Is the outcome after hepatectomy for transitional hepatocholangiocarcinoma different from that of hepatocellular carcino
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ORIGINAL ARTICLE
Is the outcome after hepatectomy for transitional hepatocholangiocarcinoma different from that of hepatocellular carcinoma and mass‑forming cholangiocarcinoma? A case‑matched analysis Damiano Gentile1 · Matteo Donadon1,2 · Luca Di Tommaso2,3 · Laura Samà1 · Eloisa Franchi1 · Guido Costa1 · Ana Lleo2,4 · Guido Torzilli1,2,5 Received: 10 February 2020 / Accepted: 13 May 2020 © Italian Society of Surgery (SIC) 2020
Abstract Hepatocholangiocarcinoma (HCC-CC) is a rare malignancy containing features of both hepatocellular carcinoma (HCC) and mass-forming cholangiocarcinoma (MFCCC), of which the outcome after hepatectomy remains to be clarified. The aim of this study was to analyze the characteristics and outcomes of patients with transitional HCC-CC and compare them with those of patients with HCC and MFCCC. Our prospectively maintained database was queried, and 14 transitional HCC-CC patients were identified over a total of 406 consecutive hepatic resections. A 1:1:1 match was performed with HCC and MFCCC patients operated in the same period. A total of 42 patients were matched according to tumor stage (T1-2-3, N0, M0), number of tumors, R0 resection, no 90-day mortality, and follow-up. Primary endpoints were disease-free survival (DFS) and overall survival (OS). Disease-free survival rates at 1-, 3-, and 5-year were 71.4%, 57.1%, 35.7% for transitional HCC-CC patients; 85.7%, 40.4%, 10.1% for HCC patients; 85.1%, 34.0%, 22.7% for MFCCC patients (5-year DFS: HCC-CC vs. HCC, p = 0.575; HCC-CC vs. MFCCC, p = 0.766, respectively). Similarly, OS rates at 1-, 3-, and 5-year were 92.9%, 71.4%, 64.3% for transitional HCC-CC patients; 100%, 64.3%, 41.7% for HCC patients; 100%, 54.5%, 43.6% for MFCCC patients (5-year OS: HCC-CC vs. HCC, p = 0.891; HCC-CC vs. MFCCC, p = 0.673, respectively). When accurately matched with respect to tumor burden, transitional HCC-CC patients show similar outcomes to those of HCC and MFCCC patients. Further evaluations of differences in tumor biology are necessary to better characterize the prognosis of transitional HCC-CC patients. Keywords Liver neoplasms · Hepatectomy · Hepatocholangiocarcinoma · Hepatocellular carcinoma · Cholangiocarcinoma
Introduction * Guido Torzilli [email protected] 1
Department of Hepatobiliary and General Surgery, Humanitas Clinical and Research Center–IRCCS, Rozzano, Milan, Italy
2
Department of Biomedical Science, Humanitas University, Pieve Emanuele, Milan, Italy
3
Department of Pathology, Humanitas Clinical and Research Center–IRCCS, Rozzano, Milan, Italy
4
Department of Internal Medicine, Humanitas Clinical and Research Center–IRCCS, Rozzano, Milan, Italy
5
Division of Hepatobiliary and General Surgery, Department of Surgery, Humanitas University, Humanitas Clinical and Research Center–IRCCS, Via Manzoni, 56, 20089 Rozzano, Milano, Italy
The majority of primary liver malignancies can be divided into two main subtypes: hepatocellular carcinoma (HCC), originating from hepatocytes; and mass-forming cholangiocarcinoma (MF
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