Combined hepatocellular-cholangiocarcinoma compared to hepatocellular carcinoma and intrahepatic cholangiocarcinoma: Different survival, similar recurrence

Boris Amory; Claire Goumard; Alexis Laurent; Serena Langella; Daniel Cherqui; Ephrem Salame; Louise Barbier; Olivier Soubrane; Olivier Farges; Christian Hobeika; Takayuki Kawai; Jean-Marc Regimbeau; François Faitot; Patrick Pessaux; Stéphanie Truant; Emmanuel Boleslawski; Astrid Herrero; Jean-Yves Mabrut; Laurence Chiche; MARCELLO DI MARTINO; Rami Rhaiem; Lilian Schwarz; Vivian Resende; Julien Calderaro; Jérémy Augustin; Stefano Caruso; Daniele Sommacale; Stefan Hofmeyr; Alessandro Ferrero; David Fuks; Eric Vibert; Guido Torzilli; Olivier Scatton; Raffaele Brustia; Julio Abba; René Adam; Mustapha Adham; Pietro Addeo; Marc-Antoine Allard; Giuliana Amaddeo; Ahmet Ayav; Daniel Azoulay; Philippe Bachellier; Pierre Balladur; Julien Barbieux; Emmanuel Boleslawski; Karim Boudjema; M. Bougard; Emmanuel Buc; Petru Bucur; Antoine Carmelo; François Cauchy; Denis Chatelain; Jean Chauvat; Zineb Cherkaoui; Mircea Chirica; Oriana Ciacio; Tatiana Codjia; Fabio Colli; Luciano De Carlis; Jean-Robert Delpero; Nicolas Demartines; Olivier Detry; Marcelo Dias Sanches; Momar Diouf; Alexandre Doussot; Christian Ducerf; Mehdi El Amrani; Jacques Ewald; Jean-Marc Fabre; Hervé Fagot; Simone Famularo; Léo Ferre; Francesco Fleres; Gilton Marques Fonseca; Álvaro Gancedo Quintana; Brice Gayet; Alessandro Giacomoni; Jean-Francois Gigot; Nicolas Golse; Emilie Gregoire; Jean Hardwigsen; Paulo Herman; Thevi Hor; François Jehaes; Ali-Reza Kianmanesh; Shohei Komatsu; Sophie Laroche; Christophe Laurent; Yves-Patrice Le Treut; Philippe Leourier; Emilie Lermite; Mikael Lesurtel; Christian Letoublon; Paul Leyman; Mickael Lesurtel; Jean Lubrano; Jean-Yves Mabrut; Georges Mantion; Ugo Marchese; Elena Martín-Pérez; Benjamin Menahem; Maxime Meunier; Guillaume Millet; Kayvan Mohkam; André Mulliri; Fabrice Muscari; Francis Navarro; Francisco Nolasco; Takeo Nomi; Jean Nunoz; Gennaro Nuzzo; Shinya Okumura; Nassima Oudafal; Gerard Pascal; Guillaume Passot; Damiano Patrono; François Paye; Fabiano Perdigao; Niccolo Petrucciani; Gabriella Pittau; François-René Pruvot; Artigas Raventos; Hélène Regnault; Michel Rivoire; Renato Romagnoli; Didier Roulin; Antonio Sa-Cunha; Michel Scotte; François-Regis Souche; Bertrand Suc; Alexandre Thobie; Boris Trechot; Stéphanie Truant; Olivier Turini; Shinji Uemoto; Xavier Unterteiner; Charles Vanbrugghe; Jean Zemour

doi:10.1016/j.surg.2023.09.040

Combined hepatocellular-cholangiocarcinoma compared to hepatocellular carcinoma and intrahepatic cholangiocarcinoma: Different survival, similar recurrence

