Surgical Treatments and Prognoses of Patients with Combined Hepatocellular Carcinoma and Cholangiocarcinoma
Surgical Treatments and Prognoses of Patients with Combined Hepatocellular Carcinoma and Cholangiocarcinoma
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DOI：
10.1245/s10434-008-0278-3
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发表时间：
2009-03-01
影响因子：
3.7
通讯作者：
Suh, Dong Jin
中科院分区：
文献类型：
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作者：
Kim, Ki Hun;Lee, Sung Gyu;Suh, Dong Jin
肝细胞癌和胆管细胞癌的结合是一种非常罕见的原发性肝癌，包含两种肿瘤类型的成分。我们评估了手术治疗的有效性以及与生存率和复发率相关的因素。在1989年1月至2006年7月在韩国首尔牙山医疗中心因原发性肝脏恶性肿瘤接受肝切除术或肝移植的2427例患者中，29例为肝细胞癌和胆管细胞癌作为单一的混合性或移行性肿瘤。回顾性分析他们的病历，6个月、1年和3年的无病生存率分别为51.1%、38.3%和25.6%。单因素分析显示CA 19-9高于37 U/ml预示总生存率低（P = 0.03），TNM分期与无病生存率显著相关（P = 0.04），合并肝细胞癌和胆管细胞癌的患者术后生存率低。高CA 19-9水平与较差的生存率相关，提示胆管癌部分可能是患者预后的主要决定因素。积极的手术治疗，包括淋巴结清扫，可能会提高疑似或诊断为这些肿瘤的患者的生存率。
Combined hepatocellular carcinoma and cholangiocarcinoma is a very rare form of primary liver cancer containing components of both tumor types. We evaluated the effectiveness of surgical treatment and factors related to survival and recurrence.Of the 2427 patients who underwent hepatectomy or liver transplantation because of a primary hepatic malignancy from January 1989 to July 2006 at the Asan Medical Center, Seoul, Korea, 29 had hepatocellular carcinoma and cholangiocarcinoma as a single mixed or transitional tumor. Their medical records were retrospectively reviewed.Disease-free survival rates at 6 months, 1 year, and 3 years were 51.1%, 38.3%, and 25.6%, respectively. Univariate analysis showed that CA 19-9 above 37 U/ml was predictive of low overall survival (P = .03) and that TNM stage was significantly associated with disease-free survival (P = .04).Patients with combined hepatocellular carcinoma and cholangiocarcinoma had poor postoperative survival rates. High CA 19-9 level was associated with poorer survival, suggesting that the cholangiocarcinoma portion may be a major determining factor for patient prognosis. Aggressive surgical treatment, including lymph node dissection, may improve survival in patients suspected of or diagnosed with these tumors.