title: Intrahepatic cholangiocarcinoma and combined hepatocellular-cholangiocarcinoma: a Western experience.
abstract: BACKGROUND
  Intrahepatic cholangiocarcinoma (ICC) is an unusual tumour.
  
  
  METHODS
  The clinicopathological data of 67 patients with ICC and combined hepatocellular-cholangiocarcinoma (HCC-ICC) are presented.
  
  
  RESULTS
  HCV-HBV infection was present in 37.3% and chronic liver disease in 38.7% of cases, a rate higher than in the normal population; in these patients the cancer was small, often asymptomatic and of combined type. Liver resection was performed in 51 patients; at 1, 3 and 5 years, overall survival was 87.9%, 59.0%, and disease-free survival was 47.7% and 78.8%, 51.4%, and 46.7%, respectively. The better results were in the group of cirrhotic patients in whom ICC was diagnosed by a screening program for HCC (5-year survival 76.6%). Nodal metastasis showed negative prognostic value for both overall and disease-free survival; in N+ patients mean survival was 14.7 months after liver resection and lymph node dissection.
  
  
  CONCLUSIONS
  Viral infection and cirrhosis may be considered risk conditions for ICC and combined HCC-ICC; in resected patients survival was good. Nodal metastases must not be considered a contraindication for liver resection.
authors.affiliation: Department of Medical and Surgical Sciences, Surgical Clinic, Brescia University, P.le Spedali Civili, 1, 25123, Brescia, Italy.
authors.forename: Nazario
authors.initials: N
authors.lastname: Portolani
authors.forename: Gian Luca
authors.initials: GL
authors.lastname: Baiocchi
authors.forename: Arianna
authors.initials: A
authors.lastname: Coniglio
authors.forename: Tullio
authors.initials: T
authors.lastname: Piardi
authors.forename: Luigi
authors.initials: L
authors.lastname: Grazioli
authors.forename: Anna
authors.initials: A
authors.lastname: Benetti
authors.forename: Andrea
authors.initials: A
authors.lastname: Ferrari Bravo
authors.forename: Stefano Maria
authors.initials: SM
authors.lastname: Giulini
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001650:Bile Duct Neoplasms / Q000473:pathology* / Q000601:surgery; D001653:Bile Ducts, Intrahepatic / Q000473:pathology* / Q000601:surgery; D006528:Carcinoma, Hepatocellular / Q000473:pathology* / Q000601:surgery; D018281:Cholangiocarcinoma / Q000473:pathology* / Q000601:surgery; D005260:Female; D006509:Hepatitis B / Q000150:complications; D006526:Hepatitis C / Q000150:complications; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications; D008113:Liver Neoplasms / Q000473:pathology* / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D009378:Neoplasms, Multiple Primary; D011379:Prognosis; D012307:Risk Factors; D015996:Survival Rate