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Clinical and pathological features of combined hepatocellular-cholangiocarcinoma compared with other liver cancers

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Title: Clinical and pathological features of combined hepatocellular-cholangiocarcinoma compared with other liver cancers
Authors: Wakizaka, Kazuki Browse this author
Yokoo, Hideki Browse this author →KAKEN DB
Kamiyama, Toshiya Browse this author →KAKEN DB
Ohira, Masafumi Browse this author
Kato, Koichi Browse this author
Fujii, Yuki Browse this author
Sugiyama, Ko Browse this author
Okada, Naoki Browse this author
Ohata, Takanori Browse this author
Nagatsu, Akihisa Browse this author
Shimada, Shingo Browse this author
Orimo, Tatsuya Browse this author
Kamachi, Hirofumi Browse this author →KAKEN DB
Taketomi, Akinobu Browse this author →KAKEN DB
Keywords: combined hepatocellular-cholangiocarcinoma
hepatocellular carcinoma
intrahepatic cholangiocarcinoma
prognosis
resection
Issue Date: Jun-2019
Publisher: John Wiley & Sons
Journal Title: Journal of gastroenterology and hepatology
Volume: 34
Issue: 6
Start Page: 1074
End Page: 1080
Publisher DOI: 10.1111/jgh.14547
PMID: 30462849
Abstract: Background and Aim Combined hepatocellular-cholangiocarcinoma (CHC) is a primary liver cancer containing both hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (ICC) elements. Its reported clinicopathological features and prognoses have varied because of its low prevalence. This study aimed to clarify these aspects of CHC. Methods We enrolled 28 patients with CHC, 1050 with HCC, and 100 with ICC and compared the clinicopathological characteristics and prognosis of CHC with HCC and ICC. We also analyzed prognostic factors, recurrence patterns, and management in CHC patients. Results The incidences of hepatitis B virus and high alpha-fetoprotein and protein induced by vitamin K absence or antagonists-II levels were significantly higher among CHC compared with ICC patients. Multiple tumors were more frequent in CHC compared with the other groups, while vascular invasion and lymph node metastasis were more frequent in the CHC than the HCC group. The 5-year overall survival and disease-free survival rates for CHC were 25.1% and 22.6%, respectively. Overall survival was significantly lower than for HCC (P < 0.001) but not ICC (P = 0.152), while disease-free survival was significantly lower than for HCC and ICC (P = 0.008 and P = 0.005, respectively). Multivariate analysis identified carcinoembryonic antigen levels and tumor size as independent predictors in patients with CHC. Conclusions The clinical features of CHC, including sex, hepatitis B virus infection, alpha-fetoprotein, and protein induced by vitamin K absence or antagonists-II levels, were similar to HCC, while its prognosis and pathological features, including vascular invasion and lymph node metastasis, were similar to ICC. Carcinoembryonic antigen levels and tumor size were independent prognostic factors in patients with CHC.
Rights: This is the peer reviewed version of the following article: Kazuki Wakizaka, Hideki Yokoo, Toshiya Kamiyama, Masafumi Ohira, Koichi Kato, Yuki Fujii, Ko Sugiyama, Naoki Okada, Takanori Ohata, Akihisa Nagatsu, Shingo Shimada, Tatsuya Orimo, Hirofumi Kamachi and Akinobu Taketomi. (2019) Clinical and pathological features of combined hepatocellular-cholangiocarcinoma compared with other liver cancers. Journal of gastroenterology and hepatology, 34: 1074-1080, which has been published in final form at https://doi.org/10.1111/jgh.14547. This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Use of Self-Archived Versions.
Type: article (author version)
URI: http://hdl.handle.net/2115/81696
Appears in Collections:医学院・医学研究院 (Graduate School of Medicine / Faculty of Medicine) > 雑誌発表論文等 (Peer-reviewed Journal Articles, etc)

Submitter: 脇坂 和貴

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