# The impact of serum ferritin on overall survival following resection in patients with intrahepatic cholangiocarcinoma

## TL;DR

High pre-surgery ferritin levels in cholangiocarcinoma patients are linked to worse survival and higher cancer recurrence.

## Contribution

Identifies serum ferritin as a potential biomarker for prognosis in intrahepatic cholangiocarcinoma.

## Key findings

- Elevated preoperative serum ferritin levels correlate with significantly worse overall survival.
- High ferritin levels are associated with higher recurrence rates after surgery.
- Serum ferritin shows potential as an adjunct to CA 19-9 for prognosis.

## Abstract

The global incidence of intrahepatic cholangiocarcinoma is increasing. Surgical resection remains the gold standard treatment. However, the long-term prognosis remains dismal. The role of serum ferritin in malignant diseases has not been fully elucidated. This study aimed to evaluate the relationship between preoperative serum ferritin levels and patient outcomes.

In our retrospective study, we analyzed data from 95 patients who underwent liver resection for intrahepatic cholangiocarcinoma at Jena University Hospital between 2009 and 2023. Comprehensive clinical and pathological data, along with the correlation between Serum ferritin and clinicopathological parameters, were systematically analyzed and compared. Survival rates were determined using the Kaplan-Meier method.

The optimal preoperative serum ferritin cut-off value for overall survival was 303.1 µg/L, with an area under the curve of 0.697 (95% CI (0.592–0.801; P < 0.001). The 1-, 3-, and 5-year survival rates were 74.7%, 50.5%, and 43.2%, respectively. Patients with elevated preoperative SF levels demonstrated significantly worse overall survival compared to the low SF group (50.9% vs. 4.5%; P < 0.001). SF had a significant impact on recurrence rates (P < 0.001). The overall recurrence rate in the high-SF group was 67,3%, compared to 43,5% in the low-SF group.

Elevated preoperative serum ferritin levels are associated with significantly worse overall and recurrence-free survival in patients with intrahepatic cholangiocarcinoma. Serum ferritin could serve as a valuable adjunct to the tumor marker CA 19 − 9.