ArticleJournal of gastrointestinal oncology2026
Association between primary tumor resection and survival in metastatic intrahepatic cholangiocarcinoma: a retrospective cohort study based on the SEER database.
Article in Journal of gastrointestinal oncology, 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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Abstract
Background: Intrahepatic cholangiocarcinoma (ICC) with distant metastasis [M1, the American Joint Committee on Cancer (AJCC) Tumor, Node, Metastasis (TNM) stage] is universally classified as terminal, with systemic chemotherapy offering limited survival benefits. While guidelines discourage surgical intervention for M1 ICC due to perceived futility, emerging evidence suggests potential survival advantages in select populations. This study evaluates the prognostic impact of primary tumor surgery in patients with M1 ICC. Methods: Using the Surveillance, Epidemiology, and End Results (SEER) database (2004-2020), we identified 256 patients with pathologically confirmed ICC and distant metastasis recommended for primary tumor resection. Propensity score matching (PSM, 1:1 ratio) were applied to adjust for confounders, including age, sex, tumor grade, TNM stage, and chemotherapy status. Cox proportional hazards models and Kaplan-Meier survival analysis were utilized to assess overall survival (OS) and cancer-specific survival (CSS). Results: Of the 256 patients included, 169 (66%) received surgery. Surgical treatment was related to better OS. After PSM, 68 pairs of patients demonstrated balanced baseline characteristics. Surgical treatment was significantly associated with improved OS [median 8 Conclusions: Primary site surgery was associated with improved survival in selected M1 ICC patients, supporting its role in carefully selected cases. However, this observational study cannot exclude selection bias, underscoring the need for cautious interpretation and multidisciplinary optimization of patient selection.
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