Boris Amory, Claire Goumard, Alexis Laurent, Serena Langella, Daniel Cherqui, Ephrem Salame, Louise Barbier, Olivier Soubrane, Olivier Farges, Christian Hobeika, Takayuki Kawai, Jean-Marc Regimbeau, François Faitot, Patrick Pessaux, Stéphanie Truant, Emmanuel Boleslawski, Astrid Herrero, Jean-Yves Mabrut, Laurence Chiche, MARCELLO DI MARTINORami Rhaiem, Lilian Schwarz, Vivian Resende, Julien Calderaro, Jérémy Augustin, Stefano Caruso, Daniele Sommacale, Stefan Hofmeyr, Alessandro Ferrero, David Fuks, Eric Vibert, Guido Torzilli, Olivier Scatton, Raffaele Brustia, Julio Abba, René Adam, Mustapha Adham, Pietro Addeo, Marc-Antoine Allard, Giuliana Amaddeo, Ahmet Ayav, Daniel Azoulay, Philippe Bachellier, Pierre Balladur, Julien Barbieux, Emmanuel Boleslawski, Karim Boudjema, M. Bougard, Emmanuel Buc, Petru Bucur, Antoine Carmelo, François Cauchy, Denis Chatelain, Jean Chauvat, Zineb Cherkaoui, Mircea Chirica, Oriana Ciacio, Tatiana Codjia, Fabio Colli, Luciano De Carlis, Jean-Robert Delpero, Nicolas Demartines, Olivier Detry, Marcelo Dias Sanches, Momar Diouf, Alexandre Doussot, Christian Ducerf, Mehdi El Amrani, Jacques Ewald, Jean-Marc Fabre, Hervé Fagot, Simone Famularo, Léo Ferre, Francesco Fleres, Gilton Marques Fonseca, Álvaro Gancedo Quintana, Brice Gayet, Alessandro Giacomoni, Jean-Francois Gigot, Nicolas Golse, Emilie Gregoire, Jean Hardwigsen, Paulo Herman, Thevi Hor, François Jehaes, Ali-Reza Kianmanesh, Shohei Komatsu, Sophie Laroche, Christophe Laurent, Yves-Patrice Le Treut, Philippe Leourier, Emilie Lermite, Mikael Lesurtel, Christian Letoublon, Paul Leyman, Mickael Lesurtel, Jean Lubrano, Jean-Yves Mabrut, Georges Mantion, Ugo Marchese, Elena Martín-Pérez, Benjamin Menahem, Maxime Meunier, Guillaume Millet, Kayvan Mohkam, André Mulliri, Fabrice Muscari, Francis Navarro, Francisco Nolasco, Takeo Nomi, Jean Nunoz, Gennaro Nuzzo, Shinya Okumura, Nassima Oudafal, Gerard Pascal, Guillaume Passot, Damiano Patrono, François Paye, Fabiano Perdigao, Niccolo Petrucciani, Gabriella Pittau, François-René Pruvot, Artigas Raventos, Hélène Regnault, Michel Rivoire, Renato Romagnoli, Didier Roulin, Antonio Sa-Cunha, Michel Scotte, François-Regis Souche, Bertrand Suc, Alexandre Thobie, Boris Trechot, Stéphanie Truant, Olivier Turini, Shinji Uemoto, Xavier Unterteiner, Charles Vanbrugghe, Jean Zemour

Dipartimento di Scienze della Salute

Risultato della ricerca: Contributo su rivista › Articolo in rivista › peer review

