title: Comparison of clinical characteristics of combined hepatocellular-cholangiocarcinoma and other primary liver cancers.
abstract: OBJECTIVE
  Combined hepatocellular-cholangiocarcinoma (CHC) is a rare liver malignancy. In this study, we compared patient characteristics and outcomes for primary CHC, intrahepatic cholangiocarcinoma (ICC), and hepatocellular carcinoma (HCC).
  
  
  METHODS
  Medical records of patients with tissue-proven CHC (65 cases) treated at the Chang Gung Memorial Hospital between 1991 and 2005 were retrospectively reviewed. These records were compared to records of patients diagnosed with tissue-proven HCC (1985 cases) and ICC (127 cases) during the same period.
  
  
  RESULTS
  Hepatitis B and C are major causes of CHC. CHC patients exhibited greater similarity to HCC than to ICC patients with respect to cirrhotic changes, age, and positive serology for hepatitis B surface antigen and anti-hepatitis C antibody. Survival was related to tumor characteristics and intervention therapies, but not to etiologies.
  
  
  CONCLUSIONS
  The clinical characteristics of CHC are similar to those of HCC, but overall survival is more similar to that of ICC; survival may be related to tumor biology rather than the cause. Multimodal treatment with an initial aggressive therapeutic approach can improve survival.
authors.affiliation: Division of General Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan. lee4570@adm.cgmh.org.tw
authors.forename: Chern-Horng
authors.initials: CH
authors.lastname: Lee
authors.forename: Sen-Yung
authors.initials: SY
authors.lastname: Hsieh
authors.forename: Chee-Jen
authors.initials: CJ
authors.lastname: Chang
authors.forename: Yu-Jr
authors.initials: YJ
authors.lastname: Lin
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D001650:Bile Duct Neoplasms / Q000473:pathology / Q000628:therapy / Q000821:virology*; D001653:Bile Ducts, Intrahepatic; D006528:Carcinoma, Hepatocellular / Q000473:pathology / Q000628:therapy / Q000821:virology*; D018281:Cholangiocarcinoma / Q000473:pathology / Q000628:therapy / Q000821:virology*; D005260:Female; D016174:Hepacivirus / Q000276:immunology; D006514:Hepatitis B Surface Antigens / Q000097:blood; D006515:Hepatitis B virus / Q000276:immunology; D019694:Hepatitis B, Chronic / Q000150:complications; D018937:Hepatitis C Antibodies / Q000097:blood; D019698:Hepatitis C, Chronic / Q000150:complications; D006801:Humans; D053208:Kaplan-Meier Estimate; D008103:Liver Cirrhosis / Q000150:complications / Q000473:pathology; D008113:Liver Neoplasms / Q000473:pathology / Q000628:therapy / Q000821:virology*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate
chemical_list: D006514:Hepatitis B Surface Antigens; D018937:Hepatitis C Antibodies