Impact of hepatitis C virus on survival in patients undergoing resection of intrahepatic cholangiocarcinoma: Report of a Japanese nationwide survey

Masaki Kaibori; Kengo Yoshii; Kosuke Kashiwabara; Takashi Kokudo; Kiyoshi Hasegawa; Namiki Izumi; Takamichi Murakami; Masatoshi Kudo; Shuichiro Shiina; Michiie Sakamoto; Osamu Nakashima; Yutaka Matsuyama; Susumu Eguchi; Tatsuya Yamashita; Tadatoshi Takayama; Norihiro Kokudo; Shoji Kubo

doi:10.1111/hepr.13676

Impact of hepatitis C virus on survival in patients undergoing resection of intrahepatic cholangiocarcinoma: Report of a Japanese nationwide survey

Hepatol Res. 2021 Aug;51(8):890-901. doi: 10.1111/hepr.13676. Epub 2021 Jun 16.

Authors

Masaki Kaibori¹, Kengo Yoshii², Kosuke Kashiwabara³, Takashi Kokudo⁴, Kiyoshi Hasegawa⁴, Namiki Izumi⁵, Takamichi Murakami⁶, Masatoshi Kudo⁷, Shuichiro Shiina⁸, Michiie Sakamoto⁹, Osamu Nakashima¹⁰, Yutaka Matsuyama¹¹, Susumu Eguchi¹², Tatsuya Yamashita¹³, Tadatoshi Takayama¹⁴, Norihiro Kokudo¹⁵, Shoji Kubo¹⁶

Affiliations

¹ Department of Surgery, Kansai Medical University, Osaka, Japan.
² Department of Mathematics and Statistics in Medical Sciences, Kyoto Prefectural University of Medicine, Kyoto, Japan.
³ Biostatistics Division, Clinical Research Support Center, Central Coordinating Unit, The University of Tokyo, Tokyo, Japan.
⁴ Department of Surgery, Graduate School of Medicine, Hepato-Biliary-Pancreatic Surgery Division, The University of Tokyo, Tokyo, Japan.
⁵ Department of Gastroenterology, Musashino Red Cross Hospital, Tokyo, Japan.
⁶ Department of Diagnostic and Interventional Radiology, Kobe University Graduate School of Medicine, Kobe, Japan.
⁷ Department of Gastroenterology and Hepatology, Kindai University Faculty of Medicine, Osaka, Japan.
⁸ Department of Gastroenterology, Juntendo University School of Medicine, Tokyo, Japan.
⁹ Department of Pathology, Keio University School of Medicine, Tokyo, Japan.
¹⁰ Department of Clinical Laboratory Medicine, Kurume University Hospital, Kurume, Japan.
¹¹ Department of Biostatics, School of Public Health University of Tokyo, Tokyo, Japan.
¹² Department of Surgery, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
¹³ Advanced Preventive Medical Research Center, Kanazawa University, Kanazawa, Japan.
¹⁴ Department of Digestive Surgery, Nihon University School of Medicine, Tokyo, Japan.
¹⁵ National Center for Global Health and Medicine, Tokyo, Japan.
¹⁶ Department of Hepato-Biliary-Pancreatic Surgery, Osaka City University Graduate School of Medicine, Osaka, Japan.

PMID: 34041804
DOI: 10.1111/hepr.13676

Abstract

Aim: We reviewed the data of a nationwide follow-up survey to determine the impact of hepatitis C virus (HCV) infection on the outcomes of hepatectomy for mass-forming (MF) type, and combined mass-forming and periductal infiltrating (MF + PI) type intrahepatic cholangiocarcinoma (ICC).

Methods: In total, 956 patients with ICC who underwent curative hepatic resection were included in this cohort study, and patients were classified according to virus status. Patients were classified according to virus status as follows: HCV-related ICC (n = 138, 14.4%), hepatitis B virus (HBV)-related ICC (n = 43, 4.5%) and non-virus-related ICC (n = 775, 81.1%). To control for variables, we used 1:1 propensity score-matching to compare outcomes after surgery between HCV-related (n = 102) and non-virus-related ICC cases (n = 102).

Results: We successfully matched HCV-related and non-virus-related ICC cases with similar liver function and tumor characteristics. Patients with HCV-related ICC had significantly shorter recurrence-free survival (hazard ratio 0.62, 95% confidence interval 0.42-0.92, p = 0.016) and overall survival (hazard ratio: 0.57, 95% confidence interval: 0.37-0.88, p = 0.011) than patients with non-virus-related ICC. Cox proportional hazard analysis showed that HCV-related ICC offered a worse prognosis than non-virus-related ICC.

Conclusions: HCV infection increases the risk of recurrence and worsens overall survival in patients after curative resection for MF and combined MF + PI type ICC.

Keywords: cholangiocarcinoma; hepatectomy; hepatitis viruses; prognosis.