Intrahepatic Cholangiocarcinoma and Combined Hepatocellular-Cholangiocarcinoma: A Western Experience

Background  Intrahepatic cholangiocarcinoma (ICC) is an unusual tumour. Methods  The clinicopathological data of 67 patients with ICC and combined hepatocellular–cholangiocarcinoma (HCC–ICC) are presented. Results  HCV–HBV infection was present in 37.3% and chronic liver disease in 38.7% of cases, a rate higher than in the normal population; in these patients the cancer was small, often asymptomatic and of combined type. Liver resection was performed in 51 patients; at 1, 3 and 5 years, overall survival was 87.9%, 59.0%, and disease-free survival was 47.7% and 78.8%, 51.4%, and 46.7%, respectively. The better results were in the group of cirrhotic patients in whom ICC was diagnosed by a screening program for HCC (5-year survival 76.6%). Nodal metastasis showed negative prognostic value for both overall and disease-free survival; in N+ patients mean survival was 14.7 months after liver resection and lymph node dissection. Conclusion  Viral infection and cirrhosis may be considered risk conditions for ICC and combined HCC–ICC; in resected patients survival was good. Nodal metastases must not be considered a contraindication for liver resection.