Annals of Surgery

Skip Navigation LinksHome > May 2014 - Volume 259 - Issue 5 > Intrahepatic Cholangiocarcinoma or Mixed Hepatocellular-Chol...
Annals of Surgery:
doi: 10.1097/SLA.0000000000000494
Original Articles

Intrahepatic Cholangiocarcinoma or Mixed Hepatocellular-Cholangiocarcinoma in Patients Undergoing Liver Transplantation: A Spanish Matched Cohort Multicenter Study

Sapisochin, G. MD, PhD*; de Lope, C. Rodríguez MD; Gastaca, M. MD; de Urbina, J. Ortiz MD; López-Andujar, R. MD, PhD§; Palacios, F. MD§; Ramos, E. MD, PhD; Fabregat, J. MD, PhD; Castroagudín, J. F. MD, PhD; Varo, E. MD, PhD; Pons, J. A. MD, PhD**; Parrilla, P. MD, PhD††; González-Diéguez, M. L. MD‡‡; Rodriguez, M. MD, PhD‡‡; Otero, A. MD, PhD§§; Vazquez, M. A. MD§§; Zozaya, G. MD¶¶; Herrero, J. I. MD, PhD‖‖; Antolin, G. Sanchez MD***; Perez, B. MD, PhD†††; Ciria, R. MD, PhD§§§; Rufian, S. MD, PhD§§§; Fundora, Y. MD, PhD¶¶¶; Ferron, J. A. MD, PhD¶¶¶; Guiberteau, A. MD‖‖‖; Blanco, G. MD, PhD‖‖‖; Varona, M. A. MD****; Barrera, M. A. MD****; Suarez, M. A. MD, PhD††††; Santoyo, J. MD, PhD††††; Bruix, J. MD‡‡‡‡; Charco, R. MD, PhD*

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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.

© 2014 by Lippincott Williams & Wilkins.

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