Clinicopathological factors impact the survival outcome following the resection of combined hepatocellular carcinoma and cholangiocarcinoma

Yap, Anthony Q.; Chen, Chao‐Long; Yong, Chee‐Chien; Kuo, Fang-Ying; Wang, Shih-Ho; Lin, Chen-Si; Liu, Yueh‐Wei; Lin, Tsan‐Shiun; Li, Weifeng; Millan, Carlos A.; Wang, Chih-Chi

doi:10.1016/j.suronc.2012.09.003

Cited by 19 publications

(19 citation statements)

References 29 publications

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“…The prognosis is in between cholangiocarcinoma and hepatocellular carcinoma, befi tting its mixed growth [ 66 , 67 ]. Combined hepatocellular carcinoma-cholangiocarcinoma has a higher risk than hepatocellular carcinoma for tumor recurrence after resection [ 68 ] and a higher risk for early tumor recurrence after liver transplantation, particularly in the fi rst year [ 69 ]. Combined hepatocellular carcinoma-cholangiocarcinomas have two physically separate morphologies (Fig.…”

Section: Combined Hepatocellular Carcinomacholangiocarcinomamentioning

confidence: 99%

Hepatocellular Carcinoma

Torbenson¹

2015

Surgical Pathology of Liver Tumors

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Hepatocellular carcinoma is the most common primary malignant tumor of the liver. Although usually morphologically distinct, hepatocellular carcinomas can demonstrate various histologic patterns, which sometimes create diagnostic challenges for the surgical pathologist. In addition, a number of subtypes are discussed in this chapter, along with typical hepatocellular carcinoma. This chapter examines the clinical, gross, and microscopic features of hepatocellular carcinoma and its variants with illustrated examples. The differential diagnosis of hepatocellular carcinoma is also covered, with a detailed discussion of the various special stains used in the diagnosis of hepatocellular carcinoma and their respective utilities and limitations. Important prognostic factors, including grading of hepatocellular carcinoma, are also reviewed.

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Section: Combined Hepatocellular Carcinomacholangiocarcinomamentioning

confidence: 99%

Hepatocellular Carcinoma

Torbenson¹

2015

Surgical Pathology of Liver Tumors

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“…cHCC-CC was first reported by Wells in 1903, and further classified by Allen and Lisa in 1949 and Goodman in 1985 56. It originates in hepatic progenitor cells, the liver-specific bipotential adult stem cells, which are activated upon injury to hepatocytes and/or cholangiocytes 7.…”

Section: Discussionmentioning

confidence: 99%

“…Several prognostic factors of cHCC-CC associated with unfavorable outcome include large tumor size, vascular invasion, lymph node metastasis, and the presence of satellite lesions 69. Ariizumi et al10 reported a median survival of 15.4 months, with a 5-year overall survival rate found in 24% of all patients.…”

Section: Discussionmentioning

confidence: 99%

“…A combined hepatocellular carcinoma-cholangiocarcnoma is a relatively rare disease entity, accounting for only 0.4–14% of all primary liver cancer 1234. The classification of hepatocellular carcinoma-cholangiocarcnoma first developed by Allen Lisa in 1949 consisted of 3 subtypes: 1) type A, characterized by synchronous, separate and autonomous epicenters of hepatocellular carcinoma (HCC) and cholangiocarcnoma (CC) in a single liver; 2) type B, comprising closely admixed and distinguished foci of HCC and CC; and 3) type C, consisting of truly combined HCC and CC components originating in the same tumor 15…”

Section: Introductionmentioning

confidence: 99%

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Adrenal metastasis in sequentially developed combined hepatocellular carcinoma-cholangiocarcinoma: A case report

