title: Recurrence patterns of combined hepatocellular-cholangiocarcinoma on enhanced computed tomography.
abstract: OBJECTIVE
  To determine whether the computed tomographic (CT) findings of primary and recurrent combined hepatocellular-cholangiocarcinoma (HCC-CC) can predict the main tumor component on histopathologic examination, and to describe the recurrence patterns of HCC-CC after surgery.
  
  
  METHODS
  Preoperative and postoperative CT findings of 12 HCC-CC patients who underwent curative surgery were retrospectively reviewed. The main features of the primary and recurrent tumors on CT and the pathological findings were classified as hepatocellular carcinoma (HCC)-dominant and cholangiocarcinoma (CC)-dominant groups. The concordance between the preoperative CT features and the initial pathological findings was evaluated using kappa statistics. The survival periods of the HCC-dominant and the CC-dominant group were compared using the Mann-Whitney U test.
  
  
  RESULTS
  In 11 (91.7%) of 12 patients, the main CT features of HCC-CC were in strong agreement with main pathological findings (kappa = 0.824). The most common site of recurrence was the remnant liver. In 3 cases, only nodal metastasis was noted. The mean survival period was significantly longer in the HCC-dominant group than in the CC-dominant group of recurrent tumor (P = 0.016).
  
  
  CONCLUSIONS
  Contrast-enhanced CT scanning can predict the dominant component of primary and recurrent HCC-CC. This capability can optimize treatment strategy for the patient with recurrent HCC-CC.
authors.affiliation: Department of Radiology, Seoul National University College of Medicine, Republic of Korea.
authors.forename: Cheong-Il
authors.initials: CI
authors.lastname: Shin
authors.forename: Jeong Min
authors.initials: JM
authors.lastname: Lee
authors.forename: Se Hyung
authors.initials: SH
authors.lastname: Kim
authors.forename: Jin Young
authors.initials: JY
authors.lastname: Choi
authors.forename: Jae Young
authors.initials: JY
authors.lastname: Lee
authors.forename: Joon Koo
authors.initials: JK
authors.lastname: Han
authors.forename: Soo Yeon
authors.initials: SY
authors.lastname: Jo
authors.forename: Byung Ihn
authors.initials: BI
authors.lastname: Choi
mesh_terms: D000328:Adult; D000368:Aged; D001650:Bile Duct Neoplasms / Q000000981:diagnostic imaging*; D001653:Bile Ducts, Intrahepatic; D006528:Carcinoma, Hepatocellular / Q000000981:diagnostic imaging*; D018281:Cholangiocarcinoma / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000000981:diagnostic imaging*; D009378:Neoplasms, Multiple Primary / Q000000981:diagnostic imaging*; D011856:Radiographic Image Enhancement; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods