Published in:
01-07-2012 | Original article
Clinical and pathological analysis of 27 patients with combined hepatocellular-cholangiocarcinoma in an Asian center
Authors:
Qian Zhan, Bai-Yong Shen, Xia-Xing Deng, Zhe-Cheng Zhu, Hao Chen, Chen-Hong Peng, Hong-Wei Li
Published in:
Journal of Hepato-Biliary-Pancreatic Sciences
|
Issue 4/2012
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Abstract
Background
Our purpose was to assess the clinicopathological features and surgical outcomes of combined hepatocellular-cholangiocarcinoma (HCC-CC) in an Asian center.
Methods
Between 1998 and 2009, 27 patients were diagnosed with combined HCC-CC at our hospital. Their medical records were reviewed and clinicopathological data retrospectively analyzed.
Results
The 27 patients included 24 (88.9%) males and 3 (11.1%) females with a mean age of 58.26 ± 11.18 years. Cirrhosis was present in 10 patients (37.0%), and 12 patients had hepatitis C or hepatitis B virus infection. Serum alpha fetoprotein was >20 ng/ml in 7 of the 19 patients in whom it was measured (36.8%). Twenty-five patients underwent hepatic resections and 2 received liver transplantations. Five (18.5%) patients had separate HCC and CC within the same liver (type I), 21 (77.8%) had tumors with mixed components (type II), and 1 patient had a type III tumor (3.7%). Of 22 patients with immunohistochemical data, 19 (86.4%) were cytokeratin (CK) 7-positive, 20 (90.9%) were CK19-positive, and 4 (18.2%) were CK20-positive. Mean follow-up was 25.8 months. The 1- and 2-year survival rates were 72.5 and 49.4%, respectively. The 1- and 2-year disease-free survival rates were 54.2 and 41.3%, respectively. Symptoms at the time of diagnosis, and regional lymph node metastases, were associated with higher mortality and recurrence.
Conclusions
Lymph node metastasis and positive resection margins are important factors affecting HCC-CC surgical outcomes.