Abstract

Background: Combined hepatocholangiocarcinoma is a rare cancer with a grim prognosis composed of both hepatocellular carcinoma and intrahepatic cholangiocarcinoma morphologic patterns in the same tumor. The aim of this multicenter, international cohort study was to compare the oncologic outcomes after surgery of combined hepatocholangiocarcinoma to hepatocellular carcinoma and intrahepatic cholangiocarcinoma. Methods: Patients treated by surgery for combined hepatocholangiocarcinoma, hepatocellular carcinoma, and intrahepatic cholangiocarcinoma from 2000 to 2021 from multicenter international databases were analyzed retrospectively. Patients with combined hepatocholangiocarcinoma (cases) were compared with 2 control groups of hepatocellular carcinoma or intrahepatic cholangiocarcinoma, sequentially matched using a propensity score based on 8 preoperative characteristics. Overall and disease-free survival were compared, and predictors of mortality and recurrence were analyzed with Cox regression after propensity score matching. Results: During the study period, 3,196 patients were included. Propensity score adjustment and 2 sequential matching processes produced a new cohort (n = 244) comprising 3 balanced groups was obtained (combined hepatocholangiocarcinoma = 56, intrahepatic cholangiocarcinoma = 66, and hepatocellular carcinoma = 122). Kaplan–Meier overall survival estimations at 1, 3, and 5 years were 67%, 45%, and 28% for combined hepatocholangiocarcinoma, 92%, 75%, and 55% for hepatocellular carcinoma, and 86%, 53%, and 42% for the intrahepatic cholangiocarcinoma group, respectively (P = .0014). Estimations of disease-free survival at 1, 3, and 5 years were 51%, 25%, and 17% for combined hepatocholangiocarcinoma, 63%, 35%, and 26% for the hepatocellular carcinoma group, and 51%, 31%, and 28% for the intrahepatic cholangiocarcinoma group, respectively (P = .19). Predictors of mortality were combined hepatocholangiocarcinoma subtype, metabolic syndrome, preoperative tumor markers alpha-fetoprotein and carbohydrate antigen 19-9, and satellite nodules, and recurrence was associated with satellite nodules rather than cancer subtype. Conclusion: Despite data limitations, overall survival among patients with combined hepatocholangiocarcinoma was worse than both groups and closer intrahepatic cholangiocarcinoma, whereas disease-free survival was similar among the 3 groups. Future research on immunophenotypic profiling may hold more promise than traditional nonmodifiable clinical characteristics (as found in this study) in predicting recurrence or response to salvage treatments.

Lingua originale	Inglese
pagine (da-a)	413-423
Numero di pagine	11
Rivista	Surgery
Volume	175
Numero di pubblicazione	2
DOI	https://doi.org/10.1016/j.surg.2023.09.040
Stato di pubblicazione	Pubblicato - 2024

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10.1016/j.surg.2023.09.040

https://hdl.handle.net/11579/198543

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Amory, B., Goumard, C., Laurent, A., Langella, S., Cherqui, D., Salame, E., Barbier, L., Soubrane, O., Farges, O., Hobeika, C., Kawai, T., Regimbeau, J.-M., Faitot, F., Pessaux, P., Truant, S., Boleslawski, E., Herrero, A., Mabrut, J.-Y., Chiche, L., ... Zemour, J. (2024). Combined hepatocellular-cholangiocarcinoma compared to hepatocellular carcinoma and intrahepatic cholangiocarcinoma: Different survival, similar recurrence. Surgery, 175(2), 413-423. https://doi.org/10.1016/j.surg.2023.09.040

@article{81339212ad6b4802a5c067cbd6655d48,

title = "Combined hepatocellular-cholangiocarcinoma compared to hepatocellular carcinoma and intrahepatic cholangiocarcinoma: Different survival, similar recurrence",

