Influence of cirrhosis on outcomes of patients with advanced intrahepatic cholangiocarcinoma receiving chemotherapy

Constance d'Abrigeon; Mairéad G McNamara; Samuel Le Sourd; Angela Lamarca; Astrid Lièvre; Héloïse Bourien; Alexandre Peinoit; Thomas Uguen; Richard A Hubner; Juan W Valle; Julien Edeline

doi:10.1038/s41416-023-02460-2

Influence of cirrhosis on outcomes of patients with advanced intrahepatic cholangiocarcinoma receiving chemotherapy

Constance d'Abrigeon, Mairéad G McNamara, Samuel Le Sourd, Angela Lamarca, Astrid Lièvre, Héloïse Bourien, Alexandre Peinoit, Thomas Uguen, Richard A Hubner, Juan W Valle, Julien Edeline

Division of Cancer Sciences (L5)

Research output: Contribution to journal › Article › peer-review

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Abstract

BACKGROUND: Cirrhosis is a risk factor for intrahepatic cholangiocarcinoma (iCC). However, its exact prevalence is uncertain and its impact on the management of advanced disease is not established.

METHODS: Retrospective analysis of patients treated with systemic chemotherapy for advanced iCC in the 1st-line setting at 2 tertiary cancer referral centres. Cirrhosis was diagnosed based on at least one element prior to any treatment: pathological diagnosis, baseline platelets <150 × 109/L, portal hypertension and/or dysmorphic liver on imaging.

RESULTS: In the cohort of patients (n = 287), 82 (28.6%) had cirrhosis (45 based on pathological diagnosis). Patients with cirrhosis experienced more grade 3/4 haematologic toxicity (44% vs 22%, respectively, P = 0.001), and more grade 3/4 non-haematologic toxicity (34% vs 14%, respectively, P = 0.001) than those without. The overall survival (OS) was significantly shorter in patients with cirrhosis: median 9.1 vs 13.1 months for those without (HR = 1.56 [95% CI: 1.19-2.05]); P = 0.002), confirmed on multivariable analysis (HR = 1.48 [95% CI: 1.04-2.60]; P = 0.028).

CONCLUSION: Cirrhosis was relatively common in patients with advanced iCC and was associated with increased chemotherapy-induced toxicity and shorter OS. Formal assessment and consideration of cirrhosis in therapeutic management is recommended.

Original language	English
Journal	British Journal of Cancer
DOIs	https://doi.org/10.1038/s41416-023-02460-2
Publication status	Published - 9 Oct 2023

Keywords

Biliary tract cancer
liver fibrosis
systemic treatment
primary liver cancer

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

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10.1038/s41416-023-02460-2Licence: CC BY

2023-10-13-Final ICC cirrhosis manuscript BJCAccepted author manuscript, 2.08 MBLicence: CC BY

Cite this

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title = "Influence of cirrhosis on outcomes of patients with advanced intrahepatic cholangiocarcinoma receiving chemotherapy",

abstract = "BACKGROUND: Cirrhosis is a risk factor for intrahepatic cholangiocarcinoma (iCC). However, its exact prevalence is uncertain and its impact on the management of advanced disease is not established.METHODS: Retrospective analysis of patients treated with systemic chemotherapy for advanced iCC in the 1st-line setting at 2 tertiary cancer referral centres. Cirrhosis was diagnosed based on at least one element prior to any treatment: pathological diagnosis, baseline platelets <150 × 109/L, portal hypertension and/or dysmorphic liver on imaging.RESULTS: In the cohort of patients (n = 287), 82 (28.6%) had cirrhosis (45 based on pathological diagnosis). Patients with cirrhosis experienced more grade 3/4 haematologic toxicity (44% vs 22%, respectively, P = 0.001), and more grade 3/4 non-haematologic toxicity (34% vs 14%, respectively, P = 0.001) than those without. The overall survival (OS) was significantly shorter in patients with cirrhosis: median 9.1 vs 13.1 months for those without (HR = 1.56 [95% CI: 1.19-2.05]); P = 0.002), confirmed on multivariable analysis (HR = 1.48 [95% CI: 1.04-2.60]; P = 0.028).CONCLUSION: Cirrhosis was relatively common in patients with advanced iCC and was associated with increased chemotherapy-induced toxicity and shorter OS. Formal assessment and consideration of cirrhosis in therapeutic management is recommended.",

keywords = "Biliary tract cancer, liver fibrosis, systemic treatment, primary liver cancer",

