Clinicopathological Features and Post-resection Prognosis of Double Primary Hepatocellular Carcinoma and Intrahepatic Cholangiocarcinoma
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Simultaneous double primary hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (ICC) (dpHCC-ICC) is very rare. This study investigated the clinicopathological features and post-resection prognosis of dpHCC-ICC.
We identified 10 patients with dpHCC-ICC through an institutional database search. Three control groups with HCC, ICC and combined HCC-cholangiocarcinoma (cHCC-CC) were selected (each n = 120) using propensity score matching.
The incidence of dpHCC-ICC was 0.23%. The mean age was 57.4 ± 11.7 years, and 8 were male. Hepatitis B virus infection was associated with 8 patients. All dpHCC-ICC were diagnosed incidentally from surgical specimens. Only two patients demonstrated simultaneous elevation of alpha-fetoprotein/des-γ-carboxy prothrombin and carbohydrate antigen 19-9. All patients underwent macroscopic curative resection. The HCC component was classified as stage I in 7 and stage II in 3, and ICC component was classified as stage I in 5, stage II in 2 and stage IV in 3. Tumor recurrence and patient survival rates were 30.0 and 90.0% at 1 year and 52.0 and 77.1% at 3 years, respectively. Tumor recurrence rates were not different between the dpHCC-ICC and the three control groups (p = 0.505). The overall and post-recurrence patient survival rates were similar between the dpHCC-ICC and cHCC-CC groups (p > 0.2); however, these were inferior to those in the HCC group but comparable with those in the ICC group.
The post-resection prognosis of dpHCC-ICC was more dependent on the tumor stage of the ICC component than that of the HCC component. Therefore, they can be clinically regarded as ICC with concurrent HCC.
KeywordsPrimary Liver Cancer Intrahepatic Cholangiocarcinoma Hepatic Progenitor Cell Tumor Recurrence Rate Primary Liver Malignancy
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 No. 2015R1A2A2A04007141 to Hwang S).
SH and DHJ designed the study; KHK, SMH, YJL, CSA, DBM, HT-Y, SG-W, ESY and SGL contributed to the data acquisition and analysis; and SH and DHJ drafted and revised the article. All authors have approved the submitted version of the manuscript.
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Conflict of interest
The authors have no conflicts of interest to disclose.
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