Portal de Periódicos da CAPES

Artigo Acesso aberto Produção Nacional Revisado por pares

BIBTEX RIS

Combined hepatocellular-cholangiocarcinoma compared to hepatocellular carcinoma and intrahepatic cholangiocarcinoma: Different survival, similar recurrence

2023; Elsevier BV; Volume: 175; Issue: 2 Linguagem: Inglês

10.1016/j.surg.2023.09.040

1532-7361

Boris Amory, Claire Goumard, Alexis Laurent, Serena Langella, Daniel Cherqui, Éphrem Salame, Louise Barbier, Olivier Soubrane, Olivier Farges, Christian Hobeika, Takayuki Kawai, Jean‐Marc Regimbeau, François Faitot, Patrick Pessaux, Stéphanie Truant, Emmanuel Boleslawski, Astrid Herrero, Jean‐Yves Mabrut, L. Chiche, Marcello Di Martino, Rami Rhaiem, Lilian Schwarz, Vívian Resende, Julien Caldéraro, Jérémy Augustin, Stefano Caruso, Danièle Sommacale, Stefan Hofmeyr, Alessandro Ferrero, David Fuks, Éric Vibert, Guido Torzilli, Olivier Scatton, Raffaele Brustia, J. Abba, René Adam, Mustapha Adham, Pietro Addeo, Marc‐Antoine Allard, Giuliana Amaddeo, Ahmet Ayav, Daniel Azoulay, Philippe Bachellier, Pierre Balladur, J. Barbieux, Emmanuel Boleslawski, Karim Boudjéma, M. Bougard, Emmanuel Buc, Petru Bucur, Antoine Carmelo, François Cauchy, Denis Chatelain, Jean Chauvat, Zineb Cherkaoui, Mircea Chirica, Oriana Ciacio, Tatiana Codjia, Fabio Colli, Luciano De Carlis, Jean‐Robert Delpéro, Nicolas Demartines, Olivier Detry, Marcelo Dias Sanches, Momar Diouf, Alexandre Doussot, Christian Ducerf, Mehdi El Amrani, Jacques Ewald, Jean-Marc Fabre, H. Fagot, Simone Famularo, Léo Ferre, Francesco Fleres, Gilton Marques Fonseca, Alvaro Quintana, Brice Gayet, Alessandro Giacomoni, Jean‐François Gigot, Nicolas Golse, Émilie Grégoire, Jean Hardwigsen, Paulo Herman, Thevi Hor, François Jehaes, Ali-Reza Kianmanesh, Shohei Komatsu, Sophie Laroche, Christophe Laurent, Yves‐Patrice Le Treut, Philippe Leourier, Émilie Lermite, Mikael Lesurtel, Christian Létoublon, Paul Leyman, Mickaël Lesurtel, Jean Lubrano, Jean‐Yves Mabrut, Georges Mantion, Ugo Marchèse, Elena Martín‐Pérez, Benjamin Menahem, Maxime A. Meunier, Guillaume Y. Millet, Kayvan Mohkam, André Mulliri, Fabrice Muscari, Françis Navarro, Francisco Nolasco, Takeo Nomi, Jean Nunoz, Gennaro Nuzzo, Shinya Okumura, Nassima Oudafal, Gérard Pascal, Guillaume Passot, Damiano Patrono, François Paye, Fabiano Perdigão, Niccolò Petrucciani, Gabriella Pittau, François‐René Pruvot, Artigas Raventós, Hélène Regnault, Michel Rivoire, Renato Romagnoli, Didier Roulin, António Sá Cunha, Michel Scotté, Régis Souche, Bertrand Suc, Alexandre Thobie, B. Tréchot, Stéphanie Truant, Olivier Turini, Shinji Üemoto, Xavier Unterteiner, Charles Vanbrugghe, Jean Zemour,

Gallbladder and Bile Duct Disorders

Background Combined hepatocholangiocarcinoma is a rare cancer with a grim prognosis composed of both hepatocellular carcinoma and intrahepatic cholangiocarcinoma morphologic patterns in the same tumor. The aim of this multicenter, international cohort study was to compare the oncologic outcomes after surgery of combined hepatocholangiocarcinoma to hepatocellular carcinoma and intrahepatic cholangiocarcinoma. Methods Patients treated by surgery for combined hepatocholangiocarcinoma, hepatocellular carcinoma, and intrahepatic cholangiocarcinoma from 2000 to 2021 from multicenter international databases were analyzed retrospectively. Patients with combined hepatocholangiocarcinoma (cases) were compared with 2 control groups of hepatocellular carcinoma or intrahepatic cholangiocarcinoma, sequentially matched using a propensity score based on 8 preoperative characteristics. Overall and disease-free survival were compared, and predictors of mortality and recurrence were analyzed with Cox regression after propensity score matching. Results During the study period, 3,196 patients were included. Propensity score adjustment and 2 sequential matching processes produced a new cohort (n = 244) comprising 3 balanced groups was obtained (combined hepatocholangiocarcinoma = 56, intrahepatic cholangiocarcinoma = 66, and hepatocellular carcinoma = 122). Kaplan–Meier overall survival estimations at 1, 3, and 5 years were 67%, 45%, and 28% for combined hepatocholangiocarcinoma, 92%, 75%, and 55% for hepatocellular carcinoma, and 86%, 53%, and 42% for the intrahepatic cholangiocarcinoma group, respectively (P = .0014). Estimations of disease-free survival at 1, 3, and 5 years were 51%, 25%, and 17% for combined hepatocholangiocarcinoma, 63%, 35%, and 26% for the hepatocellular carcinoma group, and 51%, 31%, and 28% for the intrahepatic cholangiocarcinoma group, respectively (P = .19). Predictors of mortality were combined hepatocholangiocarcinoma subtype, metabolic syndrome, preoperative tumor markers alpha-fetoprotein and carbohydrate antigen 19-9, and satellite nodules, and recurrence was associated with satellite nodules rather than cancer subtype. Conclusion Despite data limitations, overall survival among patients with combined hepatocholangiocarcinoma was worse than both groups and closer intrahepatic cholangiocarcinoma, whereas disease-free survival was similar among the 3 groups. Future research on immunophenotypic profiling may hold more promise than traditional nonmodifiable clinical characteristics (as found in this study) in predicting recurrence or response to salvage treatments.