Postresection prognosis of combined hepatocellular carcinoma-cholangiocarcinoma according to the 2010 World Health Organization classification: single-center experience of 168 patients

Minjae Kim; Shin Hwang; Chul-Soo Ahn; Ki-Hun Kim; Deok-Bog Moon; Tae-Yong Ha; Gi-Won Song; Dong-Hwan Jung; Gil-Chun Park; Seung-Mo Hong

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저자정보: Minjae Kim (University of Ulsan College of Medicine) Shin Hwang (University of Ulsan College of Medicine) Chul-Soo Ahn (University of Ulsan College of Medicine) Ki-Hun Kim (University of Ulsan College of Medicine) Deok-Bog Moon (University of Ulsan College of Medicine) Tae-Yong Ha (University of Ulsan College of Medicine) Gi-Won Song (University of Ulsan College of Medicine) Dong-Hwan Jung (University of Ulsan College of Medicine) Gil-Chun Park (University of Ulsan College of Medicine) Seung-Mo Hong (University of Ulsan College of Medicine)

저널정보: 대한외과학회 Annals of Surgical Treatment and Research Annals of Surgical Treatment and Research Vol.100 No.5

발행연도: 2021.5

수록면: 260 - 269 (10page)

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Purpose: Combined hepatocellular carcinoma and cholangiocarcinoma (cHCC-CC) has wide histologic diversity. This study investigated the effects of cHCC-CC histology, according to the 2010 World Health Organization (WHO) classification, on patient prognosis.
Methods: The medical records of patients who underwent surgical resection for cHCC-CC at our institution between July 2012 and June 2019 were retrospectively evaluated.
Results: During the study period, 168 patients, 122 males (72.6%) and 46 females (27.4%), underwent surgical resection for cHCC-CC, including 159 patients (94.6%) who underwent R0 resection. Mean tumor diameter was 4.4 ± 2.8 cm, and 161 patients (95.8%) had solitary tumors. Histologically, 86 patients (51.2%) had classical type, and 82 (48.8%) had tumors with stem cell (SC) features, including 33 (19.6%) with intermediate-cell and 23 (13.7%) each with typical SC and cholangiolocellular features; 3 tumors (1.8%) were unclassifiable. At 1, 3, and 5 years, tumor recurrence rates were 31.9%, 49.6%, and 58.1%, respectively, and patient survival rates were 91.0%, 70.2%, and 60.3%, respectively. Univariate analysis showed that tumor size of >5 cm, microscopic and macroscopic vascular invasion, lymph node metastasis, 8th edition of the American Joint Committee on Cancer (AJCC) tumor stage, and 2010 WHO classification were significantly prognostic. Multivariate analysis showed that the 8th AJCC tumor stage and 2010 WHO histologic classification were independently prognostic for tumor recurrence and patient survival. There were no significant prognostic differences among the 3 SC subtypes.
Conclusion: Postresection outcomes are better in patients with SC-type than with classical-type cHCC-CC.

#Combined tumor #Hepatic #Hepatocellular carcinoma #Progenitor cells #Stem cells

참고문헌 (29)

참고문헌 신청

Allen RA / 1949 / Combined liver cell and bile duct carcinoma / Am J Pathol 25:647~655

Goodman ZD / 1985 / Combined hepatocellular-cholangiocarcinoma: a histologic and immunohistochemical study / Cancer 55:124~135

Theise ND / 2010 / WHO classification of tumours of the digestive system / IARC :225~227

Jung DH / 2017 / Post-resection prognosis of combined hepatocellular carcinoma-cholangiocarcinoma according to the 2010 WHO classification / World J Surg 41:1347~1357

Ikeda H / 2013 / Clinico-pathologic significance of combined hepatocellular-cholangiocarcinoma with stem cell subtype components with reference to the expression of putative stem cell markers / Am J Clin Pathol 140:329~340

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