A prospective study of tumor-stroma ratio in resected intrahepatic mass-forming cholangiocarcinoma: prognostic value and correlation with gadoxetic acid-enhanced MRI.

Yi-Jun Pan, Ling-Li Chen, Zheng Wang, Jiang Lin, Yan Shan, Peng-Ju Xu

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Article in European radiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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6 authors.

Yi-Jun Pan *Department of Radiology, Zhongshan Hospital, Fudan University; Shanghai Institute of Medical Imaging, Shanghai, China.

Ling-Li Chen *Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai, China.

Zheng WangLiver Cancer Institute, Zhongshan Hospital, Fudan University, Shanghai, China.

Jiang LinDepartment of Radiology, Zhongshan Hospital, Fudan University; Shanghai Institute of Medical Imaging, Shanghai, China.

Yan ShanDepartment of Radiology, Zhongshan Hospital, Fudan University; Shanghai Institute of Medical Imaging, Shanghai, China. shan.yan@zs-hospital.sh.cn.

Peng-Ju XuDepartment of Radiology, Zhongshan Hospital, Fudan University; Shanghai Institute of Medical Imaging, Shanghai, China. xpjbfc@163.com.ORCID http://orcid.org/0000-0002-0832-083X

Funding

Science and Technology Innovation Plan Of Shanghai Science and Technology Commission 22Y11910900

6 · The paper itself

Abstract

objectivesTo assess the prognostic value of tumor-stroma ratio (TSR) in intrahepatic mass-forming cholangiocarcinoma (IMCC) and its subtypes, and to explore the correlation between gadoxetic acid-enhanced MRI and TSR. MATERIALS AND

methodsThis prospective study included participants with suspected IMCC who underwent gadoxetic acid-enhanced MRI and curative resection between March 2022 and December 2024. Participants were divided into stroma-poor and stroma-rich groups. Clinicopathologic and MRI features were assessed. Cox regression analysis and Kaplan-Meier curves were used to compare recurrence-free survival (RFS) rate. Logistic regression analysis was used to identify factors associated with TSR.

resultsA total of 86 participants (mean age 65 ± 9 years) were included, with 60 small-duct (SD) and 26 large-duct (LD) IMCC; 54 were classified as stroma-rich and 32 as stroma-poor. Participants with stroma-poor IMCC had a higher risk of recurrence than those with stroma-rich IMCC in the whole cohort (p = 0.002) and in the SD subtype (p < 0.001). TSR was an independent predictor for RFS in the whole cohort (hazard ratio = 2.755; 95% CI: 1.324, 5.735; p = 0.007) and in SD subtype (hazard ratio = 4.053; 95% CI: 1.575, 10.431; p = 0.004). The contrast-enhancement ratio on hepatobiliary phase (CER

conclusionPoor tumor-stroma is associated with an unfavorable prognosis in IMCC, especially in the SD subtype. The CER KEY POINTS: Question The prognostic implication of the TSR in IMCC and its subtypes, and its correlation with gadoxetic acid-enhanced MRI characteristics, remain inadequately understood. Findings Poor tumor-stroma is identified as a significant risk factor for recurrence, and the CER

Indexed as

Bile Duct NeoplasmsCholangiocarcinomaGadolinium DTPAMagnetic Resonance ImagingAgedContrast MediaFemaleHumansImage EnhancementMaleMiddle AgedPrognosisProspective StudiesContrast MediaGadolinium DTPAgadolinium ethoxybenzyl DTPAContrast mediaDesmoplastic fibromaIntrahepatic cholangiocarcinomaMagnetic resonance imagingPrognosis

Identifiers

PMID41307660

DOI10.1007/s00330-025-12169-w

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