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Intrahepatic Cholangiocarcinoma and Combined Hepatocellular-Cholangiocarcinoma: A Western Experience

  • Hepatic and Pancreatic Tumors
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Intrahepatic cholangiocarcinoma (ICC) is an unusual tumour.

Methods

The clinicopathological data of 67 patients with ICC and combined hepatocellular–cholangiocarcinoma (HCC–ICC) are presented.

Results

HCV–HBV infection was present in 37.3% and chronic liver disease in 38.7% of cases, a rate higher than in the normal population; in these patients the cancer was small, often asymptomatic and of combined type. Liver resection was performed in 51 patients; at 1, 3 and 5 years, overall survival was 87.9%, 59.0%, and disease-free survival was 47.7% and 78.8%, 51.4%, and 46.7%, respectively. The better results were in the group of cirrhotic patients in whom ICC was diagnosed by a screening program for HCC (5-year survival 76.6%). Nodal metastasis showed negative prognostic value for both overall and disease-free survival; in N+ patients mean survival was 14.7 months after liver resection and lymph node dissection.

Conclusion

Viral infection and cirrhosis may be considered risk conditions for ICC and combined HCC–ICC; in resected patients survival was good. Nodal metastases must not be considered a contraindication for liver resection.

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References

  1. Ohtsuka M, Ito H, Kimura F, et al. Results of surgical treatment for intrahepatic cholangiocarcinoma and clinicopathological factors influencing survival. Br J Surg 2002; 89:1525–31

    Article  PubMed  CAS  Google Scholar 

  2. Okuda K, Nakanuma Y, Miyazaki M. Cholangiocarcinoma: Recent progress. Part 1: Epidemiology and etiology. J Gastroenterol Hepatol 2002; 17:1049–55

    Article  PubMed  Google Scholar 

  3. Weber SM, Jarnagin WR, Klimstra D, et al. Intrahepatic cholangiocarcinoma: resectability, recurrence pattern, and outcomes. J Am Coll Surg 2001; 193:134–41

    Article  Google Scholar 

  4. Huang JL, Biehl TR, Lee FT, et al. Outcomes after resection of cholangiocellular carcinoma. Am J Surg 2004; 87:612–7

    Article  Google Scholar 

  5. Kim H, Park C, Han KH, et al. Primary liver carcinoma of intermediate (hepatocyte-cholangiocyte) phenotype. J Hepatol 2004; 40:298–304

    Article  PubMed  CAS  Google Scholar 

  6. Nakamura S, Suzuki S, Sakaguchi T, et al. Surgical treatment of patients with mixed hepatocellular carcinoma and cholangiocarcinoma. Cancer 1996; 78:1671–6

    Article  PubMed  CAS  Google Scholar 

  7. Ng IO, Shek TW, Nicholls J, et al. Combined hepatocellular-cholangiocarcinoma: a clinicopathological study. J Gastroenterol Hepatol 1998; 13:34–40

    Article  PubMed  CAS  Google Scholar 

  8. Taguchi J, Nakashima O, Tanaka M, et al. A clinicopathological study on combined hepatocellular and cholangiocarcinoma. J Gastroenterol Hepatol 1996; 11:758–64

    Article  PubMed  CAS  Google Scholar 

  9. Jarnagin WR, Weber S, Tickoo SK, et al. Combined hepatocellular and cholangiocarcinoma: demographic, clinical, and prognostic factors. Cancer 2002; 94:2040–6

    Article  PubMed  Google Scholar 

  10. Cazals-Hatem D, Rebouissou S, Bioulac-Sage P, et al. Clinical and molecular analysis of combined hepatocellular-cholangiocarcinomas. J Hepatol 2004; 41:292–8

    Article  PubMed  CAS  Google Scholar 

  11. Green FL (ed.) AJCC cancer staging manual, 6th edn. New York: Springer Verlag, 2002

  12. Liver cancer study group of Japan. Classification of primary liver cancer, 1st edn. Tokyo: Kanahara, 1997

  13. Goodman ZD, Ishak KG, Langloss JM, et al. Combined hepatocellular-cholangiocarcinoma. A histologic and immunohistochemical study. Cancer 1985; 55:124–35

