Comparison Between Resection and Transplantation in Combined Hepatocellular and Cholangiocarcinoma

作者：Song S; Moon H H; Lee S; Kim T S; Shin M; Kim J M; Park J B; Kwon C H D; Kim S J; Lee S K; Joh J W^*

来源：Transplantation Proceedings, 2013, 45(8): 3041-3046.

DOI：10.1016/j.transproceed.2013.08.064

Objective. The treatment of choice for combined hepatocellular and cholangiocarcinoma (cHCC-CC) is surgical resection. However, the efficacy of liver transplantation is not clear. We compared the surgical outcome of hepatic resection and liver transplantation for cHCC-CC. %26lt;br%26gt;Patients and methods. From 1995 to 2012, 89 patients were diagnosed with cHCC-CC after hepatic resection and 8 patients diagnosed with cHCC-CC after liver transplantation. We excluded 21 patients who were American Joint Committee on Cancer Staging Stage III or IV and lost to follow-up. The outcomes were reviewed retrospectively. %26lt;br%26gt;Results. The poor prognostic factors in cHCC-CC patients who underwent hepatectomy were large tumor size (%26gt;5 cm), small safety margin (%26lt;2 cm), and low preoperative albumin level. The disease-free survival (DFS) and overall survival (OS) between the hepatectomy group (n = 68) and the liver transplant group (n = 8) was not statistically different (5-year DFS: 26.2% vs 37.5%, P = .333; 5-year OS: 42.1% vs 50%, P = .591). In the small tumor subgroup (tumor size %26lt;5 cm), the DFS and OS between the 2 surgical procedures was not different, and in the adequate resection margin subgroup (safety margin %26gt;2 cm), survival was comparable. %26lt;br%26gt;Conclusions. In well-selected cases with small tumor size and with preserved liver function, liver resection should be considered when complete resection is possible.

• 出版日期2013-10