CAJ | 학술논문

BACKGROUND:?Combined? hepatocellular? carcinoma? and?cholangiocarcinoma?(cHCC-CC)?is?a?rare?subtype?of?primary?liver?cancer?consisting?of?both?hepatocellular?carcinoma?(HCC)?and?cholangiocarcinoma?(CC).?Because?of?the?rarity?of?this?tumor,?its?feature?is?poorly?understood.?The?present?study?aimed?to?evaluate?the?clinicopathological?features?and?long-term?prognosis?of?patients?with?cHCC-CC?after?surgery?and?to?compare?with?those?of?the?patients?with?stage-matched?HCC?and?CC.METHODS:?The?clinicopathological?features?of?the?patients?who?underwent?surgery?for?cHCC-CC?at?our?center?during?the?period?of?2001-2010?were?retrospectively?analyzed?and?compared?with?those?of?stage-matched?HCC?and?CC?patients.?Cancer?staging?was?performed?according?to?the?AJCC Cancer Staging Manual?(6th?ed.).?Overall?survival?and?disease-free?survival?were?compared?among?the?groups?and?prognostic?factors?of?cHCC-CC?were?evaluated. RESULTS:?Signiifcant? differences? were? observed? in? clinico-pathological?features?among?42?patients?with?cHCC-CC,?90?patients?with?HCC?and?45?patients?with?CC.?Similar?to?HCC?patients,?cHCC-CC?patients?had?frequent?hepatitis?B?virus?antigen?positivity,?microscopic?vessel?invasion,?cirrhosis?and?high?level?of?serum?alpha-fetoprotein.?Similar?to?CC?patients,?cHCC-CC?patients?showed?increased?bile?duct?invasion?and?decreased?capsule.?The?1-,?3-,?and?5-year?overall?survival?and?disease-free?survival?of?patients?with?cHCC-CC?were?not?signiifcantly?different?from?those?with?stage-matched?patients?with?CC; but?signiifcantly?poorer?than?those?with?HCC.?In?subanalysis?of?patients?with?stage?II,?the?overall?survival?in?patients?with?cHCC-CC?or?CC?was?signiifcantly?poorer?than?that?in?patients?with?HCC.?We?did?not?ifnd?the?difference?in?patients?with?other?stages.?Univariate?analysis?of?overall?and?disease-free?survival?of?patients?with?cHCC-CC?showed?that?the?vascular?invasion?and?intrahepatic?metastasis?were?the?signiifcant?predictive?factors. CONCLUSION:?Patients?with?cHCC-CC?showed?similar?clinico-pathological?features?as?those?with?HCC?or?CC,?and?patients?with?cHCC-CC?or?CC?had?a?poorer?prognosis?compared?with?those?with?HCC,?especially?at?matched?stage?II.