Clinical features and outcomes of combined hepatocellular carcinoma and cholangiocarcinoma versus hepatocellular carcinoma versus cholangiocarcinoma after surgical resection: a propensity score matching analysis

• Published in: BMC gastroenterology Vol. 21; no. 1; p. 20
• Main Authors: Lin, Chih-Wen, Wu, Tsung-Chin, Lin, Hung-Yu, Hung, Chao-Ming, Hsieh, Pei-Min, Yeh, Jen-Hao, Hsiao, Pojen, Huang, Ya-Ling, Li, Yu-Chan, Wang, Ya-Chin, Shu, Chih-Wen, Chen, Yaw-Sen
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 07.01.2021; BioMed Central; BMC
• Subjects: Age; Alcohol use; Bile Duct Neoplasms - surgery; Bile Ducts, Intrahepatic; Carcinoma, Hepatocellular - surgery; Care and treatment; Cholangiocarcinoma; Cholangiocarcinoma - surgery; Clinical outcomes; Combined hepatocellular carcinoma and cholangiocarcinoma; Comparative analysis; Diabetes; Female; Gastroenterology; Hepatectomy; Hepatitis; Hepatocellular carcinoma; Hepatoma; Humans; Hypertension; Liver cancer; Liver cirrhosis; Liver Neoplasms - surgery; Lymphatic system; Male; Medical prognosis; Metastasis; Middle Aged; Mortality; Neoplasm Recurrence, Local - epidemiology; Overall survival; Patient outcomes; Patients; Prognosis; Propensity Score; Recurrence; Retrospective Studies; Survival; Taiwan; Tumors; Taiwan; Combined hepatocellular carcinoma and cholangiocarcinoma; Recurrence; Prognosis; Overall survival
• ISSN: 1471-230X; 1471-230X
• DOI: 10.1186/s12876-020-01586-4

Combined hepatocellular carcinoma and cholangiocarcinoma (cHCC-CC) is an infrequent type of primary liver cancer that comprises hepatocellular carcinoma (HCC) and cholangiocarcinoma (CC). This study investigated the clinicopathological features and prognosis among cHCC-CC, HCC, and CC groups. We prospectively collected the data of 608 patients who underwent surgical resection for liver cancer between 2011 and 2018 at E-Da Hospital, I-Shou University, Kaohsiung, Taiwan. Overall, 505 patients with cHCC-CC, HCC, and CC were included, and their clinicopathological features, overall survival (OS), and recurrence were recorded. OS and recurrence rates were analyzed using the Kaplan-Meier analysis. In the entire cohort, the median age was 61 years and 80% were men. Thirty-five (7.0%) had cHCC-CC, 419 (82.9%) had HCC, and 51 (10.1%) had CC. The clinicopathological features of the cHCC-CC group were more identical to those of the HCC group than the CC group. OS was significantly lower in the cHCC-CC group than in the HCC group but was not significantly higher in the cHCC-CC group than in the CC group. The median OS of cHCC-CC, HCC, and CC groups was 50.1 months [95% confidence interval (CI): 38.7-61.2], 62.3 months (CI: 42.1-72.9), and 36.2 months (CI: 15.4-56.5), respectively. Cumulative OS rates at 1, 3, and 5 years in cHCC-CC, HCC, and CC groups were 88.5%, 62.2%, and 44.0%; 91.2%, 76.1%, and 68.0%; and 72.0%, 48.1%, and 34.5%, respectively. After propensity score matching (PSM), OS in the cHCC-CC group was not significantly different from that in the HCC or CC group. However, OS was significantly higher in the HCC group than in the CC group before and after PSM. Furthermore, the disease-free survival was not significantly different among cHCC-CC, HCC, and CC groups before and after PSM. The clinicopathological features of the cHCC-CC group were more identical to those of the HCC group than the CC group. The OS rate was significantly lower in the cHCC-CC group than the HCC group. However, after PSM, OS and disease-free survival in the cHCC-CC group were not significantly different from those in the HCC or CC group.