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Postresection Outcomes of Combined Hepatocellular Carcinoma-Cholangiocarcinoma, Hepatocellular Carcinoma and Intrahepatic Cholangiocarcinoma

Journal of Gastrointestinal Surgery volume 20, pages 411–420 (2016)Cite this article

Abstract

Introduction

Combined hepatocellular carcinoma and cholangiocarcinoma (cHCC-CC) is rare. This study investigated the clinicopathological features of cHCC-CC and compared the postresection survival outcomes of cHCC-CC, hepatocellular carcinoma (HCC), and intrahepatic cholangiocarcinoma (IHC).

Methods

Between January 2000 and September 2012, 53 patients with cHCC-CC underwent tumor resection, accounting for 1.1 % of surgeries for primary liver malignancies. Control groups included patients with HCC (n = 1452) and IHC (n = 149) who underwent R0 resection of stage I/II tumors ≤5 cm.

Results

Mean tumor diameter of cHCC-CC group was 5.5 ± 2.9 cm, and single tumor was identified in 50. Pathological classification included combined (n = 41), mixed (n = 11), and double (n = 1) tumors. The 1-, 3-, 5-, and 10-year tumor recurrence rates were 60.8, 71.8, 80.7, and 80.7 %, respectively. The 1-, 3-, 5-, and 10-year overall survival rates were 73.3, 35.6, 30.5, and 11.1 %, respectively. Tumor recurrence and patient survival did not differ significantly according to AJCC tumor staging and histological type (all p ≥ 0.2). Tumor recurrence rates did not differ significantly between the cHCC-CC, HCC, and IHC groups (p = 0.43), whereas differences in survival rates were significant (p = 0.000), with a median survival after tumor recurrence of 8, 51, and 6 months, respectively (p = 0.000).

Conclusions

Patients with cHCC-CC showed similar recurrence rates to those of control patients with HCC and IHC, whereas their survival outcomes were worse than those of control HCC patients because of poor responses to recurrence treatment. Further evaluation of differences in tumor characteristics and tumor biology is necessary to accurately predict the prognosis of patients with cHCC-CC.

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Author Contributions

Hwang S and Yoon YI designed the study; Lee SG, Lee YJ, Kim KH, Ahn CS, Moon DB, Ha TY, Lee JW, Hong SM, Song GW, and Yu ES contributed to data acquisition and analysis; and Hwang S drafted and revised the article.

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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

    Young-In Yoon, Shin Hwang, Young-Joo Lee, Ki-Hun Kim, Chul-Soo Ahn, Deok-Bog Moon, Tae-Yong Ha, Gi-Won Song, Dong-Hwan Jung, Jong-Woo Lee & Sung-Gyu Lee

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

    Seung-Mo Hong & Eun Sil Yu

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  1. Young-In Yoon
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  2. Shin Hwang
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Correspondence to Shin Hwang.

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None of the authors has any conflict of interest to disclose.

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None of the authors was supported financially for this study.

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Yoon, YI., Hwang, S., Lee, YJ. et al. Postresection Outcomes of Combined Hepatocellular Carcinoma-Cholangiocarcinoma, Hepatocellular Carcinoma and Intrahepatic Cholangiocarcinoma. J Gastrointest Surg 20, 411–420 (2016). https://doi.org/10.1007/s11605-015-3045-3

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  • DOI: https://doi.org/10.1007/s11605-015-3045-3

Keywords

  • Resection
  • Recurrence
  • Mixed tumor
  • Combined tumor
  • Stem cell feature