학술논문
Multi-Center Analysis of Liver Transplantation for Combined Hepatocellular Carcinoma-Cholangiocarcinoma Liver Tumors
Document Type
article
Author
Dageforde, Leigh Anne; Vachharajani, Neeta; Tabrizian, Parissa; Agopian, Vatche; Halazun, Karim; Maynard, Erin; Croome, Kristopher; Nagorney, David; Hong, Johnny C; Lee, David; Ferrone, Cristina; Baker, Erin; Jarnagin, William; Hemming, Alan; Schnickel, Gabriel; Kimura, Shoko; Busuttil, Ronald; Lindemann, Jessica; Florman, Sander; Holzner, Matthew L; Srouji, Rami; Najjar, Marc; Yohanathan, Lavanya; Cheng, Jane; Amin, Hiral; Rickert, Charles A; Yang, Ju Dong; Kim, Joohyun; Pasko, Jennifer; Chapman, William C; Majella Doyle, Maria B
Source
Journal of the American College of Surgeons. 232(4)
Subject
Language
Abstract
BackgroundCombined hepatocellular-cholangiocarcinoma liver tumors (cHCC-CCA) with pathologic differentiation of both hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma within the same tumor are not traditionally considered for liver transplantation due to perceived poor outcomes. Published results are from small cohorts and single centers. Through a multicenter collaboration, we performed the largest analysis to date of the utility of liver transplantation for cHCC-CCA.Study designLiver transplant and resection outcomes for HCC (n = 2,998) and cHCC-CCA (n = 208) were compared in a 12-center retrospective review (2009 to 2017). Pathology defined tumor type. Tumor burden was based on radiologic Milan criteria at time of diagnosis and applied to cHCC-CCA for uniform analysis. Kaplan-Meier survival curves and log-rank test were used to determine overall survival and disease-free survival. Cox regression was used for multivariate survival analysis.ResultsLiver transplantation for cHCC-CCA (n = 67) and HCC (n = 1,814) within Milan had no significant difference in overall survival (5-year cHCC-CCA 70.1%, HCC 73.4%, p = 0.806), despite higher cHCC-CCA recurrence rates (23.1% vs 11.5% 5 years, p