TOPLINE

Patients diagnosed with cholangiocarcinoma (CCA) who had chronic liver disease (CLD) more frequently had localised tumours and demonstrated improved survival compared with those who did not have CLD.

METHODOLOGY

• Using data from the Global Biliary Tract Cancer Registry, researchers evaluated the effect of CLD on clinical presentation, management strategies, and survival outcomes in patients with CCA.
• They analysed data of 3743 patients diagnosed with CCA (median age, 65 years; 43.2% women) between 2010 and 2024 across 54 referral centres in 22 countries. Of these, 993 patients had CLD and 2750 did not have CLD.
• CLD was defined as the presence of any chronic liver condition documented in the patient's medical records at or before the diagnosis of CCA.
• A subgroup of 181 patients with CLD diagnosed at least 6 months before the diagnosis of CCA were matched (1:2) with 338 patients without prior CLD and with CCA using propensity score matching.
• Overall survival and posttreatment survival were evaluated.

TAKEAWAY

• Patients with CCA who had CLD were younger at diagnosis than those who did not have CLD (median age, 63 vs 66 years; P < .001). At diagnosis, those with CLD and CCA more frequently had localised tumours (57% vs 48%) and less frequently had metastatic disease (23% vs 31%; P < .001) than those with CCA and without CLD.
• Patients with CLD and CCA had longer median overall survival than those with CCA and without CLD (hazard ratio [HR], 0.88; P = .013), particularly those with intrahepatic CCA had longer median overall survival (HR, 0.77; P < .001).
• Five-year survival was also higher among patients with CLD and CCA (odds ratio, 1.70; P < .01). Those in the CLD group more often underwent curative-intent surgery (58.0% vs 44.6%).
• In the matched cohort, localised disease was more frequently reported in patients with CCA who had preexisting CLD than in those who did not have prior CLD (65.8% vs 47.3%), whereas metastatic disease was less frequently reported (16.8% vs 38.3%; P < .001).

IN PRACTICE

"[The study] findings provide novel real-world evidence that pre-existing CLD influences the clinical presentation and outcomes of CCA and support the value of surveillance for early detection in high-risk individuals," the authors wrote.

SOURCE

The study was led by Laura Izquierdo-Sanchez, Department of Liver and Gastrointestinal Diseases, Biogipuzkoa Health Research Institute, Donostia University Hospital, University of the Basque Country, San Sebastián, Spain. It was published online on August 24, 2026, in the Journal of Hepatology.

LIMITATIONS

Variation in diagnostic protocols across countries may have affected outcomes. The lack of centralised imaging or histopathologic review may have introduced heterogeneity in diagnosis and staging. Patients with poor performance status who were not referred to specialist care may be underrepresented in the registry.

DISCLOSURES

The Global Biliary Tract Cancer Registry was funded by the European Association for the Study of the Liver, the European Union's Horizon 2020 Research and Innovation Program, and other sources. Several authors declared receiving research grants, consulting fees, honoraria, or speaker honoraria or serving on advisory boards of various companies.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.