Clinicopathological characteristics of combined hepatocellular cholangiocarcinoma from the viewpoint of patient prognosis after hepatic resection: High rate of early recurrence and its predictors.
combined hepatocellular-cholangiocarcinoma
early recurrence
predictors of early recurrence
Journal
Hepatology research : the official journal of the Japan Society of Hepatology
ISSN: 1386-6346
Titre abrégé: Hepatol Res
Pays: Netherlands
ID NLM: 9711801
Informations de publication
Date de publication:
Jul 2020
Jul 2020
Historique:
received:
12
03
2020
revised:
07
04
2020
accepted:
08
04
2020
pubmed:
27
4
2020
medline:
27
4
2020
entrez:
27
4
2020
Statut:
ppublish
Résumé
Combined hepatocellular cholangiocarcinoma (cHCC-CCA) is a very rare subtype of primary liver carcinoma; therefore, its clinicopathological characteristics have not yet been elucidated in detail. The aim of the study was to reveal the clinicopathological characteristics and prognostic factors of cHCC-CCA after hepatic resection (HR) METHODS: A total of 124 patients who underwent curative HR for cHCC-CCA between 2000 and 2016 were enrolled in this multi-institutional study conducted by the Kyushu Study Group of Liver Surgery. Clinicopathological analysis was performed from the viewpoint of patient prognosis. A total of 62 patients (50%) had early recurrence within 1.5 years after HR, including 36 patients (58%) with extrahepatic recurrence. In contrast, just four patients (3%) had late recurrence occurring >3 years after HR. The independent predictors of early recurrence were as follows: des-gamma carboxyprothrombin >40 mAU/mL (odds ratio 26.2, P = 0.0117), carbohydrate antigen 19-9>37 IU/l (odds ratio 18.0, P = 0.0200), and poorly differentiated HCC or CCA (odds ratio 11.2, P = 0.0259). Half of the patients with cHCC-CCA had early recurrence after HR. Preoperative elevation of des-gamma carboxyprothrombin or carbohydrate antigen 19-9 and the existence of poorly differentiated components of HCC or CCA in resected specimens are predictors of its early recurrence.
Types de publication
Journal Article
Langues
eng
Pagination
863-870Informations de copyright
© 2020 The Japan Society of Hepatology.
Références
Sempoux CS, Kakar S, Kondo F, Schirmacher P, WHO classification of tumors editorial board. Combined hepatocellular-cholangiocarcinoma and undifferentiated primary liver carcinoma. WHO classifications of tumors. Digestive system tumors, 5th edn. : LyonIARC Press, 2019; 260-262.
Brunt E, Aishima S, Clavien PA et al. cHCC-CCA: Consensus terminology for primary liver carcinomas with both hepatocytic and cholangiocytic differentation. Hepatology 2018; 68: 113-126.
Fowler KJ, Sheybani A, Parker RA 3rd et al. Combined hepatocellular and cholangiocarcinoma (biphenotypic) tumors: imaging features and diagnostic accuracy of contrast-enhanced CT and MRI. AJR Am J Roentgenol 2013; 201: 332-339.
Ariizumi S, Kotera Y, Katagiri S, Nakano M, Yamamoto M. Combined hepatocellular- cholangiocarcinoma had poor outcomes after hepatectomy regardless of Allen and Lisa class or the predominance of intrahepatic cholangiocarcinoma cells within the tumor. Ann Surg Oncol 2012; 19: 1628-1636.
Tickoo SK, Zee SY, Obiekwe S et al. Combined hepatocellular-cholangiocarcinoma: a histopathologic, immunohistochemical, and in situ hybridization study. Am J Surg Pathol 2002; 26: 989-997.
Yano Y, Yamamoto J, Kosuge T et al. Combined hepatocellular and cholangiocarcinoma: a clinicopathologic study of 26 resected cases. Jpn J Clin Oncol 2003; 33: 283-287.
Aishima S, Oda Y. Pathogenesis and classification of intrahepatic cholangiocarcinoma: different characters of perihilar large duct type versus peripheral small duct type. J Hepatobiliary Pancreat Sci 2015; 22: 94-100.
