Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Dec 18:11:2483-2492.
doi: 10.2147/JHC.S491243. eCollection 2024.

Prognostic Impact of CCA Components in Combined Hepatocellular Carcinoma-Cholangiocarcinoma

Zhu Zhu  1 , Chun Yang  2 , Mengsu Zeng  2 , Changwu Zhou  1
Affiliations

Prognostic Impact of CCA Components in Combined Hepatocellular Carcinoma-Cholangiocarcinoma

Zhu Zhu et al. J Hepatocell Carcinoma. .

Abstract

Purpose: To investigate the differences of combined hepatocellular carcinoma-cholangiocarcinoma (cHCC-CCA) patients with a cholangiocarcinoma (CCA) component ≥ 30% or < 30% versus intrahepatic cholangiocarcinoma (iCCA) patients in recurrence-free survival (RFS) and overall survival (OS) prognoses.

Methods: Patients with cHCC-CCA and iCCA after surgery were recruited. All cHCC-CCA patients were divided into two subgroups (CCA components ≥ 30% and < 30%). Then, Kaplan-Meier survival analysis and Cox regression analysis were used to investigate and compare the differences of cHCC-CCAs with a CCA component ≥ 30% or < 30% versus iCCAs in RFS and OS prognoses, respectively. The differences of MRI features between cHCC-CCAs with a CCA component ≥ 30% and < 30% were also compared.

Results: One hundred sixty-four cHCC-CCAs and 146 iCCAs were enrolled. Compared with iCCAs, cHCC-CCAs with a CCA component < 30% had better OS prognosis (HR: 2.888, p = 0.045). However, Cox regression analysis revealed that cHCC-CCAs with a CCA component ≥ 30% had poorer RFS (HR: 0.503, p < 0.001) and OS (HR: 0.58, p = 0.033) prognoses than iCCAs. In addition, rim APHE (OR = 0.286, p < 0.001), targetoid diffusion restriction (OR = 0.316, p = 0.019), corona enhancement (OR = 0.481, p = 0.033), delayed enhancement (OR = 0.251, p = 0.001), and LR-M (OR = 1.586, p < 0.001) were significant factors associated with cHCC-CCAs with a CCA component ≥ 30%. Multivariable regression analyses showed that only LR-M (OR = 1.522, p = 0.042) was a significantly independent predictor for cHCC-CCAs with a CCA component ≥ 30%.

Conclusion: cHCC-CCAs with a CCA component ≥ 30% had worse prognoses than iCCAs. Therefore, we suggest that the postoperative treatment of cHCC-CCAs with a CCA component ≥ 30% can be based on the treatment strategy for iCCAs.

Keywords: liver neoplasms; magnetic resonance imaging; prognosis.

PubMed Disclaimer

Conflict of interest statement

All authors report no conflicts of interest in this work. All participants are informed about the purpose of the study, in accordance with the Declaration of Helsinki.

Figures

Figure 1
Figure 1
Flowchart of this study cohort. cHCC-CCA = combined hepatocellular carcinoma-cholangiocarcinoma.
Figure 2
Figure 2
Kaplan-Meier survival curve shows that there is no significant difference in recurrence-free survival prognosis between cHCC-CCAs with a CCA component < 30% and iCCAs.
Figure 3
Figure 3
Kaplan-Meier survival curve shows that the recurrence-free survival prognosis of cHCC-CCAs with a CCA component < 30% is significantly better than that of iCCAs.
Figure 4
Figure 4
Kaplan-Meier survival curve shows that the recurrence-free survival prognosis of cHCC-CCAs with a CCA component ≥ 30% is significantly poorer than that of iCCAs.
Figure 5
Figure 5
Kaplan-Meier survival curve shows that the overall survival prognosis of cHCC-CCAs with a CCA component ≥ 30% is significantly worse than that of iCCAs.
See this image and copyright information in PMC

References

    1. Roßner F, Sinn BV, Horst D. Pathology of combined hepatocellular carcinoma-cholangiocarcinoma: an update. Cancers. 2023;15(2):494. doi:10.3390/cancers15020494 - DOI - PMC - PubMed
    1. Rosenberg N, Van Haele M, Lanton T, et al. Combined hepatocellular-cholangiocarcinoma derives from liver progenitor cells and depends on senescence and IL-6 trans-signaling. J Hepatol. 2022;77:1631–1641. doi:10.1016/j.jhep.2022.07.029 - DOI - PubMed
    1. Beaufrère A, Calderaro J, Paradis V. Combined hepatocellular-cholangiocarcinoma: an update. J Hepatol. 2021;74:1212–1224. doi:10.1016/j.jhep.2021.01.035 - DOI - PubMed
    1. Yen CC, Yen CJ, Shan YS, et al. Comparing the clinicopathological characteristics of combined hepatocellular-cholangiocarcinoma with those of other primary liver cancers by use of the updated World Health Organization classification. Histopathology. 2021;79:556–572. doi:10.1111/his.14384 - DOI - PubMed
    1. Cao J, Srinivas-Rao S, Mroueh N, et al. Cholangiocarcinoma imaging: from diagnosis to response assessment. Abdom Radiol. 2024;49:1699–1715. doi:10.1007/s00261-024-04267-y - DOI - PubMed

LinkOut - more resources