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Management and outcomes among patients with mixed hepatocholangiocellular carcinoma: A population‐based analysis
Author(s) -
Spolverato Gaya,
Bagante Fabio,
Tsilimigras Diamantis,
Ejaz Aslam,
Cloyd Jordan,
Pawlik Timothy M.
Publication year - 2019
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.25331
Subject(s) - medicine , hepatocellular carcinoma , intrahepatic cholangiocarcinoma , gastroenterology , incidence (geometry) , lymphadenectomy , oncology , cancer , physics , optics
Background We sought to define the management of mixed hepatocellular carcinoma‐intrahepatic cholangiocarcinoma (HCC‐ICC) as well as characterize short‐ and long‐term outcomes of patients with mixed HCC‐ICC. Methods Patients diagnosed with HCC‐ICC, HCC, or ICC between 2004 and 2015 were identified from the National Cancer Data Base using the International Classification of Diseases for Oncology codes. Short‐ and long‐term outcomes were assessed using univariate and multivariate analyses. Results Among 174 454 patients, 86.8% had HCC, 12.1% ICC, and 1.1% HCC‐ICC. The incidence of lymphadenectomy was 55.6% among ICC patients vs 15.1% and 34.2% for HCC and HCC‐ICC patients, respectively ( P < 0.001). A 90‐day mortality was comparable among patients with HCC (9.1%), ICC (8.8%), and HCC‐ICC (10.5%) (all P > 0.2). While 42.0% of ICC patients received adjuvant chemotherapy, adjuvant chemotherapy among HCC and HCC‐ICC patients was 13.1% and 27.4%, respectively ( P < 0.001). A 5‐year survival was 43.5% (95% CI, 42.5‐44.5), 33.3% (95% CI, 31.4‐35.3), 34.4% (95% CI, 29.1‐39.8) for HCC, ICC, and HCC‐ICC patients, respectively. Conclusion Patients who underwent resection of mixed HCC‐ICC had a prognosis that was comparable to ICC, yet worse than HCC. Utilization of lymphadenectomy and adjuvant therapy were low. HCC‐ICC remains a rare disease with a guarded prognosis that should be treated in a multidisciplinary setting.