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Post-resection Prognosis of Combined Hepatocellular Carcinoma-Cholangiocarcinoma According to the 2010 WHO Classification

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Abstract

Background

Combined hepatocellular carcinoma and cholangiocarcinoma (cHC) has wide histological diversity. We intended to investigate the prognostic influence of tumor types of cHC.

Methods

We analyzed the clinical and pathological features of cHC along 2010 WHO classification. Study group was 100 cHC patients who underwent primary resection. Control group comprised 200 propensity score-matched patients with intrahepatic cholangiocarcinoma (ICC).

Results

In cHC group, tumor diameter was 4.4 ± 2.8 cm and 95 patients had single tumor. They were classified as classical type in 46 and subtypes with stem cell (SC) features in 54. Subtypes with SC features included typical in 16, intermediate cell in 22, and cholangiolocellular in 16. Their 1- and 3-year tumor recurrence rates were 31.7 and 59.8%; and 1- and 3-year patient survival rates were 92.5 and 77.3%, respectively. Tumor recurrence (p = 0.008) and patient survival (p = 0.005) rates were different according to tumor types. Further stratification by subtypes with SC features resulted in prognostic stratification in tumor recurrence (p = 0.045) and patient survival (p = 0.042). However, tumor stage was the only independent risk factor for tumor recurrence and patient survival. Comparing with ICC control group, cHC group showed no significant difference in rates of tumor recurrence (p = 0.523), but better survival outcomes (p = 0.008). Median post-recurrence patient survival period was 20 months in cHC patients and 6 months in ICC patients (p = 0.001).

Conclusions

Our results indicated that there would be close relationship between the post-resection prognosis and histological types according to the 2010 WHO classification, but these histological types did not become an independent prognostic factor.

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Acknowledgements

This study was supported by the Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Science, ICT and Future Planning (Grant Nos. 2015R1A2A2A04007141 and 2015K1A4A3046807).

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Authors and Affiliations

  1. Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, 88 Olympic-ro 43-gil, Songpa-gu, Seoul, 138-736, Korea

    Dong-Hwan Jung, Shin Hwang, Yong-Kyu Chung, Gi-Won Song, Young-Joo Lee, Ki-Hun Kim, Chul-Soo Ahn, Deok-Bog Moon, Tae-Yong Ha, Gil-Chun Park & Sung-Gyu Lee

  2. Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea

    Seung-Mo Hong & Eun Sil Yu

  3. Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea

    Han Chu Lee & Young-Suk Lim

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  1. Dong-Hwan Jung
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  2. Shin Hwang
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  3. Seung-Mo Hong
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  4. Yong-Kyu Chung
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  11. Gil-Chun Park
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  12. Han Chu Lee
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  13. Young-Suk Lim
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  14. Eun Sil Yu
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  15. Sung-Gyu Lee
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Corresponding author

Correspondence to Shin Hwang.

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Conflict of interest

There were no authors who have conflict of interest to disclose.

Author contributions

HS and JDH designed the study; HSM, SGW, LYJ, KKH, ACS, MDB, YES, HTY, PGC, LHC, LYS, and LSG contributed to data acquisition and statistical analysis; and HS and JDH drafted and revised the article. All authors approved the submitted version of manuscript.

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Jung, DH., Hwang, S., Hong, SM. et al. Post-resection Prognosis of Combined Hepatocellular Carcinoma-Cholangiocarcinoma According to the 2010 WHO Classification. World J Surg 41, 1347–1357 (2017). https://doi.org/10.1007/s00268-016-3837-y

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  • DOI: https://doi.org/10.1007/s00268-016-3837-y

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