Recurrence patterns of combined hepatocellular-cholangiocarcinoma on enhanced computed tomography.
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.
Shin
Cheong-Il
CI
Department of Radiology, Seoul National University College of Medicine, Republic of Korea.
Lee
Jeong Min
JM
Kim
Se Hyung
SH
Choi
Jin Young
JY
Lee
Jae Young
JY
Han
Joon Koo
JK
Jo
Soo Yeon
SY
Choi
Byung Ihn
BI
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