    Article  PubMed  CAS  Google Scholar 

  14. Kojiro M. Patomorphology of advanced hepatocellular carcinoma. In: Tobe K, Kameda H, Okudaira M, et al. (eds) Primary liver cancer in Japan. Tokyo: Springer-Verlag 1992, pp 31–37

    Google Scholar 

  15. Nagafuchi Y, Okamoto K, Shono M, et al. Separate histogenesis of combined hepatocellular and cholangiocellular carcinoma in two patients. Hepatogastroenterology 1998; 45:523–7

    PubMed  CAS  Google Scholar 

  16. Liu CL, Fan ST, Lo CM, et al. Hepatic resection for combined hepatocellular and cholangiocarcinoma. Arch Surg 2003; 138:86–90

    Article  PubMed  Google Scholar 

  17. Koh KC, Lee H, Choi MS, et al. Clinicopathological features and prognosis of combined hepatocellular cholangiocarcinoma. Am J Surg 2005; 189:120–5

    Article  PubMed  Google Scholar 

  18. Yano Y, Yamamoto J, Kosuge T, et al. Combined hepatocellular and cholangiocarcinoma: a clinicopathologic study of 26 resected cases. Jpn J Clin Oncol 2003; 33:283–7

    Article  PubMed  Google Scholar 

  19. Portolani N, Coniglio A, Ghidoni S, et al. Early and late recurrence after liver resection for hepatocellular carcinoma (HCC). Prognostic and therapeutic implications. Ann Surg 2006; 243:229–35

    Article  PubMed  Google Scholar 

  20. Chiesa R, Donato F, Portolani N, et al. Primary liver cancer in a high incidence area in north Italy: ethiological hypotheses arising from routinely collected data. Eur J Epidem 1995; 6:435–42

    Article  Google Scholar 

  21. Donato F, Tagger A, Gelatti U, et al. Alcohol and hepatocellular carcinoma : the effect of lifetime intake and hepatitis virus infections in men and women. Am J Epidemiol 2002; 155:323–31

    Article  PubMed  CAS  Google Scholar 

  22. Kobayashi M, Ikeda K, Saitoh S, et al. Incidence of primary cholangiocellular carcinoma of the liver in Japanese patients with hepatitis C virus-related cirrhosis. Cancer 2000; 88:2471–7

    Article  PubMed  CAS  Google Scholar 

  23. Han SL, Zhu GB, Yao JG, et al. Diagnosis and surgical treatment of primary hepatic cholangiocarcinoma. Hepatogastroenterology 2005; 52:348–51

    PubMed  Google Scholar 

  24. Shimoda M, Farmer DG, Colquhoun SD, et al. Liver transplantation for cholangiocellular carcinoma: analysis of single-center experience and review of the literature. Liver Transplantation 2001; 7:1023–33

    Article  PubMed  CAS  Google Scholar 

  25. Valverde A, Bonhomme N, Farges O, et al. Resection of intrahepatic cholangiocarcinoma: a Western experience. J Hepatobiliary Pancreat Surg 1999; 6:122–7

    Article  PubMed  CAS  Google Scholar 

  26. Kaczynski J, Hansson G, Wallersted S. Incidence, etiologic aspects and clinicophatologic features in intrahepatic cholangiocellular carcinoma: a study of 51 cases from a low-endemicity area. Acta Oncol 1998; 37:77–83

    Article  PubMed  CAS  Google Scholar 

  27. Roayaie S, Guarrera J, Ye MQ, et al. Aggressive surgical treatment of intrahepatic cholangiocarcinoma: predictors of outcomes. J Am Coll Surg 1998; 187:365–72