abstract = "Background: Combined hepatocholangiocarcinoma is a rare cancer with a grim prognosis composed of both hepatocellular carcinoma and intrahepatic cholangiocarcinoma morphologic patterns in the same tumor. The aim of this multicenter, international cohort study was to compare the oncologic outcomes after surgery of combined hepatocholangiocarcinoma to hepatocellular carcinoma and intrahepatic cholangiocarcinoma. Methods: Patients treated by surgery for combined hepatocholangiocarcinoma, hepatocellular carcinoma, and intrahepatic cholangiocarcinoma from 2000 to 2021 from multicenter international databases were analyzed retrospectively. Patients with combined hepatocholangiocarcinoma (cases) were compared with 2 control groups of hepatocellular carcinoma or intrahepatic cholangiocarcinoma, sequentially matched using a propensity score based on 8 preoperative characteristics. Overall and disease-free survival were compared, and predictors of mortality and recurrence were analyzed with Cox regression after propensity score matching. Results: During the study period, 3,196 patients were included. Propensity score adjustment and 2 sequential matching processes produced a new cohort (n = 244) comprising 3 balanced groups was obtained (combined hepatocholangiocarcinoma = 56, intrahepatic cholangiocarcinoma = 66, and hepatocellular carcinoma = 122). Kaplan–Meier overall survival estimations at 1, 3, and 5 years were 67%, 45%, and 28% for combined hepatocholangiocarcinoma, 92%, 75%, and 55% for hepatocellular carcinoma, and 86%, 53%, and 42% for the intrahepatic cholangiocarcinoma group, respectively (P = .0014). Estimations of disease-free survival at 1, 3, and 5 years were 51%, 25%, and 17% for combined hepatocholangiocarcinoma, 63%, 35%, and 26% for the hepatocellular carcinoma group, and 51%, 31%, and 28% for the intrahepatic cholangiocarcinoma group, respectively (P = .19). Predictors of mortality were combined hepatocholangiocarcinoma subtype, metabolic syndrome, preoperative tumor markers alpha-fetoprotein and carbohydrate antigen 19-9, and satellite nodules, and recurrence was associated with satellite nodules rather than cancer subtype. Conclusion: Despite data limitations, overall survival among patients with combined hepatocholangiocarcinoma was worse than both groups and closer intrahepatic cholangiocarcinoma, whereas disease-free survival was similar among the 3 groups. Future research on immunophenotypic profiling may hold more promise than traditional nonmodifiable clinical characteristics (as found in this study) in predicting recurrence or response to salvage treatments.",

author = "Boris Amory and Claire Goumard and Alexis Laurent and Serena Langella and Daniel Cherqui and Ephrem Salame and Louise Barbier and Olivier Soubrane and Olivier Farges and Christian Hobeika and Takayuki Kawai and Jean-Marc Regimbeau and Fran{\c c}ois Faitot and Patrick Pessaux and St{\'e}phanie Truant and Emmanuel Boleslawski and Astrid Herrero and Jean-Yves Mabrut and Laurence Chiche and {DI MARTINO}, MARCELLO and Rami Rhaiem and Lilian Schwarz and Vivian Resende and Julien Calderaro and J{\'e}r{\'e}my Augustin and Stefano Caruso and Daniele Sommacale and Stefan Hofmeyr and Alessandro Ferrero and David Fuks and Eric Vibert and Guido Torzilli and Olivier Scatton and Raffaele Brustia and Julio Abba and Ren{\'e} Adam and Mustapha Adham and Pietro Addeo and Marc-Antoine Allard and Giuliana Amaddeo and Ahmet Ayav and Daniel Azoulay and Philippe Bachellier and Pierre Balladur and Julien Barbieux and Emmanuel Boleslawski and Karim Boudjema and M. Bougard and Emmanuel Buc and Petru Bucur and Antoine Carmelo and Fran{\c c}ois Cauchy and Denis Chatelain and Jean Chauvat and Zineb Cherkaoui and Mircea Chirica and Oriana Ciacio and Tatiana Codjia and Fabio Colli and {De Carlis}, Luciano and Jean-Robert Delpero and Nicolas Demartines and Olivier Detry and Sanches, {Marcelo Dias} and Momar Diouf and Alexandre Doussot and Christian Ducerf and {El Amrani}, Mehdi and Jacques Ewald and Jean-Marc Fabre and Herv{\'e} Fagot and Simone Famularo and L{\'e}o Ferre and Francesco Fleres and Fonseca, {Gilton Marques} and Quintana, {{\'A}lvaro Gancedo} and Brice Gayet and Alessandro Giacomoni and Jean-Francois Gigot and Nicolas Golse and Emilie Gregoire and Jean Hardwigsen and Paulo Herman and Thevi Hor and Fran{\c c}ois Jehaes and Ali-Reza Kianmanesh and Shohei Komatsu and Sophie Laroche and Christophe Laurent and {Le Treut}, Yves-Patrice and Philippe Leourier and Emilie Lermite and Mikael Lesurtel and Christian Letoublon and Paul Leyman and Mickael Lesurtel and Jean Lubrano and Jean-Yves Mabrut and Georges Mantion and Ugo Marchese and Elena Mart{\'i}n-P{\'e}rez and Benjamin Menahem and Maxime Meunier and Guillaume Millet and Kayvan Mohkam and Andr{\'e} Mulliri and Fabrice Muscari and Francis Navarro and Francisco Nolasco and Takeo Nomi and Jean Nunoz and Gennaro Nuzzo and Shinya Okumura and Nassima Oudafal and Gerard Pascal and Guillaume Passot and Damiano Patrono and Fran{\c c}ois Paye and Fabiano Perdigao and Niccolo Petrucciani and Gabriella Pittau and Fran{\c c}ois-Ren{\'e} Pruvot and Artigas Raventos and H{\'e}l{\`e}ne Regnault and Michel Rivoire and Renato Romagnoli and Didier Roulin and Antonio Sa-Cunha and Michel Scotte and Fran{\c c}ois-Regis Souche and Bertrand Suc and Alexandre Thobie and Boris Trechot and St{\'e}phanie Truant and Olivier Turini and Shinji Uemoto and Xavier Unterteiner and Charles Vanbrugghe and Jean Zemour",

