Combined hepatocellular-cholangiocarcinoma compared to hepatocellular carcinoma and intrahepatic cholangiocarcinoma: Different survival, similar recurrence: Report of a large study on repurposed databases with propensity score matching.

Amory, Boris; Goumard, Claire; Laurent, Alexis; Langella, Serena; Cherqui, Daniel; Salame, Ephrem; Barbier, Louise; Soubrane, Olivier; Farges, Olivier; Hobeika, Christian; Kawai, Takayuki; Regimbeau, Jean-Marc; Faitot, François; Pessaux, Patrick; Truant, Stéphanie; Boleslawski, Emmanuel; Herrero, Astrid; Mabrut, Jean-Yves; Chiche, Laurence; Di Martino, Marcello; Rhaiem, Rami; Schwarz, Lilian; Resende, Vivian; Calderaro, Julien; Augustin, Jérémy; Caruso, Stefano; Sommacale, Daniele; Hofmeyr, Stefan; Ferrero, Alessandro; Fuks, David; Vibert, Eric; Torzilli, Guido; Scatton, Olivier; Brustia, Raffaele; AFC-ICC-2009, AFC-LLR-2018, and PRS-2019 Study Group

doi:10.1016/j.surg.2023.09.040

Article (Scientific journals)

Combined hepatocellular-cholangiocarcinoma compared to hepatocellular carcinoma and intrahepatic cholangiocarcinoma: Different survival, similar recurrence: Report of a large study on repurposed databases with propensity score matching.

Amory, Boris; Goumard, Claire; Laurent, Alexis et al.

2024 • In Surgery, 175 (2), p. 413-423

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https://hdl.handle.net/2268/316688

DOI
10.1016/j.surg.2023.09.040

PubMed
37981553

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Abstract :

[en] [en] BACKGROUND: Combined hepatocholangiocarcinoma is a rare cancer with a grim prognosis composed of both hepatocellular carcinoma and intrahepatic cholangiocarcinoma morphologic patterns in the same tumor. The aim of this multicenter, international cohort study was to compare the oncologic outcomes after surgery of combined hepatocholangiocarcinoma to hepatocellular carcinoma and intrahepatic cholangiocarcinoma. METHODS: Patients treated by surgery for combined hepatocholangiocarcinoma, hepatocellular carcinoma, and intrahepatic cholangiocarcinoma from 2000 to 2021 from multicenter international databases were analyzed retrospectively. Patients with combined hepatocholangiocarcinoma (cases) were compared with 2 control groups of hepatocellular carcinoma or intrahepatic cholangiocarcinoma, sequentially matched using a propensity score based on 8 preoperative characteristics. Overall and disease-free survival were compared, and predictors of mortality and recurrence were analyzed with Cox regression after propensity score matching. RESULTS: During the study period, 3,196 patients were included. Propensity score adjustment and 2 sequential matching processes produced a new cohort (n = 244) comprising 3 balanced groups was obtained (combined hepatocholangiocarcinoma = 56, intrahepatic cholangiocarcinoma = 66, and hepatocellular carcinoma = 122). Kaplan-Meier overall survival estimations at 1, 3, and 5 years were 67%, 45%, and 28% for combined hepatocholangiocarcinoma, 92%, 75%, and 55% for hepatocellular carcinoma, and 86%, 53%, and 42% for the intrahepatic cholangiocarcinoma group, respectively (P = .0014). Estimations of disease-free survival at 1, 3, and 5 years were 51%, 25%, and 17% for combined hepatocholangiocarcinoma, 63%, 35%, and 26% for the hepatocellular carcinoma group, and 51%, 31%, and 28% for the intrahepatic cholangiocarcinoma group, respectively (P = .19). Predictors of mortality were combined hepatocholangiocarcinoma subtype, metabolic syndrome, preoperative tumor markers alpha-fetoprotein and carbohydrate antigen 19-9, and satellite nodules, and recurrence was associated with satellite nodules rather than cancer subtype. CONCLUSION: Despite data limitations, overall survival among patients with combined hepatocholangiocarcinoma was worse than both groups and closer intrahepatic cholangiocarcinoma, whereas disease-free survival was similar among the 3 groups. Future research on immunophenotypic profiling may hold more promise than traditional nonmodifiable clinical characteristics (as found in this study) in predicting recurrence or response to salvage treatments.

Disciplines :

Surgery
Gastroenterology & hepatology

Author, co-author :

Amory, Boris; Department of Digestive and Hepato-pancreatic-biliary Surgery, AP-HP, Hôpital Henri-Mondor, Paris Est Créteil University, UPEC, France, Assistance Publique-Hôpitaux de Paris, Créteil, France

Goumard, Claire; Department of Hepatobiliary and Liver Transplantation Surgery, AP-HP, Hôpital Pitié Salpêtrière, CRSA, Sorbonne Université, Paris, France

Laurent, Alexis; Department of Digestive and Hepato-pancreatic-biliary Surgery, DMU CARE, Assistance Publique-Hôpitaux de Paris (AP-HP), Hôpitaux Universitaires Henri Mondor, Créteil, France, Paris Est Créteil University, UPEC, France, Team "Pathophysiology and Therapy of Chronic Viral Hepatitis and Related Cancers," INSERM U955, Créteil, France, Assistance Publique-Hôpitaux de Paris, Créteil, France

Langella, Serena; Department of General and Oncological Surgery, Ospedale Mauriziano, Torino, Italy

Cherqui, Daniel; Center Hepato-Biliaire, AP-HP Paul Brousse Hospital, Paris-Saclay University, Villejuif, France

Salame, Ephrem; Department of Digestive Surgery and Liver Transplantation, University Hospital of Tours, University of Tours, France, FHU Support, Tours, France

Barbier, Louise; Department of Digestive Surgery and Liver Transplantation, University Hospital of Tours, University of Tours, France, FHU Support, Tours, France

Soubrane, Olivier; Department of Digestive, Oncological, and Metabolic Surgery, Institut Mutualiste Montsouris, Paris, France

Farges, Olivier; Department of HPB Surgery and Liver Transplantation, AP-HP Beaujon Hospital, University of Paris, Clichy, France

Hobeika, Christian; Department of HPB Surgery and Liver Transplantation, AP-HP Beaujon Hospital, University of Paris, Clichy, France

More authors (25 more)

Other collaborator :

Detry, Olivier ; Université de Liège - ULiège > Département des sciences cliniques > Pathologie chirurgicale abdominale et endocrinienne

Language :

English

Title :

Publication date :

February 2024

Journal title :

Surgery

ISSN :

0039-6060

eISSN :

1532-7361

Publisher :

Eslevier

Volume :

175

Issue :

Pages :

413-423

Peer reviewed :

Peer Reviewed verified by ORBi

Available on ORBi :

since 24 April 2024

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