The clinical characteristics and prognostic factors of combined Hepatocellular Carcinoma and Cholangiocarcinoma, Hepatocellular Carcinoma and Intrahepatic Cholangiocarcinoma after Surgical Resection: A propensity score matching analysis

Tang, Youyin; Wang, Lingyan; Teng, Fei; Zhang, Tao; Zhao, Ying; Chen, Zhe-Yu

doi:10.7150/ijms.50883

Cited by 19 publications

(29 citation statements)

References 35 publications

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“…Tumors with both unambiguously differentiated hepatocellular and biliary components are defined as cHCC-CCAs, based on the 2019 World Health Organization classification ( 1 ). The origin, biological behavior, treatment method and prognosis of cHCC-CCAs differ from HCCs and intrahepatic cholangiocarcinoma (ICCs), the first and second common primary hepatic malignancies ( 2 , 3 ). Liver resection may be the optimal treatment method for cHCC-CCAs, as pointed out by recent studies ( 4 , 5 ).…”

Section: Introductionmentioning

confidence: 99%

CEUS and CT/MRI LI-RADS in Association With Serum Biomarkers for Differentiation of Combined Hepatocellular-Cholangiocarcinoma From Hepatocellular Carcinoma

et al. 2022

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BackgroundCombined Hepatocellular-cholangiocarcinoma (cHCC-CCAs) are with both unambiguously differentiated hepatocellular and biliary components. cHCC-CCAs show various imaging features similar to hepatocellular carcinoma (HCCs) and intrahepatic cholangiocarcinoma (ICCs), which makes the differential diagnosis between them challenging. The accurate diagnosis of cHCC-CCAs is of great importance in selecting treatment methods and performing patient management.PurposeTo investigate the diagnostic efficacy of CEUS and CT/MRI LI-RADS in association with tumor biomarkers for differentiation of cHCC-CCAs from HCCs.MethodsA total of 54 cHCC-CCAs and 55 HCCs in two centers were retrospectively collected. The diagnostic criteria for cHCC-CCAs if one or more of the following conditions were satisfied: (1) arterial phase hyperenhancement (APHE) on CEUS and LR-M on CT/MRI; (2) LR-5 on both CEUS and CT/MRI with elevated carbohydrate antigen 19-9 (CA19-9); (3) LR-M on both CEUS and CT/MRI with elevated alphafetoprotein (AFP). The sensitivity, specificity, accuracy and area under the receiver operating characteristic curve (AUC) were calculated.ResultsThe rates of APHE and Rim-APHE on CEUS in cHCC-CCAs were 81.5% and 9.3%, respectively. The rate of early and marked washout on CEUS in cHCC-CCAs were 59.3% and 27.8%, respectively. 64.8% and 25.9% of cHCC-CCAs showed APHE and Rim-APHE on CT/MRI, respectively. 46.3% and 35.2% of cHCC-CCAs showed washout and delay enhancement on CT/MRI, respectively. The kappa value of LI-RADS categories of cHCC-CCAs on CEUS and CT/MRI was 0.319 (P=0.008). The sensitivity, specificity, accuracy and AUC of the aforementioned diagnostic criteria for cHCC-CCAs were 64.8%, 84.4%, 76.1% and 0.746, respectively.ConclusionThe combination of the CEUS and CT/MRI LI-RADS with serum tumor markers shows promising diagnostic performance of cHCC-CCAs.

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Section: Introductionmentioning

confidence: 99%

CEUS and CT/MRI LI-RADS in Association With Serum Biomarkers for Differentiation of Combined Hepatocellular-Cholangiocarcinoma From Hepatocellular Carcinoma

et al. 2022

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“…The number of patients diagnosed with CHC almost doubled during 2004-2007 and 2012-2015, and patients with CHC more often had advanced T3-T4 stage cancer (57.0%) based on the guidelines of the American Joint Committee on Cancer (AJCC) and had a grim prognosis (2)(3)(4)(5). The prognosis of CHC was reported as comparable to that of ICC but was worse than that of HCC (6)(7)(8)(9)(10), and patients with CHC have a lower survival rate than those with both the aforementioned malignancies (11)(12)(13)(14). Therefore, the survival and prognosis of patients with CHC remain significant concerns.…”

Section: Introductionmentioning

confidence: 99%

Prediction of Survival and Analysis of Prognostic Factors for Patients With Combined Hepatocellular Carcinoma and Cholangiocarcinoma: A Population-Based Study

Wang

Liao

et al. 2021

Front. Oncol.

