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Outcomes Following Resection of Mixed Hepatocellular-Cholangiocarcinoma, Hepatocellular Carcinoma, and Intrahepatic Cholangiocarcinoma: A Matched Analysis

M. L. Holzner1, F. Parvin-Nejad2, K. Fei3, S. Florman1, M. E. Schwartz1, P. Tabrizian1

1Recanati/Miller Transplantation Institute, Icahn School of Medicine at Mount Sinai, New York, NY, 2Icahn School of Medicine at Mount Sinai, New York, NY, 3Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY

Meeting: 2020 American Transplant Congress

Abstract number: 59

Keywords: Hepatocellular carcinoma

Session Information

Session Name: Liver: Hepatobiliary Surgery and Liver Transplant Potpourri

Session Type: Oral Abstract Session

Date: Saturday, May 30, 2020

Session Time: 3:15pm-4:45pm

 Presentation Time: 4:15pm-4:27pm

Location: Virtual

*Purpose: Mixed hepatocellular-cholangiocarcinoma (HCC-CC) is a biphenotypic liver cancer thought to have unfavorable tumor biology and a poor prognosis. Surgical outcomes of HCC-CC remain unclear. We aimed to evaluate the clinical and characteristics and surgical outcomes of HCC-CC.

*Methods: Case series of patients undergoing resection for HCC-CC (n=47), hepatocellular carcinoma (HCC) (n=468), and intrahepatic cholangiocarcinoma (ICC) (N=108) at a tertiary center between 2001 and 2015. Cases of HCC-CC were matched to cases of HCC and ICC on important clinical factors including tumor characteristics (size, vascular invasion, differentiation), and underlying cirrhosis.

*Results: Patients with HCC-CC had rates of viral hepatitis comparable to patients with HCC (78.5% vs. 80%) and 42.5% had underlying cirrhosis. When matched on tumor size (Figure 1A), HCC-CC was more poorly differentiated than HCC (68.3% vs. 27.3%, respectively; P<0.001) and ICC (68.3% vs. 34.8%, respectively, P=0.005) but had similar postresection survival (5-year survival: HCC-CC 49.7%, HCC 54.8%, ICC 68.7%, P=0.606) and recurrence (3-year recurrence: HCC-CC 57.9%, HCC 61.5%, and ICC 56%, P=0.549). Outcomes were similar between HCC-CC and HCC when matched on underlying cirrhosis and tumor size (Figure 1B). Cancer type was not predictive of survival or tumor recurrence.

*Conclusions: Survival after resection of HCC-CC is similar to HCC when matched for tumor size, despite HCC-CC tumors being more poorly differentiated. Exclusion of HCC-CC from management strategies recommended for HCC, including consideration for liver transplantation, may not be warranted.

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To cite this abstract in AMA style:

Holzner ML, Parvin-Nejad F, Fei K, Florman S, Schwartz ME, Tabrizian P. Outcomes Following Resection of Mixed Hepatocellular-Cholangiocarcinoma, Hepatocellular Carcinoma, and Intrahepatic Cholangiocarcinoma: A Matched Analysis [abstract]. Am J Transplant. 2020; 20 (suppl 3). https://atcmeetingabstracts.com/abstract/outcomes-following-resection-of-mixed-hepatocellular-cholangiocarcinoma-hepatocellular-carcinoma-and-intrahepatic-cholangiocarcinoma-a-matched-analysis/. Accessed June 6, 2025.

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