Gentile Damiano, Donadon Matteo, Lleo Ana, Aghemo Alessio, Roncalli Massimo, di Tommaso Luca, Torzilli Guido
aDepartment of Hepatobiliary and General Surgery, Humanitas University, Humanitas Clinical and Research Center, IRCCS, Rozzano, Milan, Italy.
bDepartment of Internal Medicine and Hepatology, Humanitas University, Humanitas Clinical and Research Center, IRCCS, Rozzano, Milan, Italy.
Liver Cancer. 2020 Jan;9(1):15-27. doi: 10.1159/000503719. Epub 2019 Nov 1.
Hepatocholangiocarcinoma (HCC-CC) is a rare liver malignancy that contains features of both hepatocellular carcinoma (HCC) and mass-forming cholangiocarcinoma (MFCCC). Three classification systems for HCC-CC are described in literature and the majority of these tumors appear to be of the transitional type. The aim of this study is to evaluate the characteristics of transitional HCC-CC and to compare long-term oncological outcomes with HCC and MFCCC in surgically treated patients.
A systematic literature search was conducted to identify relevant studies analyzing demographic and clinical characteristics of patients with transitional HCC-CC and evaluating treatments and outcomes associated with this neoplasm. Only comparative, retrospective analyses were included. A total of 14 studies, involving 13,613 patients with primary liver malignancy, were analyzed. All patients underwent surgery, either liver resection or transplantation. Four hundred and thirty-seven patients were affected by transitional HCC-CC (3.2%). For further analysis, patients with transitional HCC-CC were divided into 2 groups, the resection group and the transplantation group. Disease-free survival (DFS) and overall survival (OS) of these patients were analyzed and compared to long-term oncological outcomes of patients with HCC and/or MFCCC, who underwent the same treatment. In the resection group, DFS rate at 5-year was 15, 31.6, and 20.3% for patients with transitional HCC-CC, HCC, and MFCCC, respectively; OS rate at 5-year was 32.7, 47.5, and 30.3% for patients with transitional HCC-CC, HCC, and MFCCC, respectively. In the transplantation group, DFS rate at 5-year was 40.9 and 87.4% for patients with transitional HCC-CC and HCC, respectively; OS rate at 5-year was 49.4 and 80.3% for patients with transitional HCC-CC and HCC, respectively.
Transitional HCC-CC patients have significantly worse DFS and OS rates compared to HCC patients in both the resection group and the transplantation group. However, in the resection group, both DFS and OS rates of transitional HCC-CC patients are not statistically different from those of MFCCC patients.
肝内胆管癌（HCC-CC）是一种罕见的肝脏恶性肿瘤，兼具肝细胞癌（HCC）和肿块型胆管癌（MFCCC）的特征。文献中描述了三种HCC-CC的分类系统，这些肿瘤大多似乎属于过渡型。本研究的目的是评估过渡型HCC-CC的特征，并比较手术治疗患者中其与HCC和MFCCC的长期肿瘤学结局。
进行了一项系统的文献检索，以识别分析过渡型HCC-CC患者的人口统计学和临床特征以及评估与该肿瘤相关的治疗和结局的相关研究。仅纳入比较性、回顾性分析。共分析了14项研究，涉及13613例原发性肝脏恶性肿瘤患者。所有患者均接受了手术，包括肝切除术或肝移植。437例患者患有过渡型HCC-CC（3.2%）。为进一步分析，将过渡型HCC-CC患者分为两组，即切除组和移植组。分析了这些患者的无病生存期（DFS）和总生存期（OS），并与接受相同治疗的HCC和/或MFCCC患者的长期肿瘤学结局进行比较。在切除组中，过渡型HCC-CC、HCC和MFCCC患者的5年DFS率分别为15%、31.6%和20.3%；5年OS率分别为32.7%、47.5%和30.3%。在移植组中，过渡型HCC-CC和HCC患者的5年DFS率分别为40.9%和87.4%；5年OS率分别为49.4%和80.3%。
在切除组和移植组中，过渡型HCC-CC患者的DFS和OS率均显著低于HCC患者。然而，在切除组中，过渡型HCC-CC患者的DFS和OS率与MFCCC患者相比无统计学差异。