author = "Constance d'Abrigeon and McNamara, {Mair{\'e}ad G} and {Le Sourd}, Samuel and Angela Lamarca and Astrid Li{\`e}vre and H{\'e}lo{\"i}se Bourien and Alexandre Peinoit and Thomas Uguen and Hubner, {Richard A} and Valle, {Juan W} and Julien Edeline",

note = "{\textcopyright} 2023. The Author(s), under exclusive licence to Springer Nature Limited.",

year = "2023",

month = oct,

day = "9",

doi = "10.1038/s41416-023-02460-2",

language = "English",

journal = "British Journal of Cancer",

issn = "0007-0920",

publisher = "Springer Nature",

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TY - JOUR

T1 - Influence of cirrhosis on outcomes of patients with advanced intrahepatic cholangiocarcinoma receiving chemotherapy

AU - d'Abrigeon, Constance

AU - McNamara, Mairéad G

AU - Le Sourd, Samuel

AU - Lamarca, Angela

AU - Lièvre, Astrid

AU - Bourien, Héloïse

AU - Peinoit, Alexandre

AU - Uguen, Thomas

AU - Hubner, Richard A

AU - Valle, Juan W

AU - Edeline, Julien

PY - 2023/10/9

Y1 - 2023/10/9

N2 - BACKGROUND: Cirrhosis is a risk factor for intrahepatic cholangiocarcinoma (iCC). However, its exact prevalence is uncertain and its impact on the management of advanced disease is not established.METHODS: Retrospective analysis of patients treated with systemic chemotherapy for advanced iCC in the 1st-line setting at 2 tertiary cancer referral centres. Cirrhosis was diagnosed based on at least one element prior to any treatment: pathological diagnosis, baseline platelets <150 × 109/L, portal hypertension and/or dysmorphic liver on imaging.RESULTS: In the cohort of patients (n = 287), 82 (28.6%) had cirrhosis (45 based on pathological diagnosis). Patients with cirrhosis experienced more grade 3/4 haematologic toxicity (44% vs 22%, respectively, P = 0.001), and more grade 3/4 non-haematologic toxicity (34% vs 14%, respectively, P = 0.001) than those without. The overall survival (OS) was significantly shorter in patients with cirrhosis: median 9.1 vs 13.1 months for those without (HR = 1.56 [95% CI: 1.19-2.05]); P = 0.002), confirmed on multivariable analysis (HR = 1.48 [95% CI: 1.04-2.60]; P = 0.028).CONCLUSION: Cirrhosis was relatively common in patients with advanced iCC and was associated with increased chemotherapy-induced toxicity and shorter OS. Formal assessment and consideration of cirrhosis in therapeutic management is recommended.

AB - BACKGROUND: Cirrhosis is a risk factor for intrahepatic cholangiocarcinoma (iCC). However, its exact prevalence is uncertain and its impact on the management of advanced disease is not established.METHODS: Retrospective analysis of patients treated with systemic chemotherapy for advanced iCC in the 1st-line setting at 2 tertiary cancer referral centres. Cirrhosis was diagnosed based on at least one element prior to any treatment: pathological diagnosis, baseline platelets <150 × 109/L, portal hypertension and/or dysmorphic liver on imaging.RESULTS: In the cohort of patients (n = 287), 82 (28.6%) had cirrhosis (45 based on pathological diagnosis). Patients with cirrhosis experienced more grade 3/4 haematologic toxicity (44% vs 22%, respectively, P = 0.001), and more grade 3/4 non-haematologic toxicity (34% vs 14%, respectively, P = 0.001) than those without. The overall survival (OS) was significantly shorter in patients with cirrhosis: median 9.1 vs 13.1 months for those without (HR = 1.56 [95% CI: 1.19-2.05]); P = 0.002), confirmed on multivariable analysis (HR = 1.48 [95% CI: 1.04-2.60]; P = 0.028).CONCLUSION: Cirrhosis was relatively common in patients with advanced iCC and was associated with increased chemotherapy-induced toxicity and shorter OS. Formal assessment and consideration of cirrhosis in therapeutic management is recommended.

KW - Biliary tract cancer

KW - liver fibrosis

KW - systemic treatment

KW - primary liver cancer

U2 - 10.1038/s41416-023-02460-2

DO - 10.1038/s41416-023-02460-2

M3 - Article

C2 - 37813958

SN - 0007-0920

JO - British Journal of Cancer

JF - British Journal of Cancer

ER -

Influence of cirrhosis on outcomes of patients with advanced intrahepatic cholangiocarcinoma receiving chemotherapy

Abstract

Keywords

UN SDGs

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