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Clinicopathologic and MRI features of combined hepatocellular‐cholangiocarcinoma in patients with or without cirrhosis
Author(s) -
Yoon Jongjin,
Hwang Jeong A.,
Lee Sunyoung,
Lee Ji E.,
Ha Sang Y.,
Park Young N.
Publication year - 2021
Publication title -
liver international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.873
H-Index - 110
eISSN - 1478-3231
pISSN - 1478-3223
DOI - 10.1111/liv.14798
Subject(s) - cirrhosis , medicine , hazard ratio , proportional hazards model , magnetic resonance imaging , confidence interval , hepatocellular carcinoma , gastroenterology , retrospective cohort study , survival analysis , nuclear medicine , radiology
Background and Aims Differences in combined hepatocellular‐cholangiocarcinomas (cHCC‐CCAs) arising in high‐risk patients with or without liver cirrhosis have not been elucidated. This study aimed to compare the clinicopathologic and imaging characteristics of cHCC‐CCAs in patients with or without cirrhosis and to determine the prognostic factors for recurrence‐free survival (RFS) after curative resections of single cHCC‐CCAs. Methods This retrospective study included 113 patients with surgically resected single cHCC‐CCAs who underwent preoperative magnetic resonance imaging from January 2008 to December 2019 at two tertiary referral centres. Clinical, pathologic and imaging features of tumours were compared in high‐risk patients with or without cirrhosis. Imaging features were assessed using the Liver Imaging Reporting and Data System (LI‐RADS) version 2018. RFS and associated factors were evaluated using Cox proportional hazards regression analysis, Kaplan‐Meier analysis and log‐rank test. Results cHCC‐CCAs arising from cirrhotic livers had a smaller mean tumour size (2.9 cm vs. 4.5 cm; P < .001) and were more frequently categorized as LR‐5 or 4 (41.2% vs. 20.0%; P = .024) than those arising from non‐cirrhotic livers. In multivariable analysis, a tumour size of > 3 cm (hazard ratio [HR], 2.081; 95% confidence interval [CI], 1.180‐3.668; P = .011) and the LR‐M category (HR, 2.302; 95% CI, 1.198‐4.424; P = .012) were independent predictors associated with worse RFS. Conclusions The tumour size and distribution of LI‐RADS categories of cHCC‐CCAs differed in high‐risk patients with or without cirrhosis. And LR‐M category was a worse prognosis predictor after curative resections than LR‐5 or 4 category.