ArticleJournal of the American College of Surgeons2021
Multi-Center Analysis of Liver Transplantation for Combined Hepatocellular Carcinoma-Cholangiocarcinoma Liver Tumors.
Article in Journal of the American College of Surgeons, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
30 citing papers in PubMed, 34 citations in OpenAlex.
- Multiradiographic Diagnosis of Primary Hepatocellular Carcinoma and Evaluation of Its Postoperative Observation after Interventional Treatment.Contrast media & molecular imaging · 2022Trial
- Liver Transplantation for Unresectable Biliary Tract Cancers: Largest Single-Center Analysis of Subtype-Specific Survival and Recurrence (2007-2025).Annals of surgical oncology · 2026Article
- An Updated Review of Combined Hepatocellular Cholangiocarcinoma: A Rare and Poorly Understood Neoplasm.Diagnostics (Basel, Switzerland) · 2026Review
- From organelles to therapy: rethinking combined hepatocellular-cholangiocarcinoma.Frontiers in cell and developmental biology · 2026Review
- COMIT-ANZ: an audit of cholangiocarcinoma and mixed hepatocellular carcinoma-cholangiocarcinoma outcomes for patients undergoing liver transplantation in Australia and New Zealand.Frontiers in transplantation · 2026Article
- Liver Transplantation for Combined Hepatocellular-Cholangiocarcinoma: A Retrospective Registry-Based Study Using the Korean Organ Transplant Registry (KOTRY).Annals of transplantation · 2025Article
- Long-Term Outcomes of Combined Hepatocellular Carcinoma-Cholangiocarcinoma After Liver Transplantation in Patients with or without Concurrent Hepatocellular Carcinoma.Annals of transplantation · 2025Article
- Liver Transplantation for Cancer-Current Challenges and Emerging Solutions.Journal of clinical medicine · 2025Review
- Liver transplantation for combined hepatocellular cholangiocarcinoma: Current evidence, selection criteria, and therapeutic controversies.World journal of gastrointestinal surgery · 2025Review
- Therapeutic Advances in Initially Unresectable Locally Advanced Intrahepatic Cholangiocarcinoma: Emerging Treatments and the Role of Liver Transplantation.Current oncology (Toronto, Ont.) · 2025Review
- Establishment of a prognostic nomogram and risk stratification system for patients with combined hepatocellular-cholangiocarcinoma.Scientific reports · 2025Article
- Incidental Combined Hepatocellular-Cholangiocarcinoma in Liver Transplant Recipients: A Matched Cohort Study.Transplant international : official journal of the European Society for Organ Transplantation · 2025Article
- Sarcomatoid change in combined hepatocellular carcinoma and cholangiocarcinoma as a poor prognostic factor.Journal of gastrointestinal oncology · 2024Article
- Update on the Diagnosis and Treatment of Combined Hepatocellular Cholangiocarcinoma.Journal of clinical and translational hepatology · 2024Review
- A multi-center diagnostic system for intrahepatic mass-forming cholangiocarcinoma based on preoperative MRI and clinical features.European radiology · 2024Article
- Article
- The significance of the predominant component in combined hepatocellular-cholangiocarcinoma: MRI manifestation and prognostic value.La Radiologia medica · 2023Article
- Liver transplantation for combined hepatocellular carcinoma and cholangiocarcinoma: A multicenter study.World journal of gastrointestinal surgery · 2023Article
- Clinical outcomes of patients with unresectable primary liver cancer treated with MR-guided stereotactic body radiation Therapy: A Six-Year experience.Clinical and translational radiation oncology · 2023Article
- An international multicentre evaluation of treatment strategies for combined hepatocellular-cholangiocarcinomaJHEP reports : innovation in hepatology · 2023Article
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Authors and funding
31 authors at 17 institutions in 1 country.
Funding
Abstract
backgroundCombined hepatocellular-cholangiocarcinoma liver tumors (cHCC-CCA) with pathologic differentiation of both hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma within the same tumor are not traditionally considered for liver transplantation due to perceived poor outcomes. Published results are from small cohorts and single centers. Through a multicenter collaboration, we performed the largest analysis to date of the utility of liver transplantation for cHCC-CCA. STUDY
designLiver transplant and resection outcomes for HCC (n = 2,998) and cHCC-CCA (n = 208) were compared in a 12-center retrospective review (2009 to 2017). Pathology defined tumor type. Tumor burden was based on radiologic Milan criteria at time of diagnosis and applied to cHCC-CCA for uniform analysis. Kaplan-Meier survival curves and log-rank test were used to determine overall survival and disease-free survival. Cox regression was used for multivariate survival analysis.
resultsLiver transplantation for cHCC-CCA (n = 67) and HCC (n = 1,814) within Milan had no significant difference in overall survival (5-year cHCC-CCA 70.1%, HCC 73.4%, p = 0.806), despite higher cHCC-CCA recurrence rates (23.1% vs 11.5% 5 years, p < 0.001). Irrespective of tumor burden, cHCC-CCA tumor patient undergoing liver transplant had significantly superior overall survival (p = 0.047) and disease-free survival (p < 0.001) than those having resection. For cHCC-CCA within Milan, liver transplant was associated with improved disease-free survival over resection (70.3% vs 33.6% 5 years, p < 0.001).
conclusionsRegardless of tumor burden, outcomes after liver transplantation are superior to resection for patients with cHCC-CCA. Within Milan criteria, liver transplant for cHCC-CCA and HCC result in similar overall survival, justifying consideration of transplantation due to the higher chance of cure with liver transplantation in this traditionally excluded population.
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