Mixed hepatocellular and cholangiocarcinoma: a rare tumor with a mix of parent phenotypic characteristics

John R. Bergquist, Ryan T. Groeschl, Tommy Ivanics, Christopher R. Shubert, Elizabeth B Habermann, Michael L. Kendrick, Michael B. Farnell, David M. Nagorney, Mark Truty, Rory L. Smoot

Research output: Contribution to journalArticle

14 Citations (Scopus)

Abstract

Background Intrahepatic lesions of mixed hepatocellular (HCC) and intrahepatic cholangiocellular carcinoma (ICC) histology are rare. The aim was to describe the natural history of these tumors relative to monomorphic ICC or HCC utilizing the National Cancer Data Base (NCDB). Methods Patients with ICC, HCC, and mixed histology (cHCC-CCA) were identified in the NCDB (2004–2012). Inter-group comparisons were made. Kaplan–Meier and multivariable Cox Proportional Hazards analyzed overall survival. Results The query identified 90,499 patients with HCC; 14,463 with ICC; and 1141 with cHCC-CCA histology. Patients with cHCC-CCA histology were relatively young (61 vs. 62 (HCC, p = 0.877) and 67 (ICC, p < 0.001) years) and more likely to have poorly differentiated tumor (29.2% vs. 10.3% (HCC) and 17.2% (ICC) p < 0.001). Median overall survival for cHCC-CCA was 7.9 months vs. 10.8 (HCC) and 8.2 (ICC, all p < 0.001). Stage-specific survival for mixed histology tumors was most similar to that of HCC for all stages. cHCC-CCA were transplanted at a relatively high rate, and transplant outcomes for mixed tumors were substantially worse than for HCC lesions. Discussion cHCC-CCA demonstrate stage-specific survival similar to HCC, but post-surgical survival more consistent with ICC. Patients with a pre-operative diagnosis of cHCC-CCA should undergo resection when appropriate.

Original languageEnglish (US)
Pages (from-to)886-892
Number of pages7
JournalHPB
Volume18
Issue number11
DOIs
StatePublished - Nov 1 2016

Fingerprint

Cholangiocarcinoma
Histology
Neoplasms
Survival
Databases
Transplants

ASJC Scopus subject areas

  • Hepatology
  • Gastroenterology

Cite this

Bergquist, J. R., Groeschl, R. T., Ivanics, T., Shubert, C. R., Habermann, E. B., Kendrick, M. L., ... Smoot, R. L. (2016). Mixed hepatocellular and cholangiocarcinoma: a rare tumor with a mix of parent phenotypic characteristics. HPB, 18(11), 886-892. https://doi.org/10.1016/j.hpb.2016.07.006

Mixed hepatocellular and cholangiocarcinoma : a rare tumor with a mix of parent phenotypic characteristics. / Bergquist, John R.; Groeschl, Ryan T.; Ivanics, Tommy; Shubert, Christopher R.; Habermann, Elizabeth B; Kendrick, Michael L.; Farnell, Michael B.; Nagorney, David M.; Truty, Mark; Smoot, Rory L.

In: HPB, Vol. 18, No. 11, 01.11.2016, p. 886-892.

Research output: Contribution to journalArticle

Bergquist, JR, Groeschl, RT, Ivanics, T, Shubert, CR, Habermann, EB, Kendrick, ML, Farnell, MB, Nagorney, DM, Truty, M & Smoot, RL 2016, 'Mixed hepatocellular and cholangiocarcinoma: a rare tumor with a mix of parent phenotypic characteristics', HPB, vol. 18, no. 11, pp. 886-892. https://doi.org/10.1016/j.hpb.2016.07.006
Bergquist, John R. ; Groeschl, Ryan T. ; Ivanics, Tommy ; Shubert, Christopher R. ; Habermann, Elizabeth B ; Kendrick, Michael L. ; Farnell, Michael B. ; Nagorney, David M. ; Truty, Mark ; Smoot, Rory L. / Mixed hepatocellular and cholangiocarcinoma : a rare tumor with a mix of parent phenotypic characteristics. In: HPB. 2016 ; Vol. 18, No. 11. pp. 886-892.
@article{1af931f40aa54d71bd7875494d1814ef,
title = "Mixed hepatocellular and cholangiocarcinoma: a rare tumor with a mix of parent phenotypic characteristics",
abstract = "Background Intrahepatic lesions of mixed hepatocellular (HCC) and intrahepatic cholangiocellular carcinoma (ICC) histology are rare. The aim was to describe the natural history of these tumors relative to monomorphic ICC or HCC utilizing the National Cancer Data Base (NCDB). Methods Patients with ICC, HCC, and mixed histology (cHCC-CCA) were identified in the NCDB (2004–2012). Inter-group comparisons were made. Kaplan–Meier and multivariable Cox Proportional Hazards analyzed overall survival. Results The query identified 90,499 patients with HCC; 14,463 with ICC; and 1141 with cHCC-CCA histology. Patients with cHCC-CCA histology were relatively young (61 vs. 62 (HCC, p = 0.877) and 67 (ICC, p < 0.001) years) and more likely to have poorly differentiated tumor (29.2{\%} vs. 10.3{\%} (HCC) and 17.2{\%} (ICC) p < 0.001). Median overall survival for cHCC-CCA was 7.9 months vs. 10.8 (HCC) and 8.2 (ICC, all p < 0.001). Stage-specific survival for mixed histology tumors was most similar to that of HCC for all stages. cHCC-CCA were transplanted at a relatively high rate, and transplant outcomes for mixed tumors were substantially worse than for HCC lesions. Discussion cHCC-CCA demonstrate stage-specific survival similar to HCC, but post-surgical survival more consistent with ICC. Patients with a pre-operative diagnosis of cHCC-CCA should undergo resection when appropriate.",
author = "Bergquist, {John R.} and Groeschl, {Ryan T.} and Tommy Ivanics and Shubert, {Christopher R.} and Habermann, {Elizabeth B} and Kendrick, {Michael L.} and Farnell, {Michael B.} and Nagorney, {David M.} and Mark Truty and Smoot, {Rory L.}",
year = "2016",
month = "11",
day = "1",
doi = "10.1016/j.hpb.2016.07.006",
language = "English (US)",
volume = "18",
pages = "886--892",
journal = "HPB",
issn = "1365-182X",
publisher = "John Wiley and Sons Inc.",
number = "11",