year = "2024",

doi = "10.1016/j.surg.2023.09.040",

language = "English",

volume = "175",

pages = "413--423",

journal = "Surgery",

issn = "0039-6060",

publisher = "Elsevier Inc.",

number = "2",

}

Amory, B, Goumard, C, Laurent, A, Langella, S, Cherqui, D, Salame, E, Barbier, L, Soubrane, O, Farges, O, Hobeika, C, Kawai, T, Regimbeau, J-M, Faitot, F, Pessaux, P, Truant, S, Boleslawski, E, Herrero, A, Mabrut, J-Y, Chiche, L, DI MARTINO, MARCELLO, Rhaiem, R, Schwarz, L, Resende, V, Calderaro, J, Augustin, J, Caruso, S, Sommacale, D, Hofmeyr, S, Ferrero, A, Fuks, D, Vibert, E, Torzilli, G, Scatton, O, Brustia, R, Abba, J, Adam, R, Adham, M, Addeo, P, Allard, M-A, Amaddeo, G, Ayav, A, Azoulay, D, Bachellier, P, Balladur, P, Barbieux, J, Boleslawski, E, Boudjema, K, Bougard, M, Buc, E, Bucur, P, Carmelo, A, Cauchy, F, Chatelain, D, Chauvat, J, Cherkaoui, Z, Chirica, M, Ciacio, O, Codjia, T, Colli, F, De Carlis, L, Delpero, J-R, Demartines, N, Detry, O, Sanches, MD, Diouf, M, Doussot, A, Ducerf, C, El Amrani, M, Ewald, J, Fabre, J-M, Fagot, H, Famularo, S, Ferre, L, Fleres, F, Fonseca, GM, Quintana, ÁG, Gayet, B, Giacomoni, A, Gigot, J-F, Golse, N, Gregoire, E, Hardwigsen, J, Herman, P, Hor, T, Jehaes, F, Kianmanesh, A-R, Komatsu, S, Laroche, S, Laurent, C, Le Treut, Y-P, Leourier, P, Lermite, E, Lesurtel, M, Letoublon, C, Leyman, P, Lesurtel, M, Lubrano, J, Mabrut, J-Y, Mantion, G, Marchese, U, Martín-Pérez, E, Menahem, B, Meunier, M, Millet, G, Mohkam, K, Mulliri, A, Muscari, F, Navarro, F, Nolasco, F, Nomi, T, Nunoz, J, Nuzzo, G, Okumura, S, Oudafal, N, Pascal, G, Passot, G, Patrono, D, Paye, F, Perdigao, F, Petrucciani, N, Pittau, G, Pruvot, F-R, Raventos, A, Regnault, H, Rivoire, M, Romagnoli, R, Roulin, D, Sa-Cunha, A, Scotte, M, Souche, F-R, Suc, B, Thobie, A, Trechot, B, Truant, S, Turini, O, Uemoto, S, Unterteiner, X, Vanbrugghe, C & Zemour, J 2024, 'Combined hepatocellular-cholangiocarcinoma compared to hepatocellular carcinoma and intrahepatic cholangiocarcinoma: Different survival, similar recurrence', Surgery, vol. 175, n. 2, pagg. 413-423. https://doi.org/10.1016/j.surg.2023.09.040

