Lee Suk Won, Kim Milim, Kim Sung Hyun, Han Dai Hoon, Choi Gi Hong, Kim Kyung Sik, Choi Jin Sub, Park Young Nyun
Department of General Surgery, Severance Hospital, Seoul, Korea.
Department of Pathology, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea.
J Gastrointest Oncol. 2024 Aug 31;15(4):1796-1804. doi: 10.21037/jgo-24-313. Epub 2024 Aug 22.
Sarcomatoid change is rarely seen in epithelial malignancy that can be observed in diverse organs. Although a sarcomatoid change in combined hepatocellular-cholangiocarcinoma (cHCC-CC) is assumed to be a poor prognostic factor, this issue has not been studied due to its rare incidence. In this study, we aimed to identify the oncological impact of sarcomatoid change in patients with cHCC-CC and verify that sarcomatoid change is a poor prognostic factor for resected cHCC-CC.
Between January 2006 and December 2020, 102 patients who underwent surgical resection for cHCC-CC were retrospectively reviewed. The hazard ratio (HR) according to sarcomatoid change was calculated using other known prognostic factors for cHCC-CC. In addition, the patients were divided into two groups according to the sarcomatoid change, and their survival was compared.
The multivariate analysis demonstrated that sarcomatoid change in cHCC-CC is a poor prognostic factor {disease-free survival (DFS), HR =3.84 [95% confidence interval (CI): 1.63-9.10], P=0.002; overall survival (OS), HR =3.94 (95% CI: 1.67-9.31), P=0.002}. In the survival analysis, the sarcomatoid change group displayed a worse prognosis compared to the non-sarcomatoid change group {DFS: 4.0 [interquartile range (IQR): 1.2-6.8] 23.0 (IQR: 9.3-36.7) months, P=0.001; OS: 19.0 (IQR: 7.2-30.8) 85.0 (IQR: 31.8-138.2) months, P=0.004}.
Sarcomatoid change is a poor prognostic factor for resected cHCC-CC.
肉瘤样变在可发生于多种器官的上皮性恶性肿瘤中很少见。虽然肝细胞-胆管细胞癌（cHCC-CC）中的肉瘤样变被认为是一个预后不良因素，但由于其发病率低，这一问题尚未得到研究。在本研究中，我们旨在确定cHCC-CC患者中肉瘤样变对肿瘤学的影响，并验证肉瘤样变是切除的cHCC-CC患者的预后不良因素。
回顾性分析2006年1月至2020年12月期间接受手术切除的102例cHCC-CC患者。根据cHCC-CC的其他已知预后因素计算肉瘤样变的风险比（HR）。此外，根据肉瘤样变将患者分为两组，并比较其生存率。
多因素分析表明，cHCC-CC中的肉瘤样变是一个预后不良因素{无病生存期（DFS），HR =3.84 [95%置信区间（CI）：1.63-9.10]，P=0.002；总生存期（OS），HR =3.94（95% CI：1.67-9.31），P=0.002}。在生存分析中，肉瘤样变组的预后比非肉瘤样变组差{DFS：4.0 [四分位间距（IQR）：1.2-6.8] 23.0（IQR：9.3-36.7）个月，P=0.001；OS：19.0（IQR：7.2-30.8） 85.0（IQR：31.8-138.2）个月，P=0.004}。
肉瘤样变是切除的cHCC-CC患者的预后不良因素。
