Abstract
BackgroundLittle is known about the prognostic impact of cirrhosis on long-term survival of patients with combined hepatocellular-cholangiocarcinoma (cHCC-CC) after hepatic resection. The aim of this study was to elucidate the long-term outcome of hepatectomy in cHCC-CC patients with cirrhosis.MethodsA total of 144 patients who underwent curative hepatectomy for cHCC-CC were divided into two groups: cirrhotic group (n = 91) and noncirrhotic group (n = 53). Long-term postoperative outcomes were compared between the two groups.ResultsPatients with cirrhosis had worse preoperative liver function, higher frequency of HBV infection, and smaller tumor size in comparison to those without cirrhosis. The 5-year overall survival rate in cirrhotic group was significantly lower than that in non-cirrhotic group (34.5% versus 54.1%, P = 0.032). The cancer recurrence-related death rate was similar between the two groups (46.2% versus 39.6%, P = 0.446), while the hepatic insufficiency-related death rate was higher in cirrhotic group (12.1% versus 1.9%, P = 0.033). Multivariate analysis indicated that cirrhosis was an independent prognostic factor of poor overall survival (hazard ratio 2.072, 95% confidence interval 1.041–4.123; P = 0.038).ConclusionsThe presence of cirrhosis is significantly associated with poor prognosis in cHCC-CC patietns after surgical resection, possibly due to decreased liver function.
Highlights
Little is known about the prognostic impact of cirrhosis on long-term survival of patients with combined hepatocellular-cholangiocarcinoma after hepatic resection
Hepatic resection affords the best chance of long-term survival with a reported 5-year overall survival (OS) rate of 23.1–54.1%
Postoperative morbidity was similar in the two groups except for the higher incidence of liver dysfunction in cirrhotic group
Summary
Little is known about the prognostic impact of cirrhosis on long-term survival of patients with combined hepatocellular-cholangiocarcinoma (cHCC-CC) after hepatic resection. The aim of this study was to elucidate the long-term outcome of hepatectomy in cHCC-CC patients with cirrhosis. Combined hepatocellular-cholangiocarcinoma (cHCC-CC) is a very rare entity that includes elements of both hepatocellular carcinoma (HCC) and cholangiocarcinoma (CC) and represents 0.4–14.2% of primary liver malignancies [1]. Patients with cHCC-CC, especially in Asian countries, are frequently accompanied by liver cirrhosis, with a prevalence of 27.7–84.6% [6]. Little is known about the prognostic significance of cirrhosis in cHCC-CC patients after surgery. We compared the long-term outcomes of hepatic resection in cHCC-CC patients with and without cirrhosis
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