Adenosquamous Carcinoma of the Liver: Clinicopathologic Study of 10 Surgically Treated Cases

Abstract

This investigation presents the clinical features and outcomes of 10 surgically treated primary adenosquamous carcinomas of the liver (ADS-CCC). Peripheral cholangiocarcinoma (CCC) occurs less frequently than hepatocellular carcinoma in most parts of the world. Reports of surgically treated cases of ADS-CCC are sporadic owing to the low resectability rate, difficulty of making an early diagnosis, and its poor prognosis. Furthermore, clinicopathologic studies based on a limited number of surgically treated cases are still lacking. From 1988 to 1999 the clinical features of 10 surgically treated cases of ADS-CCC were reviewed, including clinical features, operative findings, the pathologic picture, and long-term results. The clinical features and outcomes of 171 patients with CCC were also summarized for comparison. Of 181 surgically treated CCC patients, 10 (5.3%) had ADS-CCC. Low bilirubin values and high resectability were prominent in the patients in the ADS-CCC group compared with those in the CCC group. The prognosis for ADS-CCC is dismal, although overall survival did not differ significantly between these two groups. Hepatic resection and curative hepatic resection had significant benefit on the overall survival in the CCC group but only hepatic overall survival in the ADS-CCC group. The 1- and 3-year survival rates of ADS-CCC and CCC patients were 22.2%/0% and 33.7/9.4%, respectively. This investigation presents the clinical features and outcomes of 10 surgically treated ADS-CCC patients. ADS-CCC exhibited higher resectability than CCC. Although hepatic resection might benefit the treatment and prolong the survival of ADS-CCC patients, the prognosis is still dismal because of the specific biologic behavior of the tumor.