Comparison of Combined Hepatocellular and Cholangiocarcinoma with Hepatocellular Carcinoma and Intrahepatic Cholangiocarcinoma |
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Authors: | Won-Suk Lee Kwang-Woong Lee Jin-Seok Heo Sung-Ju Kim Seong-Ho Choi Yong-Il Kim Jae-Won Joh |
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Affiliation: | (1) Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Ilwon-dong 50, Gangnam-gu, Seoul, 135-710, Korea |
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Abstract: | Purpose Combined hepatocellular and cholangiocarcinoma (HCC-CC) is a rare primary hepatic neoplasm (PHN) with features of both hepatocellular and biliary differentiation. We compared the outcome of hepatic resection in patients with HCC-CC, those with hepatocelluar carcinoma (HCC), and those with cholangiocarcinoma (ICC). Methods Between November 1994 and December 2003, 952 patients underwent hepatic resection for a PHN. Results The incidence of HCC-CC was 3.5%. Hepatitis B surface antigen was positive in 51.2% of these patients and the HCV antibody was positive in 12.2%. Positive hepatitis serology was more common in the HCC group (66.7%). The prevalence of underlying liver cirrhosis was significantly lower in the ICC group (7.8%) than in the HCC (49%) and HCC-CC (41.5%) groups (P < 0.0001). The median overall survival periods after hepatic resection of HCC-CC, HCC, and ICC were 47.3, 71.7, and 21.5 months, respectively (P < 0.0001). The median disease-free survival (DFS) periods after hepatic resection for HCC-CC, HCC, and ICC were 23.4, 68.2, and 15.5 months, respectively (P < 0.0001). Conclusion Patients with transitional type HCC-CC had significantly poorer survival rates than those with HCC, after hepatic resection. Therefore, a more aggressive treatment modality should be explored to improve the survival rate of these patients. |
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Keywords: | Combined type hepatocelluar carcinoma Hepatocelluar carcinoma Intrahepatic cholangiocarcinoma Hepatic resection Cholangiocarcinoma |
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