TY - JOUR

T1 - Combined hepatocellular-cholangiocarcinoma compared to hepatocellular carcinoma and intrahepatic cholangiocarcinoma: Different survival, similar recurrence

AU - Amory, Boris

AU - Goumard, Claire

AU - Laurent, Alexis

AU - Langella, Serena

AU - Cherqui, Daniel

AU - Salame, Ephrem

AU - Barbier, Louise

AU - Soubrane, Olivier

AU - Farges, Olivier

AU - Hobeika, Christian

AU - Kawai, Takayuki

AU - Regimbeau, Jean-Marc

AU - Faitot, François

AU - Pessaux, Patrick

AU - Truant, Stéphanie

AU - Boleslawski, Emmanuel

AU - Herrero, Astrid

AU - Mabrut, Jean-Yves

AU - Chiche, Laurence

AU - DI MARTINO, MARCELLO

AU - Rhaiem, Rami

AU - Schwarz, Lilian

AU - Resende, Vivian

AU - Calderaro, Julien

AU - Augustin, Jérémy

AU - Caruso, Stefano

AU - Sommacale, Daniele

AU - Hofmeyr, Stefan

AU - Ferrero, Alessandro

AU - Fuks, David

AU - Vibert, Eric

AU - Torzilli, Guido

AU - Scatton, Olivier

AU - Brustia, Raffaele

AU - Abba, Julio

AU - Adam, René

AU - Adham, Mustapha

AU - Addeo, Pietro

AU - Allard, Marc-Antoine

AU - Amaddeo, Giuliana

AU - Ayav, Ahmet

AU - Azoulay, Daniel

AU - Bachellier, Philippe

AU - Balladur, Pierre

AU - Barbieux, Julien

AU - Boleslawski, Emmanuel

AU - Boudjema, Karim

AU - Bougard, M.

