Long-term Outcome of Patients Undergoing Liver Transplantation for Mixed Hepatocellular Carcinoma and Cholangiocarcinoma: an Analysis of the UNOS Database

Overview

Journal HPB (Oxford)

Publisher Elsevier

Specialty Gastroenterology

Date 2016 Jan 19

PMID 26776848

Citations 41

Authors

Valery Vilchez

Malay B Shah

Michael F Daily

Luis Pena

Ching-Wei D Tzeng

Daniel Davenport

Peter J Hosein

Roberto Gedaly

Erin Maynard

Affiliations

Soon will be listed here.

Abstract

Background: Mixed hepatocellular and cholangiocarcinoma (HCC-CC) have been associated with a poor prognosis after liver transplantation (LT). We aimed to evaluate long-term outcomes in patients undergoing LT for HCC-CC versus patients with hepatocellular carcinoma (HCC) or cholangiocarcinoma (CC).

Methods: Retrospective analysis of the United Network for Organ Sharing (UNOS) database from 1994-2013. Overall survival (OS) in patients with HCC-CC, HCC, and CC, were compared.

Results: We identified 4049 patients transplanted for primary malignancy (94 HCC-CC; 3515 HCC; 440 CC). Mean age of patients with HCC-CC was 57 ± 10 years, and 77% were male. MELD score did not differ among the groups (p = 0.637). Hepatitis C virus was the most common secondary diagnosis within the HCC-CC (44%) and HCC (36%) cohorts, with primary sclerosing cholangitis in the CC (16%) cohort. OS rates at 1, 3 and 5 years for HCC-CC (82%, 47%, 40%) were similar to CC (79%, 58%, 47%), but significantly worse than HCC (86%, 72%, and 62% p = 0.002).

Discussion: Patients undergoing LT for HCC had significantly better survival compared to those transplanted for HCC-CC and CC. LT for mixed HCC-CC confers a survival rate similar to selected patients with CC. Efforts should be made to identify HCC-CC patients preoperatively.

Citing Articles

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Outcomes of Liver Transplantation with Incidental Intrahepatic Cholangiocarcinoma-Own Experience and a Systematic Review.

Remiszewski P, Topolewski P, Laski D, Drobinska A J Clin Med. 2024; 13(15).

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Current advances and future directions in combined hepatocellular and cholangiocarcinoma.

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Ye L, Schneider J, Ben Khaled N, Schirmacher P, Seifert C, Frey L Liver Cancer. 2024; 13(1):6-28.

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Update on the Diagnosis and Treatment of Combined Hepatocellular Cholangiocarcinoma.

Chu K, Kawaguchi Y, Wang H, Jiang X, Hasegawa K J Clin Transl Hepatol. 2024; 12(2):210-217.

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