LONG-TERM PROGNOSIS OF COMBINED HEPATOCELLULAR AND CHOLANGIOCARCINOMA AFTER CURATIVE RESECTION: COMPARISON WITH HEPATOCELLULAR CARCINOMA AND CHOLANGIOCARCINOMA

Abstract

Background and Aims: The prognosis of combined hepatocellular and cholangiocarcinoma (HCC-CC) has not been fully elucidated. In this study, we attempted to evaluate the prognosis of HCC-CC with comparison to hepatocellular carcinoma (HCC) and cholangiocarcinoma (CC). Methods: This study is retrospective cohort study. Patients who underwent curative resection for HCC-CC at a single tertiary care center in Seoul, Korea between January 1988 and December 2005; and their age, sex, and Child-Turcotte-Pugh (CTP) class matched HCC and CC patients were included in this study. We evaluated the time-to-recurrence (TTR) and overall survival (OS) of the HCC-CC cases and compared them to the HCC and CC patients. Results: Thirty HCC-CC patients (HCC-CC group), 60 HCC patients (HCC group) and 60 CC patients (CC group) were included. For the HCCCC group, the median TTR and OS were 5.4 months and 18.0 months. After adjustment for confounding factors, the HCC-CC group had a significantly shorter TTR than did the HCC group (hazard ratio [HR], 2.76; P<0.001) and the CC group (HR, 2.00; P = 0.013), and a significantly shorter OS than the HCC group (HR, 4.70; P<0.001). Compared to the each stage I diseases, HCC-CC had significantly shorter TTR than HCC (HR, 4.59; P = 0.001) and CC (HR, 2.74, P = 0.015) (Fig. 1) and significantly shorter OS than HCC (HR, 9.35; P = 0.001; Fig. 2). Conclusion: The results of this study showed that HCC-CC had a significantly poorer prognosis than HCC and CC. Therefore, close follow-up is needed for HCC-CC patients with risk factors for a poor prognosis even after a curative resection.