Prevalence of Nonalcoholic Steatohepatitis Among Patients with Resectable Intrahepatic Cholangiocarcinoma

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.