A Comparative Study of Clinical Features and Survival Outcomes in Intrahepatic Cholangiocarcinoma Patients With and Without HBV Infection Undergoing Liver Resection.

[BACKGROUNDS] Previous studies have established an association between hepatitis B virus (HBV) infection and an elevated risk of intrahepatic cholangiocarcinoma (ICC); the prognostic implications of HBV infection in patients with ICC remain inadequately characterized.

[METHODS] Between January 2003 and December 2013, consecutive patients with histologically confirmed ICC who underwent curative-intent liver resection were retrospectively enrolled. Patients were stratified into two cohorts based on HBV status: HBV-positive (defined as HBsAg and/or HBV DNA positivity) and HBV-negative (both HBsAg and HBV DNA negative). Clinical characteristics and survival outcomes were systematically compared between the groups.

[RESULTS] A total of 1842 patients were included in the analysis, comprising 839 (45.5%) in the HBV-positive group and 1003 (54.5%) in the HBV-negative group. Compared with HBV-negative patients, those with HBV infection were more likely to be male (76.4% vs. 58.4%), had a higher prevalence of underlying liver cirrhosis (39.4% vs. 6.0%) and macrovascular invasion (12.6% vs. 8.2%), and exhibited lower rates of lymph node metastasis (3.7% vs. 12.0%) and perineural invasion (1.9% vs. 7.1%). The HBV-positive group demonstrated superior median overall survival (41 months vs. 27 months) and significantly higher overall survival rates at 1, 3, and 5 years. However, no significant difference in disease-free survival was observed between the two groups.

[CONCLUSION] HBV-associated ICC exhibited distinct tumor biology more similar to hepatocellular carcinoma, and patients with HBV-associated ICC exhibited improved overall survival compared to their HBV-negative counterparts.