&lt;p&gt;Development and validation of a prognostic score predicting recurrence in resected combined hepatocellular cholangiocarcinoma&lt;/p&gt;

Tian, Min; Luo, Liang; Liu, Wei‐Ren; Deng, Wei; Yin, Jiacheng; Jin, Lei; Jiang, Xi‐Fei; Zhou, Yu‐Fu; Qu, Wei‐Feng; Tang, Zheng; Wang, Han; Tao, Chenyang; Fang, Yuan; Qiu, Shuang–Jian; Zhou, Jian; Liu, Jingfeng; Fan, Jian‐Gao; Shi, Ying‐Hong

doi:10.2147/cmar.s195964

Cited by 17 publications

(35 citation statements)

References 38 publications

(48 reference statements)

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“…Due to the small number of the cHCC-CCA cases, the optimal treatment for cHCC-CCA recurrence remains unclear [18][19][20]. However, to our knowledge, this report is the rst to describe the characteristics of cHCC-CCA recurrence in detail [12,21].…”

Section: Discussionmentioning

confidence: 91%

“…In the present study, all patients with cHCC-CCA were treated as having HCC; they received hepatectomy without lymph node dissection, and a pathological examination of the surgical specimens subsequently revealed cHCC-CCA. Given that the lymph nodes were the second-most common recurrence site in cHCC-CCA, hepatectomy with lymph node dissection might be necessary if a diagnosis of cHCC-CCA is made preoperatively [21,24]. Legends: Table 1.…”

Section: Discussionmentioning

confidence: 99%

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Clinicopathological features and recurrence patterns of combined hepatocellular-cholangiocarcinoma

Ishii¹,

Ito

Saito

et al. 2020

Preprint

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Background Combined hepatocellular-cholangiocarcinoma (cHCC-CCA) is a primary liver carcinoma with both hepatocellular carcinoma (HCC) and cholangiocarcinoma (CCA) components. We examined the clinicopathological characteristics and recurrence patterns of cHCC-CCA. Because of the rarity of cHCC-CCA, its etiology, clinicopathological features, and prognosis in comparison with other primary liver carcinoma remain unknown. Its recurrence pattern and sites in particular also need to be elucidated. Methods All patients who underwent hepatectomy for primary liver malignancies between 2005 and 2015 were retrospectively included in this study. Results Eight hundred and ninety-four hepatectomies were performed. Nineteen cases of cHCC-CCA (2.1%) in 16 patients were enrolled. Three patients underwent re-hepatectomy. The background of hepatitis viruses and tumor marker patterns of cHCC-CCA were similar to those of HCC and dissimilar to those of iCCA. Biliary invasion was common in cHCC-CCA and iCCA. The 5-year overall survival values of the cHCC-CCA, HCC, and iCCA patients were 44.7%, 56.6%, and 38.5%, respectively. The 5-year recurrence-free survival values of the cHCC-CCA, HCC, and iCCA patients were 44.7%, 56.6%, and 38.5%, respectively. The liver was the most common recurrence site. Unlike HCC, however, the lymph node was the second-most common recurrence site in both cHCC-CCA and iCCA. Pathological samples of the recurrent lesions were obtained in six patients, and four had cHCC-CCA recurrence pathologically. Conclusion cHCC-CCA had a mixture of characteristics of HCC and iCCA. Many cases of cHCC-CCA remained cHCC-CCA pathologically even after recurrence.

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Section: Discussionmentioning

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Clinicopathological features and recurrence patterns of combined hepatocellular-cholangiocarcinoma

Ishii¹,

Ito

Saito

et al. 2020

Preprint

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“…She had a large tumor, initially very high AFP levels, later cisplatin rising AFP during gemcitabine-cisplatin therapy. Large tumor diameter, high AFP and CA19-9 and vascular invasion are all poor prognostic signs [8]. Subsequent pembrolizumab therapy, however, led to a rapid and dramatic treatment response with complete remission that has now been maintained for 33 months from the start of pembrolizumab therapy.…”

