Abstract
224 Background: The prevalence of intrahepatic cholangiocarcinoma (ICC) is rising worldwide. The current epidemics of non-alcoholic fatty liver disease (NAFLD) and non-alcoholic steatohepatitis (NASH) might be partly responsible for this trend. Methods: Case control study investigating the prevalence of histology-confirmed NASH in peritumoral liver of resected ICC patients and controls (pre-explant biopsies of liver donors). Controls were matched for age and sex in a 2:1 fashion. Correlates between NASH, tumor characteristics and overall survival (OS) were also explored in the ICC cohort. Results: Between 2006 and 2017, 84 ICCs were resected in our Institution. Sixty-two (74%) had no apparent risk factors for ICC. Amongst this group, the prevalence of NAFLD and NASH was 45.2% and 24.2%,respectively, compared to 44.3 and 8.9% in the 124 matched liver donors (p = 1.000 and p = 0.007, respectively). The 5-year OS rate was 20.0% in NASH and 57.4% in ICC without either NASH and other risk factors (p = 0.017). Main tumor size, sex and NASH (hazard ratio 2.618 , 95% confidence interval 1.140-6.013, p = 0.023) were independent predictors of the OS at the multivariate Cox regression. Conclusions: NASH (but not NAFLD) acts as a risk factor for ICC and may affect its long-term outcome. A collaborative multicenter approach could confirm and strengthen these data.
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