Longterm prognosis of combined hepatocellular carcinoma‐cholangiocarcinoma following liver transplantation and resection

Autor: Ki-Hun Kim, Gi-Won Song, Gil-Chun Park, Shin Hwang, Woo-Hyoung Kang, Wan-Jun Kim, Seung-Mo Hong, Sung-Gyu Lee, Chul-Soo Ahn, Seok-Hwan Kim, Deok-Bog Moon, Eun Sil Yu, Tae-Yong Ha, Dong-Hwan Jung
Rok vydání: 2017
Předmět:
Male
medicine.medical_specialty
Carcinoma
Hepatocellular
medicine.medical_treatment
Liver transplantation
Gastroenterology
Cholangiocarcinoma
Neoplasms
Multiple Primary
03 medical and health sciences
Rare Diseases
0302 clinical medicine
Internal medicine
Preoperative Care
medicine
Carcinoma
Hepatectomy
Humans
Stage (cooking)
Propensity Score
Survival rate
Neoplasm Staging
Retrospective Studies
Tumor marker
Incidental Findings
Transplantation
Hepatology
business.industry
Incidence (epidemiology)
Liver Neoplasms
Middle Aged
Prognosis
medicine.disease
Liver Transplantation
Surgery
Survival Rate
Bile Ducts
Intrahepatic
Treatment Outcome
Bile Duct Neoplasms
Liver
030220 oncology & carcinogenesis
Hepatocellular carcinoma
Female
030211 gastroenterology & hepatology
Neoplasm Recurrence
Local
business
Zdroj: Liver Transplantation. 23:330-341
ISSN: 1527-6473
1527-6465
Popis: Combined hepatocellular carcinoma-cholangiocarcinoma (cHCC-CC) is a rare disease. We investigated the clinicopathological features of cHCC-CC and compared the longterm outcomes following liver transplantation (LT) and hepatic resection (HR). We identified 32 LT patients with cHCC-CC through an institutional database search. The HR control group (n = 100) was selected through propensity score-matching. The incidence of cHCC-CC among all adult LT patients was 1.0%. Mean patient age was 53.4 ± 6.7 years, and 26 patients were male. Thirty patients had hepatitis B virus infection. All patients of cHCC-CC were diagnosed incidentally in the explanted livers. Mean tumor diameter was 2.5 ± 1.3 cm, and 28 patients had single tumors. Tumor stage was stage I in 23 and II in 9. Concurrent hepatocellular carcinoma (HCC) was detected in 12 patients with stage I in 5 and II in 7. Mean tumor diameter was 1.9 ± 1.2 cm, and 5 had single tumors. Tumor recurrence and survival rates were 15.6% and 84.4% at 1 year and 32.2% and 65.8% at 5 years, respectively. Patients with very early stage cHCC-CC (1 or 2 tumors ≤ 2.0 cm) showed 13.3% tumor recurrence and 93.3% patient survival rates at 5 years, which were significantly improved than those with advanced tumors (P = 0.002). Tumor recurrence and survival rates did not differ significantly between the LT and HR control groups (P = 0.22 and P = 0.91, respectively); however, postrecurrence patient survival did (P = 0.016). In conclusion, cHCC-CC is rarely diagnosed following LT, and one-third of such patients have concurrent HCC. The longterm posttransplant prognosis was similar following LT and HR. Very early cHCC-CC resulted in favorable posttransplant prognosis, thus this selection condition can be prudently considered for LT indication. Liver Transplantation 23 330-341 2017 AASLD.
Databáze: OpenAIRE
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