AU - Buc, Emmanuel

AU - Bucur, Petru

AU - Carmelo, Antoine

AU - Cauchy, François

AU - Chatelain, Denis

AU - Chauvat, Jean

AU - Cherkaoui, Zineb

AU - Chirica, Mircea

AU - Ciacio, Oriana

AU - Codjia, Tatiana

AU - Colli, Fabio

AU - De Carlis, Luciano

AU - Delpero, Jean-Robert

AU - Demartines, Nicolas

AU - Detry, Olivier

AU - Sanches, Marcelo Dias

AU - Diouf, Momar

AU - Doussot, Alexandre

AU - Ducerf, Christian

AU - El Amrani, Mehdi

AU - Ewald, Jacques

AU - Fabre, Jean-Marc

AU - Fagot, Hervé

AU - Famularo, Simone

AU - Ferre, Léo

AU - Fleres, Francesco

AU - Fonseca, Gilton Marques

AU - Quintana, Álvaro Gancedo

AU - Gayet, Brice

AU - Giacomoni, Alessandro

AU - Gigot, Jean-Francois

AU - Golse, Nicolas

AU - Gregoire, Emilie

AU - Hardwigsen, Jean

AU - Herman, Paulo

AU - Hor, Thevi

AU - Jehaes, François

AU - Kianmanesh, Ali-Reza

AU - Komatsu, Shohei

AU - Laroche, Sophie

AU - Laurent, Christophe

AU - Le Treut, Yves-Patrice

AU - Leourier, Philippe

AU - Lermite, Emilie

AU - Lesurtel, Mikael

AU - Letoublon, Christian

AU - Leyman, Paul

AU - Lesurtel, Mickael

AU - Lubrano, Jean

AU - Mabrut, Jean-Yves

AU - Mantion, Georges

AU - Marchese, Ugo

AU - Martín-Pérez, Elena

AU - Menahem, Benjamin

AU - Meunier, Maxime

AU - Millet, Guillaume

AU - Mohkam, Kayvan

AU - Mulliri, André

AU - Muscari, Fabrice

AU - Navarro, Francis

AU - Nolasco, Francisco

AU - Nomi, Takeo

AU - Nunoz, Jean

AU - Nuzzo, Gennaro

AU - Okumura, Shinya

AU - Oudafal, Nassima

AU - Pascal, Gerard

AU - Passot, Guillaume

AU - Patrono, Damiano

AU - Paye, François

AU - Perdigao, Fabiano

AU - Petrucciani, Niccolo

AU - Pittau, Gabriella

AU - Pruvot, François-René

AU - Raventos, Artigas

AU - Regnault, Hélène

AU - Rivoire, Michel

AU - Romagnoli, Renato

AU - Roulin, Didier

AU - Sa-Cunha, Antonio

AU - Scotte, Michel

AU - Souche, François-Regis

AU - Suc, Bertrand

AU - Thobie, Alexandre

AU - Trechot, Boris

AU - Truant, Stéphanie

AU - Turini, Olivier

AU - Uemoto, Shinji

AU - Unterteiner, Xavier

AU - Vanbrugghe, Charles

AU - Zemour, Jean

PY - 2024

Y1 - 2024

N2 - Background: Combined hepatocholangiocarcinoma is a rare cancer with a grim prognosis composed of both hepatocellular carcinoma and intrahepatic cholangiocarcinoma morphologic patterns in the same tumor. The aim of this multicenter, international cohort study was to compare the oncologic outcomes after surgery of combined hepatocholangiocarcinoma to hepatocellular carcinoma and intrahepatic cholangiocarcinoma. Methods: Patients treated by surgery for combined hepatocholangiocarcinoma, hepatocellular carcinoma, and intrahepatic cholangiocarcinoma from 2000 to 2021 from multicenter international databases were analyzed retrospectively. Patients with combined hepatocholangiocarcinoma (cases) were compared with 2 control groups of hepatocellular carcinoma or intrahepatic cholangiocarcinoma, sequentially matched using a propensity score based on 8 preoperative characteristics. Overall and disease-free survival were compared, and predictors of mortality and recurrence were analyzed with Cox regression after propensity score matching. Results: During the study period, 3,196 patients were included. Propensity score adjustment and 2 sequential matching processes produced a new cohort (n = 244) comprising 3 balanced groups was obtained (combined hepatocholangiocarcinoma = 56, intrahepatic cholangiocarcinoma = 66, and hepatocellular carcinoma = 122). Kaplan–Meier overall survival estimations at 1, 3, and 5 years were 67%, 45%, and 28% for combined hepatocholangiocarcinoma, 92%, 75%, and 55% for hepatocellular carcinoma, and 86%, 53%, and 42% for the intrahepatic cholangiocarcinoma group, respectively (P = .0014). Estimations of disease-free survival at 1, 3, and 5 years were 51%, 25%, and 17% for combined hepatocholangiocarcinoma, 63%, 35%, and 26% for the hepatocellular carcinoma group, and 51%, 31%, and 28% for the intrahepatic cholangiocarcinoma group, respectively (P = .19). Predictors of mortality were combined hepatocholangiocarcinoma subtype, metabolic syndrome, preoperative tumor markers alpha-fetoprotein and carbohydrate antigen 19-9, and satellite nodules, and recurrence was associated with satellite nodules rather than cancer subtype. Conclusion: Despite data limitations, overall survival among patients with combined hepatocholangiocarcinoma was worse than both groups and closer intrahepatic cholangiocarcinoma, whereas disease-free survival was similar among the 3 groups. Future research on immunophenotypic profiling may hold more promise than traditional nonmodifiable clinical characteristics (as found in this study) in predicting recurrence or response to salvage treatments.

