Prognostic Impact of the Cholangiolar Component in Combined Hepatocellular-Cholangiocarcinoma: Insights From a Western Single-Center Study.

Autor: Nolasco F; Liver Surgery Unit, Department of Gastroenterology, Digestive Surgery Division, University of Saão Paulo Medical School, São Paulo, Brazil., Fonseca GM; Liver Surgery Unit, Department of Gastroenterology, Digestive Surgery Division, University of Saão Paulo Medical School, São Paulo, Brazil., de Mello ES; Departament of Pathology, University of São Paulo Medical School, São Paulo, Brazil., Kruger JAP; Liver Surgery Unit, Department of Gastroenterology, Digestive Surgery Division, University of Saão Paulo Medical School, São Paulo, Brazil., Jeismann VB; Liver Surgery Unit, Department of Gastroenterology, Digestive Surgery Division, University of Saão Paulo Medical School, São Paulo, Brazil., Makdissi FF; Liver Surgery Unit, Department of Gastroenterology, Digestive Surgery Division, University of Saão Paulo Medical School, São Paulo, Brazil., Coelho FF; Liver Surgery Unit, Department of Gastroenterology, Digestive Surgery Division, University of Saão Paulo Medical School, São Paulo, Brazil., Alves VAF; Departament of Pathology, University of São Paulo Medical School, São Paulo, Brazil., Herman P; Liver Surgery Unit, Department of Gastroenterology, Digestive Surgery Division, University of Saão Paulo Medical School, São Paulo, Brazil.
Jazyk: angličtina
Zdroj: Journal of surgical oncology [J Surg Oncol] 2024 Oct 15. Date of Electronic Publication: 2024 Oct 15.
DOI: 10.1002/jso.27955
Abstrakt: Introduction: Primary liver malignancies, such as hepatocellular carcinoma (HCC), intrahepatic cholangiocarcinoma (ICC), and combined hepatocellular-cholangiocarcinoma (cHCC-CCA), represent significant contributors to global cancer-related mortality. The diagnostic challenges associated with distinguishing cHCC-CCA from HCC and ICC stem from their rarity and overlapping histological features.
Objectives: This study aimed to reclassify primary liver tumors resected at a Western center and to compare clinicopathological features and prognosis among patients with HCC, ICC, and cHCC-CCA.
Methods: A retrospective analysis was conducted on patients undergoing resection for HCC, ICC, or cHCC-CCA between 2007 and 2017. Clinical and perioperative data were collected, and pathological specimens were reclassified by a specialized pathologist. Statistical analysis was employed to compare clinical features and survival outcomes among the different tumor types.
Results: Out of the initially identified 192 patients, 140 were included in the analysis. Following reclassification, 71.42% were diagnosed with HCC, 12.14% with ICC, and 16.42% with cHCC-CCA. Patients with HCC were predominantly male and exhibited a higher incidence of isolated liver recurrence. ICC patients more frequently underwent open procedures. Additionally, patients with HCC and cHCC-CCA showed higher rates of cirrhosis, elevated alpha-fetoprotein levels, and extrahepatic recurrence, while those with ICC and cHCC-CCA demonstrated elevated CA 19-9 levels. Overall survival and disease-free survival were longer for HCC compared to cases with a cholangiolar component (ICC and cHCC-CCA).
Conclusions: Histological evaluation should actively incorporate the search for a cholangiolar component in primary liver tumors to prevent misdiagnosis, as its presence indicates a poorer prognosis.
(© 2024 Wiley Periodicals LLC.)
Databáze: MEDLINE
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