Nugroho

Lee

et al. 2018

Ann Hepatobiliary Pancreat Surg

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The incidence of combined hepatocellular carcinoma-cholangiocarcinoma (cHCC-CC) in a single patient accounts for only 0.4 to 14% of all primary liver cancer. However, the prognosis of its intrahepatic cholangiocarcinoma (ICC) component is poor. We experienced a unique case of a sequentially developed cHCC-CC with adrenal metastasis as the primary presentation and a hidden primary hepatocellular carcinoma. A 65-year-old female with a history of jaundice and abdominal discomfort was diagnosed with S4 ICC measuring 5 cm in diameter, and characterized histologically as papillary adenocarcinoma with intraductal growth, but without any evidence of malignant hepatocyte. S4 segmentectomy with hepaticojejunostomy revealed no additional masses. A follow-up CT scan 3 months after surgery showed a right adrenal mass with markedly increased serum AFP (4950 ng/mL), which was treated with right adrenalectomy. Histopathology revealed a metastatic hepatocellular carcinoma testing positive for AFP, glypican-3, and hepatocytes, but negative for CD-10, inhibin-α, EMA, S-100, and cytokeratin-7. Serum AFP level immediately plummeted to 4.1 ng/mL upon adrenal mass removal. A recurrent S7 liver mass was suspected 1 year later with serum AFP value of 7.6 ng/mL, and characteristic CT imaging of HCC. TACE was performed with good response. Adrenal metastasis may manifest as the primary focus of hepatocellular carcinoma in sequentially developed cHCC-CC patients with hidden primary HCC. cHCC-CC should be considered in the differential diagnosis of cholangiocarcinoma with elevated AFP.

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“…[9] However, several studies showed controversial outcomes about the exact relationship of liver cirrhosis with the prognosis of ICC after LR. [10][11][12] In the present study, utilizing the Surveillance, Epidemiology, and End Results (SEER) database, we aimed to explore the independent relationship between liver cirrhosis ( brosis score) and the long-term prognosis of patients with ICC receiving surgical or non-surgical treatment.…”

Section: Introductionmentioning

confidence: 99%

Association of liver cirrhosis with the prognosis of patients with intrahepatic cholangiocarcinoma: a SEER-based cohort study

Zhang

2020

Preprint

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Background The association of liver cirrhosis with the prognosis of intrahepatic cholangiocarcinoma (ICC) remains controversial. We aimed to evaluate the relationship between liver cirrhosis (fibrosis score) and the long-term prognosis of patients with ICC. Methods SEER 18 registry from 2004 to 2015 was queried for this study. Propensity score matching (PSM) was performed to eliminate possible bias. In addition, multivariable analysis was utilized to adjust for potential confounders. The interaction test was performed to explore the impact of each stratified factor on the relationship between FS and patient survival. Overall survival (OS) and disease-specific survival (DSS) were the major endpoints. Results During the study period, 359 patients (66.5%) with lower fibrosis score (LFS; F0-4) and 181 patients (33.5%) with higher fibrosis score (HFS; F5-6) were enrolled. In the multivariable adjusted cohort (OS: n = 540; DSS: n = 417), patients with HFS had worse OS (HR, 1.43; 95% CI, 1.10 to 1.85; P = 0.007) and DSS (HR, 1.46; 95% CI, 1.08 to 1.97; P = 0.013) compared to patients with LFS. In the propensity-matched cohort, patients with HFS still had worse OS (HR, 1.50; 95% CI, 1.08 to 2.09; P = 0.016) and DSS (HR, 1.54; 95% CI, 1.05 to 2.26; P = 0.026) compared to patients with LFS. In multivariable analyses stratified by clinicopathologic features, patients with HFS were found to have significantly worse OS and DSS compared to those with LFS across all the subgroups. Conclusion Our outcomes indicated that fibrosis score is an independent risk factor for both overall and tumor-specific survival of ICC patients.

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Clinicopathological factors impact the survival outcome following the resection of combined hepatocellular carcinoma and cholangiocarcinoma

Cited by 19 publications

References 29 publications

Hepatocellular Carcinoma

Hepatocellular Carcinoma

Adrenal metastasis in sequentially developed combined hepatocellular carcinoma-cholangiocarcinoma: A case report

Association of liver cirrhosis with the prognosis of patients with intrahepatic cholangiocarcinoma: a SEER-based cohort study

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