AB - Background: Combined hepatocholangiocarcinoma is a rare cancer with a grim prognosis composed of both hepatocellular carcinoma and intrahepatic cholangiocarcinoma morphologic patterns in the same tumor. The aim of this multicenter, international cohort study was to compare the oncologic outcomes after surgery of combined hepatocholangiocarcinoma to hepatocellular carcinoma and intrahepatic cholangiocarcinoma. Methods: Patients treated by surgery for combined hepatocholangiocarcinoma, hepatocellular carcinoma, and intrahepatic cholangiocarcinoma from 2000 to 2021 from multicenter international databases were analyzed retrospectively. Patients with combined hepatocholangiocarcinoma (cases) were compared with 2 control groups of hepatocellular carcinoma or intrahepatic cholangiocarcinoma, sequentially matched using a propensity score based on 8 preoperative characteristics. Overall and disease-free survival were compared, and predictors of mortality and recurrence were analyzed with Cox regression after propensity score matching. Results: During the study period, 3,196 patients were included. Propensity score adjustment and 2 sequential matching processes produced a new cohort (n = 244) comprising 3 balanced groups was obtained (combined hepatocholangiocarcinoma = 56, intrahepatic cholangiocarcinoma = 66, and hepatocellular carcinoma = 122). Kaplan–Meier overall survival estimations at 1, 3, and 5 years were 67%, 45%, and 28% for combined hepatocholangiocarcinoma, 92%, 75%, and 55% for hepatocellular carcinoma, and 86%, 53%, and 42% for the intrahepatic cholangiocarcinoma group, respectively (P = .0014). Estimations of disease-free survival at 1, 3, and 5 years were 51%, 25%, and 17% for combined hepatocholangiocarcinoma, 63%, 35%, and 26% for the hepatocellular carcinoma group, and 51%, 31%, and 28% for the intrahepatic cholangiocarcinoma group, respectively (P = .19). Predictors of mortality were combined hepatocholangiocarcinoma subtype, metabolic syndrome, preoperative tumor markers alpha-fetoprotein and carbohydrate antigen 19-9, and satellite nodules, and recurrence was associated with satellite nodules rather than cancer subtype. Conclusion: Despite data limitations, overall survival among patients with combined hepatocholangiocarcinoma was worse than both groups and closer intrahepatic cholangiocarcinoma, whereas disease-free survival was similar among the 3 groups. Future research on immunophenotypic profiling may hold more promise than traditional nonmodifiable clinical characteristics (as found in this study) in predicting recurrence or response to salvage treatments.

UR - https://iris.uniupo.it/handle/11579/198543

U2 - 10.1016/j.surg.2023.09.040

DO - 10.1016/j.surg.2023.09.040

M3 - Article

SN - 0039-6060

VL - 175

SP - 413

EP - 423

JO - Surgery

JF - Surgery

IS - 2

ER -

Combined hepatocellular-cholangiocarcinoma compared to hepatocellular carcinoma and intrahepatic cholangiocarcinoma: Different survival, similar recurrence

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