Division of Hepatology, Division of Clinical Bioinformatics, Dept. of Internal Medicine II, Medical Faculty Mannheim, Heidelberg University, Mannheim; Clinical Cooperation Unit Healthy Metabolism, Center for Preventive Medicine and Digital Health Baden- Württemberg (CPDBW), Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
Division of Hepatology, Division of Clinical Bioinformatics, Dept. of Internal Medicine II, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
J Gastrointestin Liver Dis. 2023 Jun 22;32(2):190-196. doi: 10.15403/jgld-4893.
Primary liver cancer (PLC) ranks among of the most common cancers worldwide. Within this group, a minority of cases displays characteristics of both hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (iCCA), known as combined hepatocellular cholangiocarcinoma (cHCC- CCA). Currently, there is no specific standardized therapy for these mixed tumors. Therefore, the aim of our study was to analyze the clinical course, treatment and outcome of cHCC-CCA patients in a European population-based registry.
We investigated 9,144 patients with PLC (6,622 HCC, 2,356 iCCA, and 166 cHCC-CCA) diagnosed between 2009 and 2020. All data were obtained from Clinical Cancer Registry of Baden-Württemberg (BW), Germany.
In all three groups patients were predominantly male (82%, 57%, and 68% for HCC, iCCA and cHCC-CCA groups, respectively). 48% of cHCC-CCA patients were diagnosed as stage IV cancers, which was more than for HCC (31%) but less compared to CCA (64%). Overall median survival of cHCC-CCA patients was worse compared to HCC (9-13 months vs. 15.5 months, p<0.001) and rather comparable to CCA (11.8 months).
Our data demonstrated that cHCC-CCA tumors appear to have a distinct clinical course with worse overall survival compared to HCC. Thus, identification of these cancers by histopathology is essential in order to further characterize this tumor entity and to provide accurate treatment to these patients.
原发性肝癌（PLC）是全球最常见的癌症之一。在这一组中，少数病例同时具有肝细胞癌（HCC）和肝内胆管癌（iCCA）的特征，称为混合型肝细胞癌-胆管癌（cHCC-CCA）。目前，这些混合肿瘤没有特定的标准化治疗方法。因此，我们的研究目的是分析欧洲基于人群的登记处中 cHCC-CCA 患者的临床过程、治疗和结局。
我们调查了 2009 年至 2020 年间诊断的 9144 例 PLC 患者（6622 例 HCC、2356 例 iCCA 和 166 例 cHCC-CCA）。所有数据均来自德国巴登-符腾堡州临床癌症登记处（BW）。
在所有三组患者中，男性患者居多（HCC、iCCA 和 cHCC-CCA 组分别为 82%、57%和 68%）。48%的 cHCC-CCA 患者被诊断为 IV 期癌症，高于 HCC（31%）但低于 CCA（64%）。cHCC-CCA 患者的总体中位生存期明显短于 HCC（9-13 个月 vs. 15.5 个月，p<0.001），与 CCA 相当（11.8 个月）。
我们的数据表明，cHCC-CCA 肿瘤的临床过程似乎具有独特的特征，总体生存率较 HCC 更差。因此，通过组织病理学识别这些癌症对于进一步确定这种肿瘤实体并为这些患者提供准确的治疗至关重要。
