TY - JOUR
T1 - Mixed hepatocellular and cholangiocarcinoma
T2 - a rare tumor with a mix of parent phenotypic characteristics
AU - Bergquist, John R.
AU - Groeschl, Ryan T.
AU - Ivanics, Tommy
AU - Shubert, Christopher R.
AU - Habermann, Elizabeth B.
AU - Kendrick, Michael L.
AU - Farnell, Michael B.
AU - Nagorney, David M.
AU - Truty, Mark J.
AU - Smoot, Rory L.
N1 - Funding Information:
The Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery provides salary support for Drs. Habermann and Ivanics and in kind material support for Drs. Bergquist and Shubert. Drs. Bergquist and Shubert have received salary support from the Mayo Clinic Clinician Investigator Training program. No specific grants are associated with this work.
Publisher Copyright:
© 2016 International Hepato-Pancreato-Biliary Association Inc.
PY - 2016/11/1
Y1 - 2016/11/1
N2 - Background Intrahepatic lesions of mixed hepatocellular (HCC) and intrahepatic cholangiocellular carcinoma (ICC) histology are rare. The aim was to describe the natural history of these tumors relative to monomorphic ICC or HCC utilizing the National Cancer Data Base (NCDB). Methods Patients with ICC, HCC, and mixed histology (cHCC-CCA) were identified in the NCDB (2004–2012). Inter-group comparisons were made. Kaplan–Meier and multivariable Cox Proportional Hazards analyzed overall survival. Results The query identified 90,499 patients with HCC; 14,463 with ICC; and 1141 with cHCC-CCA histology. Patients with cHCC-CCA histology were relatively young (61 vs. 62 (HCC, p = 0.877) and 67 (ICC, p < 0.001) years) and more likely to have poorly differentiated tumor (29.2% vs. 10.3% (HCC) and 17.2% (ICC) p < 0.001). Median overall survival for cHCC-CCA was 7.9 months vs. 10.8 (HCC) and 8.2 (ICC, all p < 0.001). Stage-specific survival for mixed histology tumors was most similar to that of HCC for all stages. cHCC-CCA were transplanted at a relatively high rate, and transplant outcomes for mixed tumors were substantially worse than for HCC lesions. Discussion cHCC-CCA demonstrate stage-specific survival similar to HCC, but post-surgical survival more consistent with ICC. Patients with a pre-operative diagnosis of cHCC-CCA should undergo resection when appropriate.
AB - Background Intrahepatic lesions of mixed hepatocellular (HCC) and intrahepatic cholangiocellular carcinoma (ICC) histology are rare. The aim was to describe the natural history of these tumors relative to monomorphic ICC or HCC utilizing the National Cancer Data Base (NCDB). Methods Patients with ICC, HCC, and mixed histology (cHCC-CCA) were identified in the NCDB (2004–2012). Inter-group comparisons were made. Kaplan–Meier and multivariable Cox Proportional Hazards analyzed overall survival. Results The query identified 90,499 patients with HCC; 14,463 with ICC; and 1141 with cHCC-CCA histology. Patients with cHCC-CCA histology were relatively young (61 vs. 62 (HCC, p = 0.877) and 67 (ICC, p < 0.001) years) and more likely to have poorly differentiated tumor (29.2% vs. 10.3% (HCC) and 17.2% (ICC) p < 0.001). Median overall survival for cHCC-CCA was 7.9 months vs. 10.8 (HCC) and 8.2 (ICC, all p < 0.001). Stage-specific survival for mixed histology tumors was most similar to that of HCC for all stages. cHCC-CCA were transplanted at a relatively high rate, and transplant outcomes for mixed tumors were substantially worse than for HCC lesions. Discussion cHCC-CCA demonstrate stage-specific survival similar to HCC, but post-surgical survival more consistent with ICC. Patients with a pre-operative diagnosis of cHCC-CCA should undergo resection when appropriate.
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U2 - 10.1016/j.hpb.2016.07.006
DO - 10.1016/j.hpb.2016.07.006
M3 - Article
C2 - 27546172
AN - SCOPUS:84992704040
SN - 1365-182X
VL - 18
SP - 886
EP - 892
JO - HPB
JF - HPB
IS - 11
ER -