Combined Hepatocellular Carcinoma and Cholangiocarcinoma: Clinical Features, Treatment Modalities, and Prognosis

Abstract

cHCC-CC has biological behavior and prognosis that are intermediate between HCC and ICC. Radical liver resection can provide a better outcome for this uncommon malignancy.

MR comparative study of combined hepatocellular-cholangiocarcinoma in normal, fibrotic, and cirrhotic livers

“…In our study, cHCC-CC was male predominant in the middle 50s with high hepatitis B viral infection rate and elevated AFP level, more like HCC, consistent with previous studies [6,9,11]. Overall, tumors in the fibrotic and cirrhotic livers were smaller than those in the normal liver, which may be corresponded to a more frequent follow-up in these patients, thus regular surveillance may be necessary.…”

Hepatocellular Carcinoma

“…They arise in both cirrhotic and noncirrhotic livers [ 62 ]. However, combined hepatocellular carcinoma-cholangiocarcinomas are more likely than hepatocellular carcinoma to metastasize to lymph nodes [ 65 ]. The prognosis is in between cholangiocarcinoma and hepatocellular carcinoma, befi tting its mixed growth [ 66 , 67 ].…”

Collision and composite tumors; radiologic and pathologic correlation

“…Hepatocellular cholangiocarcinomas (HCC-CCs) are primary liver composite carcinomas with biphenotypic differentiation that stem from either common progenitor cell lineages or the dedifferentiation of mature liver cells [9]. Studies indicate that HCC-CCs have a worse prognosis than either HCC or CC alone [10][11][12][13][14][15][16]. Treatment modalities include local radiofrequency ablative therapy, chemotherapy, transarterial chemoembolization, liver transplantation, and radical resection, which is preferred over nonoperative management in terms of survival outcome (16.5 months) [13,15,17,18].…”

“…Studies indicate that HCC-CCs have a worse prognosis than either HCC or CC alone [10][11][12][13][14][15][16]. Treatment modalities include local radiofrequency ablative therapy, chemotherapy, transarterial chemoembolization, liver transplantation, and radical resection, which is preferred over nonoperative management in terms of survival outcome (16.5 months) [13,15,17,18]. Approximately 20% of all liver transplants in the United States are performed for HCC, and current guidelines state that pathologic proof is not required if MRI and CT imaging with contrast is concordant [18,19].…”