}

TY - JOUR

T1 - Mixed hepatocellular and cholangiocarcinoma

T2 - a rare tumor with a mix of parent phenotypic characteristics

AU - Bergquist, John R.

AU - Groeschl, Ryan T.

AU - Ivanics, Tommy

AU - Shubert, Christopher R.

AU - Habermann, Elizabeth B

AU - Kendrick, Michael L.

AU - Farnell, Michael B.

AU - Nagorney, David M.

AU - Truty, Mark

AU - Smoot, Rory L.

PY - 2016/11/1

Y1 - 2016/11/1

N2 - Background Intrahepatic lesions of mixed hepatocellular (HCC) and intrahepatic cholangiocellular carcinoma (ICC) histology are rare. The aim was to describe the natural history of these tumors relative to monomorphic ICC or HCC utilizing the National Cancer Data Base (NCDB). Methods Patients with ICC, HCC, and mixed histology (cHCC-CCA) were identified in the NCDB (2004–2012). Inter-group comparisons were made. Kaplan–Meier and multivariable Cox Proportional Hazards analyzed overall survival. Results The query identified 90,499 patients with HCC; 14,463 with ICC; and 1141 with cHCC-CCA histology. Patients with cHCC-CCA histology were relatively young (61 vs. 62 (HCC, p = 0.877) and 67 (ICC, p < 0.001) years) and more likely to have poorly differentiated tumor (29.2% vs. 10.3% (HCC) and 17.2% (ICC) p < 0.001). Median overall survival for cHCC-CCA was 7.9 months vs. 10.8 (HCC) and 8.2 (ICC, all p < 0.001). Stage-specific survival for mixed histology tumors was most similar to that of HCC for all stages. cHCC-CCA were transplanted at a relatively high rate, and transplant outcomes for mixed tumors were substantially worse than for HCC lesions. Discussion cHCC-CCA demonstrate stage-specific survival similar to HCC, but post-surgical survival more consistent with ICC. Patients with a pre-operative diagnosis of cHCC-CCA should undergo resection when appropriate.

AB - Background Intrahepatic lesions of mixed hepatocellular (HCC) and intrahepatic cholangiocellular carcinoma (ICC) histology are rare. The aim was to describe the natural history of these tumors relative to monomorphic ICC or HCC utilizing the National Cancer Data Base (NCDB). Methods Patients with ICC, HCC, and mixed histology (cHCC-CCA) were identified in the NCDB (2004–2012). Inter-group comparisons were made. Kaplan–Meier and multivariable Cox Proportional Hazards analyzed overall survival. Results The query identified 90,499 patients with HCC; 14,463 with ICC; and 1141 with cHCC-CCA histology. Patients with cHCC-CCA histology were relatively young (61 vs. 62 (HCC, p = 0.877) and 67 (ICC, p < 0.001) years) and more likely to have poorly differentiated tumor (29.2% vs. 10.3% (HCC) and 17.2% (ICC) p < 0.001). Median overall survival for cHCC-CCA was 7.9 months vs. 10.8 (HCC) and 8.2 (ICC, all p < 0.001). Stage-specific survival for mixed histology tumors was most similar to that of HCC for all stages. cHCC-CCA were transplanted at a relatively high rate, and transplant outcomes for mixed tumors were substantially worse than for HCC lesions. Discussion cHCC-CCA demonstrate stage-specific survival similar to HCC, but post-surgical survival more consistent with ICC. Patients with a pre-operative diagnosis of cHCC-CCA should undergo resection when appropriate.

UR - http://www.scopus.com/inward/record.url?scp=84992704040&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84992704040&partnerID=8YFLogxK

U2 - 10.1016/j.hpb.2016.07.006

DO - 10.1016/j.hpb.2016.07.006

M3 - Article

C2 - 27546172

AN - SCOPUS:84992704040

VL - 18

SP - 886

EP - 892

JO - HPB

JF - HPB

SN - 1365-182X

IS - 11

ER -