ArticleAnnals of transplantation2025
Long-Term Outcomes of Combined Hepatocellular Carcinoma-Cholangiocarcinoma After Liver Transplantation in Patients with or without Concurrent Hepatocellular Carcinoma.
Article in Annals of transplantation, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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11 authors.
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Abstract
BACKGROUND Combined hepatocellular carcinoma-cholangiocarcinoma (CHC), a rare disease, is usually an incidental diagnosis after liver transplantation (LT). In this study, we investigated the long-term post-transplant outcomes of CHC patients. MATERIAL AND METHODS From 2000 to 2022, 60 CHC patients were identified from a single-center database containing 6985 adult LT cases. RESULTS The incidence of CHC in adult LT patients was 0.9%. All CHC cases, except 1, were diagnosed incidentally in explanted livers. The mean CHC tumor diameter was 2.5±1.7 cm, and 51 recipients (85.0%) had a single tumor. Viable hepatocellular carcinoma (HCC) co-existed CHC in 23 patients (38.3%). The 5-year all-type tumor recurrence (TR) and overall survival (OS) rates were 37.9% and 57.7%, respectively. The presence of concurrent HCC did not affect all-type TR (p=0.228) or OS (p=0.083). The tumor stage of CHC was a significant prognostic factor for TR (p=0.017) and OS (p=0.038). In 37 patients with CHC alone, TR occurred in 13 (35.1%). In 23 patients with concurrent HCC, all-type TR occurred in 11 cases (47.8%). The 5-year TR and OS rates for 17 patients with very early-stage CHC without concurrent HCC were 17.6% and 82.4%, respectively. CONCLUSIONS CHC is a rare diagnosis following LT, and 38.3% of patients in this study had concurrent HCC. The post-transplant prognosis of CHC was unfavorable, except for patients with very early-stage CHC. Given that the majority of recurrences occur within the first 5 years after transplantation, intensive surveillance is crucial during this high-risk period. Patients with very early-stage CHC may be appropriate candidates for LT.
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