumor diameter, vascular invasion proportion, differentiation, margin, intraoperative bleeding, postoperative complications, postoperative hospital days were no statistical significance (all P>0.05). Patients in the EOICC group had better outcomes than the LOICC group (median survival time: 29.7 months vs. 25.0 months, 3-year overall survival: 45.1% vs. 37.8%, P=0.027). Conclusion:EOICC patients are better than LOICC patients in carcinoembryonic antigen, CA19-9, ALT, physical strength status and TNM stage, and the long-term prognosis is also better than LOICC patients.
