The diagnostic conundrum and liver transplantation outcome for combined hepatocellular-cholangiocarcinoma

C. Panjala, D. L. Senecal, M. D. Bridges, G. P. Kim, R. E. Nakhleh, J. H.H. Nguyen, D. M. Harnois

Research output: Contribution to journalArticle

65 Scopus citations

Abstract

Combined hepatocellular-cholangiocarcinoma (cHCC-CC) is a rare primary liver malignancy with mixed hepatocellular carcinoma (HCC) and cholangiocarcinoma (CC) histological features. It is almost impossible to obtain an accurate, preoperative noninvasive diagnosis of cHCC-CC with tumor markers or cross-sectional abdominal imaging due to the mixed histological features. Despite these difficulties, accurate cHCC-CC diagnosis remains an important goal with prognostic significance. In our study, we retrospectively reviewed the tumor markers: AFP and CA 19-9, and cross-sectional liver imaging, in light of liver explant findings, to identify and characterize cHCC-CC features followed by liver transplantation (LT) outcome analysis. The results from this 12 patient cohort failed to identify characteristic features for cHCC-CC. None of the imaging features helped to identify the cHCC-CC tumor and they mimicked either HCC or CC, depending on the degree of glandular differentiation expressed histologically. In our cHCC-CC LT recipients, the 1-, 3- and 5-year cumulative survival probabilities were 79%, 66% and 16%, respectively with a 5-year survival comparable to or better than LT for intrahepatic CC but poorer than LT for HCC following the Milan criteria. Conceivably explained by its cholangiocarcinoma component the LT outcome for this rare and hard to diagnose tumor appears poor.

Original languageEnglish (US)
Pages (from-to)1263-1267
Number of pages5
JournalAmerican Journal of Transplantation
Volume10
Issue number5
DOIs
StatePublished - May 1 2010

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Keywords

  • Cholangiocarcinoma
  • Hepatocellular carcinoma
  • Liver cancer
  • Liver transplantation
  • Surgery/liver transplantation
  • Survival rate

ASJC Scopus subject areas

  • Immunology and Allergy
  • Transplantation
  • Pharmacology (medical)

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