Abstract
BackgroudIntestinal hepatoid adenocarcinoma (IHA) is a very rare and unique intestinal malignancy. Due to the lack of case series specifically pertaining to IHA, the clinicopathological features and prognosis of it remain unclear.ResultsOf the 42 patients enrolled in this study, 30 (71.4%) were male. Twenty-one cases (50.0%) were located in the colon. Eight cases (19.0%) had accompanying inflammatory bowel disease (IBD). Elevated serum alpha-fetoprotein (AFP) was detected for most patients (25/33, 84.8%). Twenty-five (59.5%) patients received complete resections. Vascular invasion (22/36, 61.1%), lymph node metastasis (28/36, 77.8%) and distant metastasis (21/42, 50.0%) were common. The 1-year progression-free survival (PFS) and disease-specific survival (DSS) of IHA were 26.9% and 30.6%, respectively. Multivariate analysis showed that only pTNM stage was an independent risk factor for PFS and DSS. PFS and DSS in patients with IHA were significantly lower than those with colorectal adenocarcinoma (CA) and hepatoid adenocarcinoma of the stomach (HAS).ConclusionsIHA most commonly occurred in the colon and accompanied by IBD in several cases. pTNM stage was an independent factor for prognosis. The prognosis of IHA was significantly worse than that of CA and HAS.Patients and MethodsClinical data of IHA from four patients managed at our institution between January 2010 and December 2016, and 38 cases from research databases prior to 2017 were retrospectively studied.
Highlights
Hepatoid adenocarcinoma (HAC) is a rare and special type of extrahepatic malignancy with an estimated annual incidence of 0.58–0.83 cases per million people [1, 2]
Multivariate analysis showed that only pTNM stage was an independent risk factor for progression-free survival (PFS) and disease-specific survival (DSS)
Intestinal hepatoid adenocarcinoma (IHA) most commonly occurred in the colon and accompanied by inflammatory bowel disease (IBD) in several cases. pTNM stage was an independent factor for prognosis
Summary
Hepatoid adenocarcinoma (HAC) is a rare and special type of extrahepatic malignancy with an estimated annual incidence of 0.58–0.83 cases per million people [1, 2]. It is distinguished by having foci with characteristics of both hepatocellular differentiation and adenomatous differentiation [3]. IHA commonly exhibits an elevated serum www.impactjournals.com/oncotarget alpha-fetoprotein (AFP) levels, and usually presents extensive vascular invasion, frequent liver metastasis and oftentimes advanced pTNM stage, all of which may contribute to its extremely poor prognosis [9]. Extensive data regarding the clinicopathological profiles and prognosis of IHA remain limited, with all studies in the literature being case reports. We investigated the potential factors that may predict prognosis
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