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BackgroundCombined hepatocellular carcinoma and cholangiocarcinoma (CHC) is an uncommon subtype of primary liver cancer. Because of limited epidemiological data, prognostic risk factors and therapeutic strategies for patients with CHC tend to be individualized. This study aimed to identify independent prognostic factors and develop a nomogram-based model for predicting the overall survival (OS) of patients with CHC.MethodsWe recruited eligible individuals from the Surveillance, Epidemiology, and End Results (SEER) database between 2004 and 2015 and randomly divided them into the training or verification cohort. Univariate and multivariate analyses were performed to identify independent variables associated with OS. Based on multivariate analysis, the nomogram was established, and its prediction performance was evaluated using the consistency index (C-index) and calibration curve.ResultsIn total, 271 patients with CHC were included in our study. The median OS was 14 months, and the 1-, 3-, and 5-year OS rates were 52.3%, 27.1%, and 23.3%, respectively. In the training cohort, multivariate analysis showed that the pathological grade (hazard ratio [HR], 1.26; 95% confidence interval [CI]: 0.96–1.66), TNM stage (HR, 1.21; 95% CI: 1.02 - 1.44), and surgery (HR, 0.26; 95% CI: 0.17 - 0.40) were independent indicators of OS. The nomogram-based model related C-indexes were 0.76 (95% CI: 0.72 - 0.81) and 0.72 (95% CI: 0.66 - 0.79) in the training and validation cohorts, respectively. The calibration of the nomogram showed good consistency of 1-, 3-, and 5-year OS rates between the actual observed survival and predicted survival in both cohorts. The TNM stage (HR, 1.23; 95% CI: 1.01 - 1.49), and M stage (HR, 1.87; 95% CI: 1.14 3.05) were risk factors in the surgical treatment group. Surgical resection and liver transplantation could significantly prolong the survival, with no statistical difference observed.ConclusionsThe pathological grade, TNM stage, and surgery were independent prognostic factors for patients with CHC. We developed a nomogram model, in the form of a static nomogram or an online calculator, for predicting the OS of patients with CHC, with a good predictive performance.

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“…Cholangiocarcinoma (ICC) is an aggressive primary hepatic carcinoma originating in the bile duct epithelium [76]. Unlike HCC, surgical resection is currently the only treatment method for patients with ICC [77]. A study [78] extracted the most predictive radiomics features for evaluating MVI, perineural invasion, differentiation, Ki-67, VEGFR and CK7 in ICC and reported that these features had moderate efficiency in non-invasively predicting the biological behavior of ICC.…”

Section: Evaluation Of Tumor Biological Behaviors and Molecular Profilesmentioning

confidence: 99%

Ultrasound-based radiomics: current status, challenges and future opportunities

et al. 2022

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Ultrasound (US) imaging is part of conventional medical imaging in clinical practice that is low-cost, non-ionizing, portable and capable of real-time image acquisition and display. However, in certain cases, US has limited sensitivity and specificity in differentiating between malignant and benign lesions. Ultrasound-based radiomics, as a new branch of radiomics, can provide additional features such as heterogeneity of lesions that are invisible to the naked eye, alone or in combination with demographic, histological, genomic or proteomic data, thereby improving the accuracy of US in diagnosis of disease. This article provides an introduction to ultrasound-based radiomics, covering its workflow, the application of machine learning, and current research status. Current limitations of radiomics, such as consistency of image acquisition, parameter variations, and difficulty in calibrating quantitative methods in ultrasound, will also be covered.

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The clinical characteristics and prognostic factors of combined Hepatocellular Carcinoma and Cholangiocarcinoma, Hepatocellular Carcinoma and Intrahepatic Cholangiocarcinoma after Surgical Resection: A propensity score matching analysis

Cited by 19 publications

References 35 publications

CEUS and CT/MRI LI-RADS in Association With Serum Biomarkers for Differentiation of Combined Hepatocellular-Cholangiocarcinoma From Hepatocellular Carcinoma

CEUS and CT/MRI LI-RADS in Association With Serum Biomarkers for Differentiation of Combined Hepatocellular-Cholangiocarcinoma From Hepatocellular Carcinoma

Prediction of Survival and Analysis of Prognostic Factors for Patients With Combined Hepatocellular Carcinoma and Cholangiocarcinoma: A Population-Based Study

Ultrasound-based radiomics: current status, challenges and future opportunities

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