Surgical Treatments and Prognoses of Patients with Combined Hepatocellular Carcinoma and Cholangiocarcinoma (original) (raw)

Abstract

Background

Combined hepatocellular carcinoma and cholangiocarcinoma is a very rare form of primary liver cancer containing components of both tumor types. We evaluated the effectiveness of surgical treatment and factors related to survival and recurrence.

Patients and Methods

Of the 2427 patients who underwent hepatectomy or liver transplantation because of a primary hepatic malignancy from January 1989 to July 2006 at the Asan Medical Center, Seoul, Korea, 29 had hepatocellular carcinoma and cholangiocarcinoma as a single mixed or transitional tumor. Their medical records were retrospectively reviewed.

Results

Disease-free survival rates at 6 months, 1 year, and 3 years were 51.1%, 38.3%, and 25.6%, respectively. Univariate analysis showed that CA 19–9 above 37 U/ml was predictive of low overall survival (P = .03) and that TNM stage was significantly associated with disease-free survival (P = .04).

Conclusions

Patients with combined hepatocellular carcinoma and cholangiocarcinoma had poor postoperative survival rates. High CA 19–9 level was associated with poorer survival, suggesting that the cholangiocarcinoma portion may be a major determining factor for patient prognosis. Aggressive surgical treatment, including lymph node dissection, may improve survival in patients suspected of or diagnosed with these tumors.

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Authors and Affiliations

  1. Department of Hepatobiliary Surgery and Liver Transplantation, University of Ulsan College of Medicine and Asan Medical Center, Seoul, South Korea
    Ki Hun Kim MD, PhD, Sung Gyu Lee MD, PhD, Eun Hwa Park MD, Shin Hwang MD, PhD, Chul Soo Ahn MD, PhD, Deok Bog Moon MD, PhD, Tae Yong Ha MD, PhD, Gi Won Song MD & Dong Hwan Jung MD, PhD
  2. Department of Internal Medicine, University of Ulsan College of Medicine and Asan Medical Center, Seoul, South Korea
    Kang Mo Kim MD, PhD, Young Suk Lim MD, PhD, Han Chu Lee MD, PhD, Young Hwa Chung MD, PhD, Yung Sang Lee MD, PhD & Dong Jin Suh MD, PhD

Authors

  1. Ki Hun Kim MD, PhD
  2. Sung Gyu Lee MD, PhD
  3. Eun Hwa Park MD
  4. Shin Hwang MD, PhD
  5. Chul Soo Ahn MD, PhD
  6. Deok Bog Moon MD, PhD
  7. Tae Yong Ha MD, PhD
  8. Gi Won Song MD
  9. Dong Hwan Jung MD, PhD
  10. Kang Mo Kim MD, PhD
  11. Young Suk Lim MD, PhD
  12. Han Chu Lee MD, PhD
  13. Young Hwa Chung MD, PhD
  14. Yung Sang Lee MD, PhD
  15. Dong Jin Suh MD, PhD

Corresponding author

Correspondence toKi Hun Kim MD, PhD.

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Kim, K.H., Lee, S.G., Park, E.H. et al. Surgical Treatments and Prognoses of Patients with Combined Hepatocellular Carcinoma and Cholangiocarcinoma.Ann Surg Oncol 16, 623–629 (2009). https://doi.org/10.1245/s10434-008-0278-3

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