title: Effect of liver transplantation in combined hepatocellular and cholangiocellular carcinoma: a case series.
abstract: BACKGROUND
  Liver transplantation is a treatment option for combined hepatocellular and cholangiocellular carcinoma (cHCC-CC) but its prognostic significance remains unclear. The present study aimed to evaluate the therapeutic effects of liver transplantation on cHCC-CC and analyze the clinicopathological factors affecting prognosis.
  
  
  METHODS
  Retrospective analysis of the clinicopathological data of a case series of 21 patients with cHCC-CC who underwent orthotopic liver transplantation from April 2000 to April 2011 was performed. Cumulative survival rate and tumor-free survival rate were calculated using the Kaplan-Meier method followed by the log-rank test.
  
  
  RESULTS
  The operative survival rate of the 21 patients was 100%; the 30 day mortality was 4.8% (1/21) and 90-day mortality was 9.5% (2/21); 1-, 2-, 3-, and 5-year overall cumulative survival rates were 64%, 47%, 39%, and 39%, respectively; and the corresponding cumulative tumor-free survival rates were 64%, 37%, 30%, and 30%, respectively. Cumulative tumor diameter, lymph node metastasis, macroscopic portal vein tumor thrombus, and mixed states according to Allen typing were identified as the primary influencing factors of poor prognosis (all P < 0.05).
  
  
  CONCLUSIONS
  Liver transplantation may be an effective therapeutic method for the treatment of cHCC-CC. Strict screening of potential liver transplantation candidates with cHCC-CC can help reduce the risks of tumor recurrence and metastasis.
authors.affiliation: Department of Hepatobiliary Surgery, Orient Organ Transplant Center, The First Center Hospital of Tianjin, Tianjin, 300192, China. 13920989565@139.com.
authors.forename: Di
authors.initials: D
authors.lastname: Wu
authors.affiliation: Department of Hepatobiliary Surgery, Orient Organ Transplant Center, The First Center Hospital of Tianjin, Tianjin, 300192, China. zhongyangshen@gmail.com.
authors.forename: Zhong-Yang
authors.initials: ZY
authors.lastname: Shen
authors.affiliation: Department of Hepatobiliary Surgery, Orient Organ Transplant Center, The First Center Hospital of Tianjin, Tianjin, 300192, China. zhangyamin@medmail.com.cn.
authors.forename: Ya-Min
authors.initials: YM
authors.lastname: Zhang
authors.affiliation: Department of Hepatobiliary Surgery, Orient Organ Transplant Center, The First Center Hospital of Tianjin, Tianjin, 300192, China. edi20000@sina.com.
authors.forename: Jian
authors.initials: J
authors.lastname: Wang
authors.affiliation: Department of Hepatobiliary Surgery, Orient Organ Transplant Center, The First Center Hospital of Tianjin, Tianjin, 300192, China. zhenghong@medmail.com.cn.
authors.forename: Hong
authors.initials: H
authors.lastname: Zheng
authors.affiliation: Department of Hepatobiliary Surgery, Orient Organ Transplant Center, The First Center Hospital of Tianjin, Tianjin, 300192, China. dengyonglin@medmail.com.cn.
authors.forename: Yong-Lin
authors.initials: YL
authors.lastname: Deng
authors.affiliation: Department of Hepatobiliary Surgery, Orient Organ Transplant Center, The First Center Hospital of Tianjin, Tianjin, 300192, China. pancheng@medmail.com.cn.
authors.forename: Cheng
authors.initials: C
authors.lastname: Pan
mesh_terms: D000328:Adult; D000368:Aged; D001650:Bile Duct Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D006528:Carcinoma, Hepatocellular / Q000150:complications* / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D018281:Cholangiocarcinoma / Q000150:complications* / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008113:Liver Neoplasms / Q000150:complications* / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D016031:Liver Transplantation / Q000379:methods; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D012189:Retrospective Studies; D016896:Treatment Outcome