Clinicopathological characteristics of combined hepatocellular cholangiocarcinoma from the viewpoint of patient prognosis after hepatic resection: High rate of early recurrence and its predictors

Yo ichi Yamashita, Shinichi Aishima, Yosuke Nakao, Tomoharu Yoshizumi, Hiroaki Nagano, Tamotsu Kuroki, Yuko Takami, Takao Ide, Masayuki Ohta, Mitsuhisa Takatsuki, Atsushi Nanashima, Fuminori Ishii, Kenji Kitahara, Satoshi Iino, Toru Beppu, Hideo Baba, Susumu Eguchi

Research output: Contribution to journalArticlepeer-review

3 Citations (Scopus)

Abstract

Aim: Combined hepatocellular cholangiocarcinoma (cHCC-CCA) is a very rare subtype of primary liver carcinoma; therefore, its clinicopathological characteristics have not yet been elucidated in detail. The aim of the study was to reveal the clinicopathological characteristics and prognostic factors of cHCC-CCA after hepatic resection (HR). Methods: A total of 124 patients who underwent curative HR for cHCC-CCA between 2000 and 2016 were enrolled in this multi-institutional study conducted by the Kyushu Study Group of Liver Surgery. Clinicopathological analysis was performed from the viewpoint of patient prognosis. Results: A total of 62 patients (50%) had early recurrence within 1.5 years after HR, including 36 patients (58%) with extrahepatic recurrence. In contrast, just four patients (3%) had late recurrence occurring >3 years after HR. The independent predictors of early recurrence were as follows: des-gamma carboxyprothrombin >40 mAU/mL (odds ratio 26.2, P = 0.0117), carbohydrate antigen 19–9>37 IU/l (odds ratio 18.0, P = 0.0200), and poorly differentiated HCC or CCA (odds ratio 11.2, P = 0.0259). Conclusions: Half of the patients with cHCC-CCA had early recurrence after HR. Preoperative elevation of des-gamma carboxyprothrombin or carbohydrate antigen 19–9 and the existence of poorly differentiated components of HCC or CCA in resected specimens are predictors of its early recurrence.

Original languageEnglish
Pages (from-to)863-870
Number of pages8
JournalHepatology Research
Volume50
Issue number7
DOIs
Publication statusPublished - Jul 1 2020
Externally publishedYes

All Science Journal Classification (ASJC) codes

  • Hepatology
  • Infectious Diseases

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