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Clinicopathological characteristics of combined hepatocellular cholangiocarcinoma from the viewpoint of patient prognosis after hepatic resection: High rate of early recurrence and its predictors
Author(s) -
Yamashita Yoichi,
Aishima Shinichi,
Nakao Yosuke,
Yoshizumi Tomoharu,
Nagano Hiroaki,
Kuroki Tamotsu,
Takami Yuko,
Ide Takao,
Ohta Masayuki,
Takatsuki Mitsuhisa,
Nanashima Atsushi,
Ishii Fuminori,
Kitahara Kenji,
Iino Satoshi,
Beppu Toru,
Baba Hideo,
Eguchi Susumu
Publication year - 2020
Publication title -
hepatology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.123
H-Index - 75
eISSN - 1872-034X
pISSN - 1386-6346
DOI - 10.1111/hepr.13507
Subject(s) - odds ratio , medicine , hepatocellular carcinoma , gastroenterology , confidence interval
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.