| Clinical analysis of double primary hepatocellular carcinoma and intrahepatic cholangiocarcinoma |
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| Citation of this paper:LI Xiao-long1△,PAN Hu-xiao2△,SHI Guo-ming1,HUANG Cheng1,CAI Jia-bin1,SUN Hui-chuan1,JI Yuan3,ZHOU Jian1,FAN Jia1,SHEN Ying-hao1*.Clinical analysis of double primary hepatocellular carcinoma and intrahepatic cholangiocarcinoma[J].Chinese Journal of Clinical Medicine,2018,25(4):518-525 |
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| Author Name | Affiliation | | LI Xiao-long1△,PAN Hu-xiao2△,SHI Guo-ming1,HUANG Cheng1,CAI Jia-bin1,SUN Hui-chuan1,JI Yuan3,ZHOU Jian1,FAN Jia1,SHEN Ying-hao1* | 1.Department of Liver Surgery, Zhongshan Hospital, Fudan University, Shanghai 200032, China2.Department of General Surgery, Jiangyin Chinese Medicine External Therapy Special Hospital of Hepatobiliary, Jiangyin 214404, Jiangsu, China3.Department of Pathology, Zhongshan Hospital, Fudan University, Shanghai 200032, China |
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| Abstract:Objective：To explore the clinicopathological features and prognosis of double primary hepatocellular carcinoma and intrahepatic cholangiocarcinoma (dpHCC-ICC). Methods：We retrospectively analyzed the clinical data of 26 dpHCC-ICC patients who underwent hepatectomy at our center. Data of clinical manifestations, preoperative diagnosis, pathological features, treatments, and prognosis were included. The data of patients with dpHCC-ICC and those with combined hepatocellular carcinoma and cholangiocarcinoma (CHC-CC) at the same time were compared. Results：Eighteen patients (69%) were male, with an average age of (56.2 ± 14.6) years old. Seventeen patients (65%) were HBsAg positive. All patients were Child-Pugh class A grade. There were 11, 13, and 2 patients of the Barcelona Clinic Liver Cancer Classification (BCLC) A, B, and C, respectively. The median tumor diameter was 3.3 cm (2.0 7.1 cm). Tumor number: 19 cases (73%) with 2 tumor nodules and 7 cases (27%) with more than 2 tumor nodules. All patients underwent R0 resection and were pathologically confirmed as dpHCC-ICC. All patients had complete follow-up after operation, and the 1-, 3- , and 5-year survival rates were 92%, 73%, and 62%, respectively. For dpHCC-ICC, preoperative GGT > 60 U/L and ALB < 35 g/L were independent risk factors for the recurrence free survival (RFS) after surgery and microvascular invasion (MVI) was an independent risk factor for the overall survival (OS). There was no significant difference in survival between the dpHCC-ICC and CHC CC patients during the same period. However, in the BCLC B subpopulation, the RFS of dpHCC-ICC was superior to the classical CHC-CC (P=0.041). Conclusions：dpHCC-ICC is a clinically rare liver tumor that is difficult to diagnose preoperatively. Definite diagnosis requires postoperative histopathological examination. The main treatment of dpHCC-ICC is surgical resection. For dpHCC-ICC, preoperative GGT > 60 U/L and ALB < 35 g/L are independent risk factors for the RFS and MVI is an independent risk factor for the OS. |
| keywords:double primary hepatocellular carcinoma and intrahepatic cholangiocarcinoma hepatocellular carcinoma intrahepatic cholangiocarcinoma combined hepatocellular carcinoma and cholangiocarcinoma |
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