    Article  PubMed  CAS  Google Scholar 

  28. Sasaki A, Aramaki M, Kawano K, et al. Intrahepatic peripheral cholangiocarcinoma: mode of spread and choice of surgical treatment. Br J Surg 1998; 85:1206–9

    Article  PubMed  CAS  Google Scholar 

  29. Nakeeb A, Pitt HA, Sohn TA, et al. Cholangiocarcinoma. A spectrum of intrahepatic, perihilar, and distal tumors. Ann Surg 1996; 224:463–75

    Article  PubMed  CAS  Google Scholar 

  30. Nozaki Y, Yamamoto M, Ikai I, et al. Reconsideration of the lymph node metastasis pattern (N factor) from intrahepatic cholangiocarcinoma using the international union against cancer TNM staging system for primary liver carcinoma. Cancer 2001; 83:1923–9

    Article  Google Scholar 

  31. Isa T, Kusano T, Shimoji H, et al. Predictive factors for long-term survival in patients with intrahepatic cholangiocarcinoma. Am J Surg 2001; 181:507–11

    Article  PubMed  CAS  Google Scholar 

  32. Inoue M, Makuuchi T, Takayama, et al. Long-term survival and prognostic factors in the surgical treatment of mass-forming type cholangiocarcinoma. Surgery 2000; 127:498–505

    Article  PubMed  CAS  Google Scholar 

  33. Grobmyer SR, Wang L, Gonen M, et al. Perihepatic lymph node assessment in patients undergoing partial hepatectomy for malignancy. Ann Surg 2006; 244:260–4

    Article  PubMed  Google Scholar 

  34. Akatsu T, Shimazu M, Kawachi S, et al. Long-term survival of intrahepatic cholangiocarcinoma with hilar lymph node metastasis and portal vein involvement. Hepatogastroenterology 2005; 52:603–5

    PubMed  Google Scholar 

  35. Lang H, Sotiropulos GC, Fruhauf NR, et al. Extended hepatectomy for intrahepatic cholangiocellular carcinoma (ICC). Ann Surg 2005; 241:134–43

    PubMed  Google Scholar 

  36. Puhalla H, Schuell B, Pokorny H, et al. Treatment and outcome of intrahepatic cholangiocellular carcinoma. Am J Surg 2005; 189:173–7

    Article  PubMed  Google Scholar 

  37. Slakey DP. Radiofequency ablation of recurrent cholangiocarcinoma. Am Surg 2002; 68:395–7

    PubMed  Google Scholar 

  38. Shirabe K, Shimada M, Tsujita E. Prognostic factors in node-negative intrahepatic cholangiocarcinoma with special reference to angiogenesis. Am J Surg 2004; 187:538–42

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Medical and Surgical Sciences, Surgical Clinic, Brescia University, P.le Spedali Civili, 1, 25123, Brescia, Italy

    Nazario Portolani MD, Gian Luca Baiocchi MD, Arianna Coniglio MD, Tullio Piardi MD, Andrea Ferrari Bravo MD & Stefano Maria Giulini MD

  2. Department of Radiology, Azienda Ospedaliera Spedali Civili di Brescia, Brescia, Italy

    Luigi Grazioli MD

  3. Department of Pathology, Brescia University, Brescia, Italy

    Anna Benetti MD

Authors
  1. Nazario Portolani MD
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  2. Gian Luca Baiocchi MD
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  3. Arianna Coniglio MD
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  4. Tullio Piardi MD
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  5. Luigi Grazioli MD
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  6. Anna Benetti MD
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  7. Andrea Ferrari Bravo MD
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  8. Stefano Maria Giulini MD
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Correspondence to Gian Luca Baiocchi MD.

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Portolani, N., Baiocchi, G.L., Coniglio, A. et al. Intrahepatic Cholangiocarcinoma and Combined Hepatocellular-Cholangiocarcinoma: A Western Experience. Ann Surg Oncol 15, 1880–1890 (2008). https://doi.org/10.1245/s10434-008-9933-y

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  • DOI: https://doi.org/10.1245/s10434-008-9933-y

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