KMID : 0614620070490030158
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Korean Journal of Gastroenterology 2007 Volume.49 No. 3 p.158 ~ p.165
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Analysis of Prognostic Factors after Curative Resection for Combined Hepatocellular and Cholangiocarcinoma
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Kim Won
Lee Jeong-Hoon Kim Yoon-Jun Yoon Jung-Hwan Suh Kyung-Suk Lee Kuhn-Uk Jang Ja-June Lee Hyo-Suk
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Abstract
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Background/Aims: Combined hepatocellular and cholangiocarcinoma (HCC-CC) is a rare form of primary liver carcinoma which contains characteristics of both hepatocellular carcinoma and cholangiocarcinoma. The aim of this study was to evaluate the prognostic factors of combined HCC-CC after curative resection.
Methods: Between January 1987 and December 2005, pathologically confirmed combined HCC-CC patients who underwent curative resection at Seoul National University Hospital were evaluated. We reviewed the medical records and evaluated the time-to-recurrence (TTR), overall survival (OS) and prognostic factors of combined HCC-CC.
Results: A total of 31 patients were evaluated (M:F=27:4; median age, 61 years). According to the American Joint Committee on Cancer system, patients with stage ¥°, ¥±, ¥²A, ¥²B and ¥²C at the time of resection were 4, 16, 7, 2 and 2, respectively. Twenty six patients (83.9%) had tumor recurrence during the follow-up period and their median TTR was 5.7 months. Twenty one patients received additional treatment while 5 patients did not. As a result, median OS was 21.6 months and 3 year survival rate was 15.4%. In multivariate analysis, stage ¥² than stage ¥° or ¥± at resection was an independent prognostic factor associated with shortened TTR (p£¼0.01). Older age (p=0.03), stage ¥²C rather than stage ¥°, ¥±, ¥²A at time of resection (p=0.02), and Child-Pugh B rather than A (p£¼0.01) were independent prognostic factors associated with shortened OS.
Conclusion: Even after curative resections, patients with combined HCC-CC show poor prognosis with early recurrence and poor survival. However, surgical treatment should be warranted for relatively young patients in early stage with well preserved liver function. (Korean J Gastroenterol 2007;49:158-165)
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KEYWORD
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Carcinoma, Hepatocellular, Cholangiocarcinoma, Recurrence, Prognosis
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