title: Impact of incidental/misdiagnosed intrahepatic cholangiocarcinoma and combined hepatocellular cholangiocarcinoma on the outcomes of liver transplantation: an institutional case series and literature review.
abstract: Intrahepatic cholangiocarcinoma (ICC) or combined hepatocellular cholangiocarcinoma (cHCC-CC) is considered to be contraindications for liver transplantation (LT); however, recent studies have shown that the outcomes of LT in small incidental ICC/cHCC-CC tumors are comparable to those in HCC. Studies reporting the survival outcome of patient(s) undergoing LT and found to have incidental or misdiagnosed ICC and/or cHCC-CC in liver explants were reviewed. Our institutional data were also included in the review analysis. In this review, 21 studies reporting 19865 cases of liver transplantation were included. The incidence of misdiagnosed/incidental ICC/cHCC-CC in liver explants was found to be 0.7% (136/19636). Hepatitis B and C virus infection was reported in 19 and 47% of the cases, respectively. The recurrence rate after LT was 42%. The most common site for recurrence was extrahepatic (73%). The disease free survival rate at 3 years was reported to range 33-86%. The 3-year overall survival rate was reported be 22-70%. The outcome of LT in patients with incidental/misdiagnosed ICC/cHCC-CC was found to be poorer than that of matched patients with HCC in five studies; however, the outcome becomes equivalent to those of HCC in cases of small (<2 cm), well-differentiated ICC/cHCC-CC tumors without vascular invasion.
authors.affiliation: Artificial Organ and Transplantation Division, Department of Surgery, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.|Department of HPB Surgery and Liver Transplantation, CARE hospital, Hyderabad, India.
authors.forename: Rahul
authors.initials: R
authors.lastname: Gupta
authors.affiliation: Artificial Organ and Transplantation Division, Department of Surgery, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
authors.forename: Junichi
authors.initials: J
authors.lastname: Togashi
authors.affiliation: Artificial Organ and Transplantation Division, Department of Surgery, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan. nakamats-tky@umin.ac.jp.
authors.forename: Nobuhisa
authors.initials: N
authors.lastname: Akamatsu
authors.affiliation: Artificial Organ and Transplantation Division, Department of Surgery, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan.
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Sakamoto
authors.affiliation: Artificial Organ and Transplantation Division, Department of Surgery, Graduate School of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan. kokudo-2su@h.u-tokyo.ac.jp.
authors.forename: Norihiro
authors.initials: N
authors.lastname: Kokudo
mesh_terms: D001650:Bile Duct Neoplasms / Q000175:diagnosis* / Q000401:mortality / Q000601:surgery*; D006528:Carcinoma, Hepatocellular / Q000175:diagnosis* / Q000401:mortality / Q000601:surgery*; D018281:Cholangiocarcinoma / Q000175:diagnosis* / Q000401:mortality / Q000601:surgery*; D003951:Diagnostic Errors; D006801:Humans; D015994:Incidence; D033162:Incidental Findings; D008113:Liver Neoplasms / Q000175:diagnosis* / Q000401:mortality / Q000601:surgery*; D016031:Liver Transplantation / Q000401:mortality; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology; D009378:Neoplasms, Multiple Primary / Q000175:diagnosis* / Q000401:mortality / Q000601:surgery*; D015996:Survival Rate; D016896:Treatment Outcome
keywords: Incidental; Intrahepatic cholangiocarcinoma; Liver transplantation; Misdiagnosed; Recurrence