Paolo Magistri1, Giuseppe Tarantino2, Valentina Serra2, Cristiano Guidetti2, Roberto Ballarin2, Fabrizio Di Benedetto2. 1. Hepato-Pancreato-Biliary Surgery and Liver Transplantation Unit, University of Modena and Reggio Emilia, Modena, Italy; Department of General Surgery, Sapienza-University of Rome, Rome, Italy. Electronic address: paolo.magistri@uniroma1.it. 2. Hepato-Pancreato-Biliary Surgery and Liver Transplantation Unit, University of Modena and Reggio Emilia, Modena, Italy.
Abstract
INTRODUCTION: Combined hepatocellular-cholangiocarcinoma (CHC or cHCC-CC) is a rare primary liver tumor displaying histological features of both hepatocellular carcinoma (HCC) and cholangiocarcinoma (CCA). Most patients are not suitable for surgery because of the advanced stage of the disease at the moment of diagnosis. We decided to review the literature in order to identify the outcomes after liver transplantation for CHC and to clarify which is the most appropriate treatment. MATERIAL AND METHODS: A systematic literature search was performed. Studies reporting outcomes of liver transplantation (LT) for CHC and studies comparing oncologic outcomes after LT versus liver resection (LR) for CHC were included in this review. RESULTS: The mean 5-y Disease Free Survival (DFS) reported in literature is 45.4%, while the mean 5-y overall survival (OS) is 41.8%, analyzing a cohort of 418 cases. The mean DSF in our series after LT was 7.97 months, while the mean OS was 11.7 months. CONCLUSIONS: LT should be avoided for the treatment of CHC, in order to allocate organs for more appropriate diseases. Moreover, surgical resections, and in particular major hepatectomies, seem to be associated with acceptable outcomes. An accurate preoperative management is needed, and the use of PET-CT when differential diagnosis is difficult should be considered.
INTRODUCTION: Combined hepatocellular-cholangiocarcinoma (CHC or cHCC-CC) is a rare primary liver tumor displaying histological features of both hepatocellular carcinoma (HCC) and cholangiocarcinoma (CCA). Most patients are not suitable for surgery because of the advanced stage of the disease at the moment of diagnosis. We decided to review the literature in order to identify the outcomes after liver transplantation for CHC and to clarify which is the most appropriate treatment. MATERIAL AND METHODS: A systematic literature search was performed. Studies reporting outcomes of liver transplantation (LT) for CHC and studies comparing oncologic outcomes after LT versus liver resection (LR) for CHC were included in this review. RESULTS: The mean 5-y Disease Free Survival (DFS) reported in literature is 45.4%, while the mean 5-y overall survival (OS) is 41.8%, analyzing a cohort of 418 cases. The mean DSF in our series after LT was 7.97 months, while the mean OS was 11.7 months. CONCLUSIONS: LT should be avoided for the treatment of CHC, in order to allocate organs for more appropriate diseases. Moreover, surgical resections, and in particular major hepatectomies, seem to be associated with acceptable outcomes. An accurate preoperative management is needed, and the use of PET-CT when differential diagnosis is difficult should be considered.
Authors: Sun Kyung Jeon; Ijin Joo; Dong Ho Lee; Sang Min Lee; Hyo-Jin Kang; Kyoung-Bun Lee; Jeong Min Lee Journal: Eur Radiol Date: 2018-06-28 Impact factor: 5.315
Authors: Daniel R Ludwig; Tyler J Fraum; Roberto Cannella; David H Ballard; Richard Tsai; Muhammad Naeem; Maverick LeBlanc; Amber Salter; Allan Tsung; Anup S Shetty; Amir A Borhani; Alessandro Furlan; Kathryn J Fowler Journal: Abdom Radiol (NY) Date: 2019-06
Authors: Ka Wing Ma; Kenneth Siu Ho Chok; Wong Hoi She; Tan To Cheung; Albert Chi Yan Chan; Wing Chiu Dai; James Yan Yue Fung; Chung Mau Lo Journal: Hepatol Int Date: 2018-02-15 Impact factor: 6.047