An update on long-term outcome of curative hepatic resection for hepatocholangiocarcinoma.
BACKGROUND
Hepatocholangiocarcinoma (HCC-CC) is a rare primary liver cancer. Its long-term prognosis is still not well-defined. Results from the Eastern and Western literature have been conflicting and no conclusions can be drawn. The aim of the present study was to review the long-term outcome of curative hepatectomy for HCC-CC.


METHODS
Prospectively collected data from December 1991 to 2006 recording patients with primary liver cancer receiving curative hepatectomy were reviewed. Twenty-five patients, 16 men and 9 women with a median age of 48 years, all ethnic Chinese, had HCC-CC. Their long-term outcome of resection was analyzed and compared to that of patients with cholangiocarcinoma (CC) or hepatocellular carcinoma (HCC).


RESULTS
The HCC-CC patients had a median tumor size of 7.5 cm. Five of them developed postoperative complications. The median follow-up period was 25 months. All of the patients developed recurrence. The median overall survival was 25.2 months. The HCC-CC and CC groups had significantly worse overall survival than the HCC group (HCC versus HCC-CC, p = 0.012; HCC versus CC, p = 0.001) whereas between them there was no significant difference (p = 0.822). As for disease-free survival, there was no significant difference between the three groups; the median disease-free survival for HCC-CC patients was 13.5 months; that for CC patients, 16.1 months; and that for HCC patients, 19.0 months. All HCC-CC patients died within 120 months of primary surgery.


CONCLUSIONS
Hepatocholangiocarcinoma entails poor long-term outcome after potentially curative hepatectomy. Other modalities of treatment should be explored in order to prolong survival of patients with this disease.
Chok
Kenneth Siu-Ho
KS
Division of Hepatobiliary and Pancreatic Surgery, Department of Surgery, The University of Hong Kong, Queen Mary Hospital, 102 Pok Fu Lam Road, Hong Kong, China. kennethchok@yahoo.com.hk
Ng
Kelvin K C
KK
Cheung
Tan To
TT
Yuen
Wai Key
WK
Poon
Ronnie T P
RT
Lo
Chung Mau
CM
Fan
Sheung Tat
ST
D000328:Adult; D000368:Aged; D018281:Cholangiocarcinoma / Q000601:surgery*; D005260:Female; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D008113:Liver Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D018709:Statistics, Nonparametric; D015996:Survival Rate; D016896:Treatment Outcome