Intrahepatic Cholangiocarcinoma or Mixed Hepatocellular-Cholangiocarcinoma in Patients Undergoing Liver Transplantation

Autores de IIS La Fe

• Rafael López Andújar

  Autor

• Eva Ramos Martinez

  Autor

• Jose Antonio Pons Miñano

  Autor

• Mercedes Rodríguez Serna

  Autor

• Jose Ignacio Herrero Sanchez

  Autor

Participantes ajenos a IIS La Fe

• Sapisochin G
• de Lope CR
• Gastaca M
• de Urbina JO
• Palacios F
• Fabregat J
• Castroagudín JF
• Varo E
• Parrilla P
• González-Diéguez ML
• Otero A
• Vazquez MA
• Zozaya G
• Antolin GS
• Perez B
• Ciria R
• Rufian S
• Fundora Y
• Ferron JA
• Guiberteau A
• Blanco G
• Varona MA
• Barrera MA
• Suarez MA
• Santoyo J
• Bruix J
• Charco R

Grupos

• Dermatología y Regeneración Tisular

  

  Leader

  Rafael Botella Estrada

• Hepatología experimental y Trasplante hepático

  Investigador Principal

  Laia Tolosa Pardo

Abstract

Objective: To evaluate the outcome of patients with hepatocellular-cholangiocarcinoma (HCC-CC) or intrahepatic cholangiocarcinoma (I-CC) on pathological examination after liver transplantation for HCC. Background: Information on the outcome of cirrhotic patients undergoing a transplant for HCC and with a diagnosis of HCC-CC or I-CC by pathological study is limited. Methods: Multicenter, retrospective, matched cohort 1:2 study. Study group: 42 patients undergoing a transplant for HCC and with a diagnosis of HCC-CC or I-CC by pathological study; and control group: 84 patients with a diagnosis of HCC. I-CC subgroup: 27 patients compared with 54 controls; HCC-CC subgroup: 15 patients compared with 30 controls. Patients were also divided according to the preoperative tumor size and number: uninodular tumors 2 cm or smaller and multinodular or uninodular tumors 2 cm or larger. Median follow-up: 51 (range, 3-142) months. Results: The 1-, 3-, and 5-year actuarial survival rate differed between the study and control groups (83%, 70%, and 60% vs 99%, 94%, and 89%, respectively; P < 0.001). Differences were found in 1-, 3-, and 5-year actuarial survival rates between the I-CC subgroup and their controls (78%, 66%, and 51% vs 100%, 98%, and 93%; P < 0.001), but no differences were observed between the HCC-CC subgroup and their controls (93%, 78%, and 78% vs 97%, 86%, and 86%; P = 0.9). Patients with uninodular tumors 2 cm or smaller in the study and control groups had similar 1-, 3-, and 5-year survival rate (92%, 83%, 62% vs 100%, 80%, 80%; P = 0.4). In contrast, patients in the study group with multinodular or uninodular tumors larger than 2 cm had worse 1-, 3-, and 5-year survival rates than their controls (80%, 66%, and 61% vs 99%, 96%, and 90%; P < 0.001). Conclusions: Patients with HCC-CC have similar survival to patients undergoing a transplant for HCC. Preoperative diagnosis of HCC-CC should not prompt the exclusion of these patients from transplant option.

Keywords

• hepatocellular carcinoma; intrahepatic cholangiocarcinoma; liver transplantation; mixed hepatocellular cholangiocarcinoma; outcome