title: Tumors with intrahepatic bile duct differentiation in cirrhosis: implications on outcomes after liver transplantation.
abstract: BACKGROUND
  The role of liver transplantation (LT) in the management of cirrhotic patients with tumors exhibiting intrahepatic bile duct differentiation remains controversial. The objective of this study was to characterize the spectrum of these tumors and analyze post-LT outcomes.
  
  
  METHODS
  Retrospective pathology database search of explant histology analysis of liver transplants between April 1993 and November 2013.
  
  
  RESULTS
  Thirty-two patients were analyzed, 75% were men with a mean age of 60 years. Seven patients had nodules demonstrating intrahepatic cholangiocarcinoma (I-CCA), nine had I-CCA nodules occurring concomitantly with hepatocellular carcinoma (HCC), and 16 had mixed HCC-CCA nodules. The median number of tumors was 1 and size was 2.5 cm. Overall patient survival post-LT at 1 and 5 years was 71% and 57%, respectively. Patients within Milan criteria, especially with I-CCA features, showed a 5-year tumor recurrence rate (10%) and 5-year survival rate (78%) comparable with other patients having HCC within Milan criteria.
  
  
  CONCLUSIONS
  This series showed that patients with CCA within Milan criteria may be able to achieve acceptable long-term post-LT survival.
authors.affiliation: 1 Recanati Miller Transplantation Institute, The Mount Sinai Medical Center, New York, NY. 2 The Lillian and Henry M. Stratton-Hans Popper Department of Pathology, The Mount Sinai Medical Center, New York, NY.
authors.forename: Marcelo E
authors.initials: ME
authors.lastname: Facciuto
authors.forename: Manoj K
authors.initials: MK
authors.lastname: Singh
authors.forename: Nir
authors.initials: N
authors.lastname: Lubezky
authors.forename: Motaz A
authors.initials: MA
authors.lastname: Selim
authors.forename: Dorothy
authors.initials: D
authors.lastname: Robinson
authors.forename: Leona
authors.initials: L
authors.lastname: Kim-Schluger
authors.forename: Sander
authors.initials: S
authors.lastname: Florman
authors.forename: Stephen C
authors.initials: SC
authors.lastname: Ward
authors.forename: Swan N
authors.initials: SN
authors.lastname: Thung
authors.forename: MariaIsabel
authors.initials: M
authors.lastname: Fiel
authors.forename: Thomas D
authors.initials: TD
authors.lastname: Schiano
mesh_terms: D001650:Bile Duct Neoplasms / Q000209:etiology / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D001653:Bile Ducts, Intrahepatic / Q000473:pathology / Q000601:surgery*; D006528:Carcinoma, Hepatocellular / Q000209:etiology / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D002454:Cell Differentiation; D018281:Cholangiocarcinoma / Q000209:etiology / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008103:Liver Cirrhosis / Q000150:complications / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D008113:Liver Neoplasms / Q000209:etiology / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D016031:Liver Transplantation / Q000009:adverse effects / Q000401:mortality; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D018193:Neoplasms, Complex and Mixed; D012189:Retrospective Studies; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome