Photo Credit: Henadzi Pechan

The following is a summary of “Intrahepatic cholangiocarcinoma with arterial phase hyperenhancement and specialized tumor microenvironment associated with good prognosis after radical resection: A single-center retrospective study,” published in the May 2024 issue of Surgery by Mashiko et al.

A cohort of 53 patients diagnosed with mass-forming Intrahepatic cholangiocarcinoma (ICC) between 2007 and 2021 underwent analysis based on various parameters, including preoperative computed tomography patterns (specifically arterial phase enhancement), clinical profiles, and immunohistochemical evaluation of the tumor microenvironment. Patients were stratified into hyperenhancement (n = 13) and hypoenhancement (n = 40) groups based on a 50% cutoff of tumors showing higher attenuation than liver parenchyma.

Patients in the hyperenhancement group exhibited significantly better overall survival than those in the hypoenhancement group (5-year survival: 86% vs. 27%, respectively; P < 0.001). Furthermore, the hyperenhancement group showed higher peritumoral infiltration (92% vs. 58%; P = 0.020) and intratumoral CD3-positive T lymphocytes (85% vs. 35%; P = 0.002). In contrast, the hypoenhancement group demonstrated increased infiltration of peritumoral CD163-positive tumor-associated macrophages (60% vs. 8%; P = 0.001), peritumoral pentraxin 3–positive tumor-associated macrophages (50% vs. 15%; P = 0.024), and intratumoral α–smooth muscle actin–positive cancer-associated fibroblasts (15% vs. 68%; P = 0.001). Multiple regression analysis identified low intratumoral CD3-positive T lymphocytes (HR = 2.75) and high levels of peritumoral (HR = 2.38) and intratumoral CD163-positive tumor-associated macrophages (HR = 2.81) as independent predictors of poor overall survival (all P values < 0.05).

This study underscores that hypervascular mass-forming ICC, characterized by arterial phase hyperenhancement on imaging, correlates with enhanced tumor immune infiltration and better prognosis than hypovascular counterparts. These findings highlight the potential of immunological markers in predicting outcomes and guiding therapeutic strategies for patients with ICC.

Source: sciencedirect.com/science/article/pii/S0039606024001892onc