Combined hepatocellular-cholangiocarcinoma (cHCC-CC): a distinct entity

O’Connor, Kate; Walsh, Joanna; Schaeffer, David F.

doi:10.1016/s1665-2681(19)30859-2

Cited by 54 publications

(42 citation statements)

References 22 publications

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“…30 Although some studies have reported a good response of CHC to transarterial chemoembolization and sorafenib, these treatments require further evaluation. 27,31,32 Survival of patients with CHC has been reported in several previous studies, with a 5-year OS rate of 7.9-36.4%. 1,[21][22][23] Previous studies consistently found that CHC had a poorer prognosis than HCC, 1,2,21-23,33 while the prognosis with regard to ICC varied, with some reports showing a poorer or similar prognosis and others showing a better prognosis.…”

Section: Discussionmentioning

confidence: 69%

“…The outcomes following liver transplantation are consistently poorer in patients with CHC compared with HCC, and one study found no survival benefit of transplant over resection in patients with CHC . Although some studies have reported a good response of CHC to transarterial chemoembolization and sorafenib, these treatments require further evaluation …”

Section: Discussionmentioning

confidence: 99%

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

Wakizaka

Yokoo

Kamiyama

et al. 2018

J of Gastro and Hepatol

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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 α‐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, α‐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.

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Section: Discussionmentioning

confidence: 69%

Section: Discussionmentioning

confidence: 99%

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

Wakizaka

Yokoo

Kamiyama

et al. 2018

J of Gastro and Hepatol

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“…The publications mention some isolated cases of the application of chemotherapy (gemcitabine and cisplatin) in the dissemination stage of the cancer [11]. The use of other techniques, such as radiotherapy and transdermal ethanol injections, did not lead to any satisfactory results [12].…”

Section: Discussionmentioning

confidence: 99%

“…Within the post-operative follow-up, a periodic ultrasound and Ct evaluation is used as well as the measurement of the levels of AFP and CA19-9 in blood serum [12].…”

Section: Discussionmentioning

confidence: 99%

Combined hepatocellular-cholangiocarcinoma containing the cells of hepatocellular cancer and bile duct cancer

Legkiy¹,

Ćwierz²,

Wysocka³

et al. 2018

Nowotwory. Journal of Oncology

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Combined hepatocellular-cholangiocarcinoma (cHCC-CC) is a rare (< 1%) primary liver cancer which contains elements of hepatocellular cancer (HCC) and bile duct cancer (CC). On account of the difficulties in reaching preoperative diagnosis, it is frequently diagnosed only after resection is performed. A surgical resection of the liver is the treatment of choice, whilst a liver transplant is a rarely implemented option. The prognosis of cHCC-CC tumours is better than in CC but worse than in HCC. This paper presents the case report of a 62-year-old man undergoing a left hemihepatectomy for a cHCC-CC liver tumour. NOWOTWORY J Oncol 2018; 68, 2: 92-94

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“…A combined hepatocellular carcinoma-cholangiocarcnoma is a relatively rare disease entity, accounting for only 0.4–14% of all primary liver cancer 1234. The classification of hepatocellular carcinoma-cholangiocarcnoma first developed by Allen Lisa in 1949 consisted of 3 subtypes: 1) type A, characterized by synchronous, separate and autonomous epicenters of hepatocellular carcinoma (HCC) and cholangiocarcnoma (CC) in a single liver; 2) type B, comprising closely admixed and distinguished foci of HCC and CC; and 3) type C, consisting of truly combined HCC and CC components originating in the same tumor 15…”

Section: Introductionmentioning

confidence: 99%

Adrenal metastasis in sequentially developed combined hepatocellular carcinoma-cholangiocarcinoma: A case report

Nugroho

Lee

et al. 2018

Ann Hepatobiliary Pancreat Surg

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The incidence of combined hepatocellular carcinoma-cholangiocarcinoma (cHCC-CC) in a single patient accounts for only 0.4 to 14% of all primary liver cancer. However, the prognosis of its intrahepatic cholangiocarcinoma (ICC) component is poor. We experienced a unique case of a sequentially developed cHCC-CC with adrenal metastasis as the primary presentation and a hidden primary hepatocellular carcinoma. A 65-year-old female with a history of jaundice and abdominal discomfort was diagnosed with S4 ICC measuring 5 cm in diameter, and characterized histologically as papillary adenocarcinoma with intraductal growth, but without any evidence of malignant hepatocyte. S4 segmentectomy with hepaticojejunostomy revealed no additional masses. A follow-up CT scan 3 months after surgery showed a right adrenal mass with markedly increased serum AFP (4950 ng/mL), which was treated with right adrenalectomy. Histopathology revealed a metastatic hepatocellular carcinoma testing positive for AFP, glypican-3, and hepatocytes, but negative for CD-10, inhibin-α, EMA, S-100, and cytokeratin-7. Serum AFP level immediately plummeted to 4.1 ng/mL upon adrenal mass removal. A recurrent S7 liver mass was suspected 1 year later with serum AFP value of 7.6 ng/mL, and characteristic CT imaging of HCC. TACE was performed with good response. Adrenal metastasis may manifest as the primary focus of hepatocellular carcinoma in sequentially developed cHCC-CC patients with hidden primary HCC. cHCC-CC should be considered in the differential diagnosis of cholangiocarcinoma with elevated AFP.

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Combined hepatocellular-cholangiocarcinoma (cHCC-CC): a distinct entity

Cited by 54 publications

References 22 publications

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

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

Combined hepatocellular-cholangiocarcinoma containing the cells of hepatocellular cancer and bile duct cancer

Adrenal metastasis in sequentially developed combined hepatocellular carcinoma-cholangiocarcinoma: A case report

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