Intrahepatic cholangiocarcinoma or mixed hepatocellular-cholangiocarcinoma in patients undergoing liver transplantation: A spanish matched cohort multicenter study

G. Sapisochin, C. Rodríguez De Lope, M. Gastaca, J. Ortiz De Urbina, R. López-Andujar, F. Palacios, E. Ramos, J. Fabregat, J. F. Castroagudín, E. Varo, J. A. Pons, P. Parrilla, M. L. González-Diéguez, M. Rodriguez, A. Otero, M. A. Vazquez, G. Zozaya, J. I. Herrero, G. Sanchez Antolin, B. PerezR. Ciria, S. Rufian, Y. Fundora, J. A. Ferron, A. Guiberteau, G. Blanco, M. A. Varona, M. A. Barrera, M. A. Suarez, J. Santoyo, J. Bruix, R. Charco

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Abstract

OBJECTIVE: To evaluate the outcome of patients with hepatocellular- cholangiocarcinoma (HCC-CC) or intrahepatic cholangiocarcinoma (I-CC) on pathological examination after liver transplantation for HCC. BACKGROUND: Information on the outcome of cirrhotic patients undergoing a transplant for HCC and with a diagnosis of HCC-CC or I-CC by pathological study is limited. METHODS: Multicenter, retrospective, matched cohort 1:2 study. Study group: 42 patients undergoing a transplant for HCC and with a diagnosis of HCC-CC or I-CC by pathological study; and control group: 84 patients with a diagnosis of HCC. I-CC subgroup: 27 patients compared with 54 controls; HCC-CC subgroup: 15 patients compared with 30 controls. Patients were also divided according to the preoperative tumor size and number: uninodular tumors 2 cm or smaller and multinodular or uninodular tumors 2 cm or larger. Median follow-up: 51 (range, 3-142) months. RESULTS: The 1-, 3-, and 5-year actuarial survival rate differed between the study and control groups (83%, 70%, and 60% vs 99%, 94%, and 89%, respectively; P < 0.001). Differences were found in 1-, 3-, and 5-year actuarial survival rates between the I-CC subgroup and their controls (78%, 66%, and 51% vs 100%, 98%, and 93%; P < 0.001), but no differences were observed between the HCC-CC subgroup and their controls (93%, 78%, and 78% vs 97%, 86%, and 86%; P = 0.9). Patients with uninodular tumors 2 cm or smaller in the study and control groups had similar 1-, 3-, and 5-year survival rate (92%, 83%, 62% vs 100%, 80%, 80%; P = 0.4). In contrast, patients in the study group with multinodular or uninodular tumors larger than 2 cm had worse 1-, 3-, and 5-year survival rates than their controls (80%, 66%, and 61% vs 99%, 96%, and 90%; P < 0.001). CONCLUSIONS: Patients with HCC-CC have similar survival to patients undergoing a transplant for HCC. Preoperative diagnosis of HCC-CC should not prompt the exclusion of these patients from transplant option. Copyright © 2014 by Lippincott Williams & Wilkins.
Original languageEnglish
Pages (from-to)944-952
JournalAnnals of Surgery
Volume259
Issue number5
DOIs
Publication statusPublished - 1 Jan 2014

Keywords

  • hepatocellular carcinoma
  • intrahepatic cholangiocarcinoma
  • liver transplantation
  • mixed hepatocellular cholangiocarcinoma
  • outcome

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