Prevalence of Chronic liver disease in Cholangiocarcinoma: a Meta-Analysis

Abstract

Chronic liver disease is a known risk factor for cholangiocarcinoma (CCA), but the proportion of people with CCA who have concurrent chronic liver disease is unclear. We aimed to evaluate the prevalence of chronic liver diseases in people with cholangiocarcinoma. In this single-arm meta-analysis, we searched MEDLINE and EMBASE from inception to 10 August 2024 for articles in English containing data for cholangiocarcinoma with and without chronic liver diseases. Data were pooled to obtain the prevalence of different chronic liver diseases, with further stratification by geographical location and tumor location. In total, 118068 individuals diagnosed with cholangiocarcinoma were included, of whom 16771 had chronic liver diseases. A pooled analysis of 109 studies determined that the prevalence of chronic liver disease was 25.23% (95% CI: 20.82% - 30.23%; I2=99.0%), and 10.21% (7.75% - 13.35%; I2=98.6%) of CCA patients had cirrhosis. Chronic liver diseases were associated more with intrahepatic CCAs, compared to extrahepatic CCAs (RR: 2.46, CI: 2.37 - 2.55, p < 0.0001). This was observed across all etiologies of liver disease, except for primary sclerosing cholangitis which was associated with extrahepatic CCAs (RR: 0.49; CI: 0.43 - 0.57, p < 0.0001). Around one in four people with cholangiocarcinoma have chronic liver diseases, and one in ten have cirrhosis.