Prevalence of Nonalcoholic Steatohepatitis Among Patients with Resectable Intrahepatic Cholangiocarcinoma

Srinevas K. Reddy, Omar Hyder, J. Wallis Marsh, Georgios C. Sotiropoulos, Andreas Paul, Sorin Alexandrescu, Hugo Marques, Carlo Pulitano, Eduardo Barroso, Luca Aldrighetti, David A. Geller, Christine Sempoux, Vlad Herlea, Irinel Popescu, Robert Anders, Laura Rubbia-Brandt, Jean Francois Gigot, Giles Mentha, Timothy M. Pawlik

Research output: Contribution to journalArticlepeer-review


Background and Aims: The objective of this report was to determine the prevalence of underlying nonalcoholic steatohepatitis in resectable intrahepatic cholangiocarcinoma. Methods: Demographics, comorbidities, clinicopathologic characteristics, surgical treatments, and outcomes from patients who underwent resection of intrahepatic cholangiocarcinoma at one of eight hepatobiliary centers between 1991 and 2011 were reviewed. Results: Of 181 patients who underwent resection for intrahepatic cholangiocarcinoma, 31 (17. 1 %) had underlying nonalcoholic steatohepatitis. Patients with nonalcoholic steatohepatitis were more likely obese (median body mass index, 30. 0 vs. 26. 0 kg/m2, p <0.001) and had higher rates of diabetes mellitus (38. 7 vs. 22. 0 %, p = 0. 05) and the metabolic syndrome (22. 6 vs. 10. 0 %, p = 0. 05) compared with those without nonalcoholic steatohepatitis. Presence and severity of hepatic steatosis, lobular inflammation, and hepatocyte ballooning were more common among nonalcoholic steatohepatitis patients (all p <0. 001). Macrovascular (35. 5 vs. 11. 3 %, p = 0. 01) and any vascular (48. 4 vs. 26. 7 %, p = 0. 02) tumor invasion were more common among patients with nonalcoholic steatohepatitis. There were no differences in recurrence-free (median, 17. 0 versus 19. 4 months, p = 0. 42) or overall (median, 31. 5 versus 36. 3 months, p = 0. 97) survival after surgical resection between patients with and without nonalcoholic steatohepatitis. Conclusions: Nonalcoholic steatohepatitis affects up to 20 % of patients with resectable intrahepatic cholangiocarcinoma.

Original languageEnglish
Pages (from-to)748-755
Number of pages8
JournalJournal of Gastrointestinal Surgery
Issue number4
Publication statusPublished - 2013


  • Intrahepatic cholangiocarcinoma
  • Nonalcoholic fatty liver disease
  • Nonalcoholic fatty liver disease activity score
  • Nonalcoholic steatohepatitis

ASJC Scopus subject areas

  • Surgery
  • Gastroenterology


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