Yamashita YI, Wang H, Kurihara T et al. Clinical Significances of Preoperative Classification of Intrahepatic Cholangiocarcinoma: Different Characteristics of Perihilar vs. Peripheral ICC. Anticancer Res 2016; 36: 6563-6569.
Clavien PA, Barkun J, de Oliveira ML et al. The Clavien-Dindo classification of surgical complications: five-year experience. Ann Surg 2009; 250: 187-196.
Liver Cancer Study Group of Japan. The General Rules for the Clinical and Pathological Study of Primary Liver Cancer, 6th ed supplementary version: TokyoKanehara, 2019.
Li L, Qian M, Chen IH et al. Acquisition of Cholangiocarcinoma Traits during Advanced Hepatocellular Carcinoma Development in Mice. Am J Pathol 2018; 188: 656-671.
Zen C, Zen Y, Mitry RR et al. Mixed phenotype hepatocellular carcinoma after transarterial chemoembolization and liver transplantation. Liver Transpl 2011; 17: 943-954.
Coulouarn C, Cavard C, Rubbia-Brandt L et al. Combined hepatocellular- cholangiocarcinomas exhibit progenitor features and activation of Wnt and TGFβ signaling pathways. Carcinogenesis 2012; 33: 1791-1796.
Cazals-Hatem D, Rebouissou S, Bioulac-Sage P et al. Clinical and molecular analysis of combined hepatocellular-cholangiocarcinomas. J Hepatol 2004; 41: 292-298.
Fujimoto A, Furuta M, Shiraishi Y et al. Whole-genome mutational landscape of liver cancers displaying biliary phenotype reveals hepatitis impact and molecular diversity. Nat Commun 2015; 6: 6120.
Liu ZH, Lian BF, Dong QZ et al. Whole-exome mutational and transcriptional landscapes of combined hepatocellular cholangiocarcinoma and intrahepatic cholangiocarcinoma reveal molecular diversity. Biochim Biophys Acta Mol Basis Dis 2018; 1864: 2360-2368.
Sasaki M, Sato Y, Nakanuma Y. Mutational landscape of combined hepatocellular carcinoma and cholangiocarcinoma, and its clinicopathological significance. Histopathology 2017; 70: 423-434.
Yamashita Y, Tsuijita E, Takeishi K et al. Predictors for microinvasion of small hepatocellular carcinoma ≤ 2 cm. Ann Surg Oncol 2012; 19: 2027-2034.
Taketomi A, Sanefuji K, Soejima Y et al. Impact of des-gamma-carboxy prothrombin and tumor size on the recurrence of hepatocellularcarcinoma after living donor liver transplantation. Transplantation 2009; 87: 531-537.
Bergquist JR, Ivanics T, Storlie CB et al. Implications of CA19-9 elevation for survival, staging, and treatment sequencing in intrahepatic cholangiocarcinoma: A national cohort analysis. J Surg Oncol 2016; 114: 475-482.
Kondo N, Murakami Y, Uemura K et al. Elevated perioperative serum CA 19-9 levels are independent predictors of poor survival in patients with resectable cholangiocarcinoma. J Surg Oncol 2014; 110: 422-429.
Kusano H, Naito Y, Mihara Y et al. Distinctive clinicopathological features and KRAS and IDH1/2 mutation status of cholangiolocellular carcinoma. Hepatol Res 2020; 50: 84-91.
Wakizaka K, Yokoo H, Kamiyama T et al. CD133 and epithelial cell adhesion molecule expressions in the cholangiocarcinoma componentare prognostic factors for combined hepatocellular cholangiocarcinoma. Hepatol Res 2020; 50: 258-267.
Theise ND, Nakashima O, Park NY, WHO classification of tumors editorial board. Tumors of the liver and intrahepatic bile ducts; combined hepatocellular-choplangiocarcinoma. WHO Classification of Tumors of the Digestive System, 4th edn. : LyonIARC Press, 2010; 225-227.
Komuta M, Spee B, Vander Borght S et al. Clinicopathological study on cholangiolocellular carcinoma suggesting hepatic progenitor cell origin. Hepatology 2008; 47: 1544-1556.