ArticleEuropean radiology2022
Combined hepatocellular carcinoma-cholangiocarcinoma: MRI features correlated with tumor biomarkers and prognosis.
Article in European radiology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 20 papers, 1 of them a synthesis that pooled it.
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Who cites it
20 citing papers in PubMed, 1 synthesis or guideline pooled it, 29 citations in OpenAlex.
- 2022 KLCA-NCC Korea practice guidelines for the management of hepatocellular carcinoma.Clinical and molecular hepatology · 2022Guideline
- Nomogram based on clinical and preoperative CT features for predicting the early recurrence of combined hepatocellular-cholangiocarcinoma: a multicenter study.La Radiologia medica · 2023Trial
- Defining the evaluation standards for the cholangiocytic component in cHCC-CCA: a pathology-based perspective.Hepatology international · 2026Article
- Intratumoral heterogeneity of CT enhancement for component prediction and prognostic significance in combined hepatocellular carcinoma‑cholangiocarcinoma.European radiology · 2026Article
- Diagnostic challenges in hepatic metastatic olfactory neuroblastoma: a case report and literature review.Discover oncology · 2026Article
- Imaging differentiation of hepatocellular carcinoma, combined hepatocellular-cholangiocarcinoma, and intrahepatic cholangiocarcinoma: pitfalls and advances.Journal of liver cancer · 2026Review
- Systemic treatment strategies for combined hepatocellular-cholangiocarcinoma: current evidence and future direction.Journal of liver cancer · 2026Review
- Is it necessary to distinguish between combined hepatocellular carcinoma-cholangiocarcinoma with less than 10% of cholangiocarcinoma components versus hepatocellular carcinoma?Hepatology international · 2025Article
- Clinical value of blood routine and tumor markers in differentiating hepatocellular carcinoma from intrahepatic cholangiocarcinoma.Medicine · 2025Article
- Advancements in Phytosomal Therapies for Liver Cancer: A Comprehensive Review.Current cancer drug targets · 2025Review
- MRI features of combined hepatocellular-cholangiocarcinoma.Abdominal radiology (New York) · 2025Review
- How to differentiate between combined hepatocellular carcinoma-cholangiocarcinoma and intrahepatic cholangiocarcinoma with rim arterial phase hyperenhancement?Abdominal radiology (New York) · 2024Article
- Prognostic Impact of CCA Components in Combined Hepatocellular Carcinoma-Cholangiocarcinoma.Journal of hepatocellular carcinoma · 2024Article
- Establishment and Validation of the LI-RADS Morphologic Type II Hepatocellular Carcinoma Early Recurrence Risk Scoring System.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2023Article
- Solitary hypovascular hepatic nodules: comparison and differentiation between peripheral nodular cholangiocarcinoma and atypical liver hemangioma with MRI.Translational cancer research · 2023Article
- Non-invasive imaging in the diagnosis of combined hepatocellular carcinoma and cholangiocarcinoma.Abdominal radiology (New York) · 2023Review
- 2022 KLCA-NCC Korea practice guidelines for the management of hepatocellular carcinoma.Journal of liver cancer · 2023Review
- Prognosis of Primary Liver Cancer Based on LI-RADS Classification with Extracellular Agent-Enhanced MRI.Journal of hepatocellular carcinoma · 2023Article
- 2022 KLCA-NCC Korea Practice Guidelines for the Management of Hepatocellular Carcinoma.Korean journal of radiology · 2022Review
- The Fibrinogen/Albumin Ratio Index as an Independent Prognostic Biomarker for Patients with Combined Hepatocellular Cholangiocarcinoma After Surgery.Cancer management and research · 2022Article
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Authors and funding
6 authors at 4 institutions in 1 country.
Funding
Abstract
objectivesTo determine how MRI features are correlated to biomarkers, and to the prognostic factors for recurrence-free survival (RFS) and overall survival (OS) in combined hepatocellular carcinoma-cholangiocarcinoma (cHCC-CCA) patients.
methodsThe study enrolled 160 cHCC-CCA patients pathologically confirmed according to the 2019 WHO classification. The preoperative MRI features and clinical data were retrospectively evaluated and compared between patients grouped by AFP or CA19-9 level and with pathological findings. The RFS and OS of cHCC-CCA patients were estimated using Kaplan-Meier survival curves and compared using the log-rank test. Moreover, predictors of RFS and OS were investigated using Cox regression analyses.
resultsOne hundred and sixty patients (mean age, males vs. females: 55.7 ± 10.2 years vs. 54.9 ± 14.0 years) were evaluated. The incidence of nodule-in-nodule architecture, mosaic architecture, intratumoral hemorrhage, hepatic capsule retraction, arterial phase peritumoral enhancement, and portal vein thrombus was significantly higher in patients with AFP > 20 ng/ml (all p < 0.05). Multivariate Cox regression analysis indicated that age (HR 1.031, p = 0.03), CA19-9 > 37 U/ml (HR 1.880, p = 0.04), arterial phase peritumoral enhancement (HR 2.287, p = 0.01), and delayed enhancement (HR 0.377, p = 0.02) were independent predictors of poor RFS, while arterial phase peripheral enhancement (HR 2.391, p = 0.04) was an independent predictor of poor OS.
conclusionscHCC-CCA imaging features are complex and not correlated with AFP or CA19-9. Age, CA19-9 > 37 U/ml, arterial phase peritumoral enhancement, and delayed enhancement are independent predictors of poor RFS. Arterial phase peripheral enhancement is an independent predictor of poor OS. KEY POINTS: • The imaging features of combined hepatocellular carcinoma-cholangiocarcinoma are complex and are not correlated with the alpha fetoprotein or CA19-9 levels. • Age, CA19-9 > 37 U/ml, arterial phase peritumoral enhancement, and delayed enhancement are independent predictors of poor recurrence-free survival in combined hepatocellular carcinoma-cholangiocarcinoma patients. • Arterial phase peripheral enhancement is an independent predictor of poor overall survival in patients with combined hepatocellular carcinoma-cholangiocarcinoma.
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