Section: Discussionmentioning

confidence: 99%

Checkpoint Inhibition Causing Complete Remission of Metastatic Combined Hepatocellular-Cholangiocarcinoma after Hepatic Resection

et al. 2020

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Combined hepatocellular-cholangiocarcinoma (CHC) is a rare type of primary liver cancer, speculated to arise from hepatic progenitor cells, and with a worse prognosis than hepatocellular carcinoma (HCC). Serum alpha-fetoprotein (AFP) levels may be one prognostic factor. It has been suggested that checkpoint inhibition might be useful in the treatment of HCC where there is an increased expression of PD-1 and PD-L1 in the microenvironment. Its effect on CHC is unknown. We report a case with a large CHC, which was radically resected, but the 53-yearold female patient subsequently developed pulmonary metastases. Histology demonstrated low-differentiated CHC without microsatellite instability. Treatment with sorafenib was started but was stopped due to angioedema. Under subsequent gemcitabine/cisplatin treatment, the metastatic disease progressed with rising AFP levels. A third-line treatment with pembrolizumab was then started, 2 mg/kg b.w. i.v. every third week for 6 months. This resulted in a radiologically complete remission of the pulmonary metastases and AFP levels were normalized (<10 μg/L) from a level of 1,790 μg/L before treatment. The patient developed immunerelated adverse events (AEs) including diarrhea and hepatitis. These AEs were successfully treated with prednisolone and mycophenolate mofetil, and they were eventually resolved. There are no signs of cancer recurrence neither in the liver nor in the lungs at 33 months after the start of the checkpoint inhibition treatment, and the patient is doing well. Further study is urgently needed on the role of checkpoint inhibition therapy in liver cancer. are responsible for the surgical care and M.P. and L.N. for the oncologic care of the patient. F.A. and J.S. for conception of the study and drafting the manuscript. L.S. is responsible for the pathology examination of the primary liver tumor and pulmonary metastases including histology, immunohistochemistry analyses of MSI. F.H. is responsible for the radiological examinations of the patient. All authors were involved in writing the final manuscript.

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“…Due to the small number of the cHCC-CCA cases, the optimal treatment for cHCC-CCA recurrence remains unclear [20 -22]. However, to our knowledge, this report is the rst to describe the characteristics of cHCC-CCA recurrence in detail [12,23].…”

Section: Discussionmentioning

confidence: 99%

Clinicopathological features and recurrence patterns of combined hepatocellular-cholangiocarcinoma

Ishii

Ito

Saito

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: Combined hepatocellular-cholangiocarcinoma (cHCC-CCA) is a primary liver carcinoma with both hepatocellular carcinoma (HCC) and cholangiocarcinoma (CCA) components. We examined the clinicopathological characteristics and recurrence patterns of cHCC-CCA. Because of the rarity of cHCC-CCA, its etiology, clinicopathological features, and prognosis in comparison with other primary liver carcinoma remain unknown. Its recurrence pattern and sites in particular also need to be elucidated.Methods: All patients who underwent hepatectomy for primary liver malignancies between 2005 and 2015 were retrospectively included in this study. Results: Eight hundred and ninety-four hepatectomies were performed. Nineteen cases of cHCC-CCA (2.1%) in 16 patients were enrolled. Three patients underwent re-hepatectomy. The background of hepatitis viruses and tumor marker patterns of cHCC-CCA were similar to those of HCC and dissimilar to those of intrahepatic CCA (iCCA). Biliary invasion was common in cHCC-CCA and iCCA. The 5-year overall survival values of the cHCC-CCA, HCC, and iCCA patients were 44.7%, 56.6%, and 38.5%, respectively. The 5-year recurrence-free survival values of the cHCC-CCA, HCC, and iCCA patients were 12.2%, 28.7%, and 32.9%, respectively. The liver was the most common recurrence site. Unlike HCC, however, the lymph node was the second-most common recurrence site in both cHCC-CCA and iCCA. Pathological samples of the recurrent lesions were obtained in six patients, and four had cHCC-CCA recurrence pathologically.Conclusion: cHCC-CCA had a mixture of characteristics of HCC and iCCA. Many cases of cHCC-CCA remained cHCC-CCA pathologically even after recurrence.

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<p>Development and validation of a prognostic score predicting recurrence in resected combined hepatocellular cholangiocarcinoma</p>

Cited by 17 publications

References 38 publications

Clinicopathological features and recurrence patterns of combined hepatocellular-cholangiocarcinoma

Clinicopathological features and recurrence patterns of combined hepatocellular-cholangiocarcinoma

Checkpoint Inhibition Causing Complete Remission of Metastatic Combined Hepatocellular-Cholangiocarcinoma after Hepatic Resection

Clinicopathological features and recurrence patterns of combined hepatocellular-cholangiocarcinoma

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