" Very Early'' Intrahepatic Cholangiocarcinoma in Cirrhotic Patients: Should Liver Transplantation Be Reconsidered in These Patients?

Autores de IIS La Fe

• Rafael López Andújar

  Autor

• Mercedes Rodríguez Serna

  Autor

• Sacramento Rodriguez Ferron

  Autor

• Eva Ramos Martinez

  Autor

• María Ciria Calduch

  Autor

• Jose Antonio Pons Miñano

  Autor

• Jose Ignacio Herrero Sanchez

  Autor

Participantes ajenos a IIS La Fe

• Sapisochin G
• Rodríguez de Lope C
• Gastaca M
• Ortiz de Urbina J
• Suarez MA
• Santoyo J
• Castroagudín JF
• Varo E
• Palacios F
• Sanchez Antolín G
• Perez B
• Guiberteau A
• Blanco G
• González-Diéguez ML
• Varona MA
• Barrera MA
• Fundora Y
• Fabregat J
• Rufian S
• Otero A
• Vazquez MA
• Parrilla P
• Zozaya G
• Charco R
• Bruix J

Grupos

• Dermatología y Regeneración Tisular

  

  Leader

  Rafael Botella Estrada

• Hepatología experimental y Trasplante hepático

  Investigador Principal

  Laia Tolosa Pardo

Abstract

A retrospective cohort multicenter study was conducted to analyze the risk factors for tumor recurrence after liver transplantation (LT) in cirrhotic patients found to have an intrahepatic cholangiocarcinoma (iCCA) on pathology examination. We also aimed to ascertain whether there existed a subgroup of patients with single tumors 2cm (very early) in which results after LT can be acceptable. Twenty-nine patients comprised the study group, eight of whom had a very early iCCA (four of them incidentals). The risk of tumor recurrence was significantly associated with larger tumor size as well as larger tumor volume, microscopic vascular invasion and poor degree of differentiation. None of the patients in the very early iCCA subgroup presented tumor recurrence compared to 36.4% of those with single tumors >2cm or multinodular tumors, p=0.02. The 1-, 3- and 5-year actuarial survival of those in the very early iCCA subgroup was 100%, 73% and 73%, respectively. The present is the first multicenter attempt to ascertain the risk factors for tumor recurrence in cirrhotic patients found to have an iCCA on pathology examination. Cirrhotic patients with iCCA 2cm achieved excellent 5-year survival, and validation of these findings by other groups may change the current exclusion of such patients from transplant programs. This multicenter study analyzes the outcome of patients transplanted for hepatocellular carcinoma who were found to have an intrahepatic cholangiocarcinoma at pathology examination, and focuses on the excellent posttransplant outcome of patients with single intrahepatic cholangiocarcinomas 2 cm.

Keywords

• Intrahepatic cholangiocarcinoma; liver transplantation; outcome; "very early"