Copyright
©The Author(s) 2022. Published by Baishideng Publishing Group Inc. All rights reserved.
Prognostic analysis of patients with combined hepatocellular-cholangiocarcinoma after radical resection: A retrospective multicenter cohort study
Ge Zhang, Bo-Wen Chen, Xiao-Bo Yang, Huai-Yuan Wang, Xu Yang, Fu-Cun Xie, Xiang-Qi Chen, Ling-Xiang Yu, Jie Shi, Yin-Ying Lu, Hai-Tao Zhao
Ge Zhang, Xiao-Bo Yang, Huai-Yuan Wang, Xu Yang, Fu-Cun Xie, Xiang-Qi Chen, Hai-Tao Zhao, Department of Liver Surgery, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
Bo-Wen Chen, Yin-Ying Lu, 302 Clinical Medical School, Peking University, Beijing 100039, China
Bo-Wen Chen, Ling-Xiang Yu, Yin-Ying Lu, Senior Department of Hepatology, The 5th Medical Center of the PLA General Hospital, Beijing 100039, China
Jie Shi, Department of Pathology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
Yin-Ying Lu, Guangdong Key Laboratory of Epigenetics, College of Life Sciences and Oceanography, Shenzhen University, Shenzhen 518055, Guangdong Province, China
Author contributions: Zhao HT, Lu YY, and Shi J led the entire project, and all authors participated in the discussion and interpretation of the data and results; Zhang G, Chen BW, and Yang XB performed the data collection, main analysis, and wrote the original manuscript; Wang HY, Xie FC, and Yu LX were participated in data collection and generation of figures and tables; Yang X and Shi J were involved in pathology review.
Supported by the CAMS Innovation Fund for Medical Sciences (CIFMS), No. 2021-I2M-1-061 and No. 2021-1-I2M-003; CSCO-hengrui Cancer Research Fund, No. Y-HR2019-0239; and CSCO-MSD Cancer Research Fund, No. Y-MSDZD2021-0213.
Institutional review board statement: The study was reviewed and approved by the Ethics Committee of Peking Union Medical College Hospital (Approval No. JS-3390); and The 5th Medical Center of the PLA General Hospital (Approval No. KY-2022-4-23-1).
Informed consent statement: Patients were not required to give informed consent to the study because the study used identifiable human body materials or data that cannot be found, and the research project does not involve personal privacy and commercial interests.
Conflict-of-interest statement: There are no conflicts of interest to report.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author at zhaoht@pumch.cn. Participants gave informed consent for data sharing.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
https://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Hai-Tao Zhao, MD, Professor, Department of Liver Surgery, State Key Laboratory of Complex Severe and Rare Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No. 1 Shuai-Fu-Yuan, Wang-Fu-Jing, Beijing 100730, China. zhaoht@pumch.cn
Received: August 19, 2022
Peer-review started: August 19, 2022
First decision: September 12, 2022
Revised: September 24, 2022
Accepted: October 13, 2022
Article in press: October 13, 2022
Published online: November 7, 2022
ARTICLE HIGHLIGHTS
Research background
Combined hepatocellular-cholangiocarcinoma (cHCC-CCA) is a relatively rare type of primary liver cancer. For patients who undergo radical resection, despite being able to undergo surgery, the overall postoperative prognosis is poor and the factors affecting postoperative recurrence and survival are unknown.
Research motivation
The motivation for this study was the poor prognosis of patients with cHCC-CCA who underwent radical surgery. Factors affecting postoperative survival remain controversial. There is a lack of clear guidelines for the choice of postoperative adjuvant therapy.
Research objectives
To explore the factors affecting postoperative recurrence and survival in patients with cHCC-CCA who underwent radical resection, leading to better risk stratification of patients and to investigate the impact of postoperative adjuvant therapy on prognosis.
Research methods
This study is a multicenter retrospective study focusing on rare cancer types. Ninety-five patients who underwent radical resection and had surgical pathology confirmed cHCC-CCA were included. Clinical information was collected and follow-up was performed for these patients. The number of patients enrolled in this study was large and the follow-up was adequate.
Research results
For patients with cHCC-CCA undergoing radical resection, most patients recur within 1 year after surgery, with a median survival of approximately 2 years. The 5-year survival rate does not exceed 30%. In addition to the biological characteristics of the tumor, postoperative transarterial chemoembolization (TACE) can significantly affect the prognosis. This finding helps to assist physicians and patients in the selection of postoperative adjuvant therapy.
Research conclusions
Most patients with cHCC-CCA experience recurrence within a short period of time after surgery. Postoperative adjuvant TACE prolongs RFS and is a possible option for postoperative adjuvant therapy.
Research perspectives
The main direction of future research is to explore appropriate preoperative diagnostic methods as well as postoperative adjuvant treatment options.
