Cholangiocarcinoma in liver cirrhosis
Version of Record online: 26 FEB 2003
Journal of Gastroenterology and Hepatology
Volume 18, Issue 3, pages 337–341, March 2003
How to Cite
HUI, C.-K., YUEN, M.-F., TSO, W.-K., NG, I. O.-L., CHAN, A. O.-O. and LAI, C.-L. (2003), Cholangiocarcinoma in liver cirrhosis. Journal of Gastroenterology and Hepatology, 18: 337–341. doi: 10.1046/j.1440-1746.2003.02977.x
- Issue online: 26 FEB 2003
- Version of Record online: 26 FEB 2003
- Accepted for publication 18 October 2002.
- hepatitis B;
- liver cirrhosis;
- median survival;
- portal vein thrombosis
Background and Aim: Hepatocellular carcinoma (HCC) is usually associated with chronic liver diseases and liver cirrhosis, while conversely, cholangiocarcinoma (CC) usually occurs in a non-cirrhotic liver. The purpose of the present study was to evaluate CC in liver cirrhosis.
Methods: Between January 1998 and December 1999, 26 patients with CC were retrospectively reviewed. The occurrence of CC in chronic hepatitis B infection-related liver cirrhosis, portal vein thrombosis (PVT) and survival were analyzed.
Results: Twenty-six patients with CC (19 with a non-cirrhotic liver and seven with chronic hepatitis B infection-related liver cirrhosis) were included in the present study. All cases of CC in the cirrhotic group were incidentally discovered during routine screening for HCC. The mean age (± SD) was 58.8 ± 14 years in the cirrhotic group and 73.2 ± 15.9 years (P = 0.001) in the non-cirrhotic group. When compared to the cirrhotic group, the non-cirrhotic group had a higher median level of albumin (42 compared to 30 g/L, P = 0.005), bilirubin (117.5 compared to 18 µmol/L, P = 0.01), alkaline phosphatase (291.5 compared to 100 U/L, P = 0.001) and gamma glutamyl transpeptidases (215.5 compared to 31 U/L, P = 0.001). In contrast, the cirrhotic group had a higher median prothrombin time (PT) compared to the non-cirrhotic group (18.2 compared to 12 s, P = 0.05). In the non-cirrhotic group, only one patient (5.3%) showed evidence of PVT on a computerized tomography and Doppler ultrasound, while in the cirrhotic group six patients (85.7%) had PVT (P < 0.001). The median survival period in the cirrhotic group was six months (range 2–24 months) compared to 16 months (range 6–41 months) in the non-cirrhotic group (P = 0.036).
Conclusion: CC in cirrhotic liver presented at a younger age and patients who developed CC were prone to PVT. The survival period was also shorter in comparison to that of non-cirrhotic liver patients.