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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Bibliography

Calderaro, J., Ziol, M., Paradis, V., Zucman-Rossi, J., Molecular and histological correlations in liver cancer. J Hepatol 71 (2019), 616–630.
Gigante, E., Paradis, V., Ronot, M., et al. New insights into the pathophysiology and clinical care of rare primary liver cancers. JHEP Reports Innov Hepatol, 3, 2020.
Nguyen, C.T., Caruso, S., Maille, P., et al. Immune profiling of combined hepatocellular- cholangiocarcinoma reveals distinct subtypes and activation of gene signatures predictive of response to immunotherapy. Clin Cancer Res 28 (2022), 540–551.
Calderaro, J., Di Tommaso, L., Maillé, P., et al. Nestin as a diagnostic and prognostic marker for combined hepatocellular-cholangiocarcinoma. J Hepatol 77 (2022), 1586–1597.
Yoon, Y.I., Hwang, S., Lee, Y.J., et al. Postresection outcomes of combined hepatocellular carcinoma-cholangiocarcinoma, hepatocellular carcinoma and intrahepatic cholangiocarcinoma. J Gastrointest Surg 20 (2016), 411–420.
Holzner, M.L., Tabrizian, P., Parvin-Nejad, F.P., et al. Resection of mixed hepatocellular-cholangiocarcinoma, hepatocellular carcinoma, and intrahepatic cholangiocarcinoma. Liver Transpl 26 (2020), 888–898.
von Elm, E., Altman, D.G., Egger, M., et al. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Lancet 370 (2007), 1453–1457.
Farges, O., Fuks, D., Le Treut, Y.P., et al. AJCC seventh edition of TNM staging accurately discriminates outcomes of patients with resectable intrahepatic cholangiocarcinoma. Cancer 117 (2011), 2170–2177.
Brustia R, Langella S, Kawai T, et al. Preoperative risk score for prediction of long-term outcomes after hepatectomy for intrahepatic cholangiocarcinoma: report of a collaborative, international-based, external validation study. Eur J Surg Oncol. November 2019. https://doi.org/10.1016/j.ejso.2019.10.041.
Kawaguchi, Y., Fuks, D., Kokudo, N., Gayet, B., Difficulty of laparoscopic liver resection. Ann Surg 267 (2018), 13–17.
Kawaguchi Y, Hasegawa K, Tzeng C-WD, et al. Performance of a modified three-level classification in stratifying open liver resection procedures in terms of complexity and postoperative morbidity. Br J Surg. October 2019. https://doi.org/10.1002/bjs.11351.
Dindo, D., Demartines, N., Clavien, P.-A., Classification of surgical complications. Ann Surg 240 (2004), 205–213.
Spolverato, G., Bagante, F., Tsilimigras, D., Ejaz, A., Cloyd, J., Pawlik, T.M., Management and outcomes among patients with mixed hepatocholangiocellular carcinoma: A population-based analysis. J Surg Oncol 119 (2019), 278–287.
Wang, J., Li, Z., Liao, Y., et al. Prediction of survival and analysis of prognostic factors for patients with combined hepatocellular carcinoma and cholangiocarcinoma: a population-based study. Front Oncol, 11, 2021, 10.3389/FONC.2021.686972.
Ramai, D., Ofosu, A., Lai, J.K., Reddy, M., Adler, D.G., Combined hepatocellular cholangiocarcinoma: a population-based retrospective study. Am J Gastroenterol 114 (2019), 1496–1501.
Trikalinos, N.A., Zhou, A., Majella Doyle, M.B., et al. Systemic therapy for combined hepatocellular-cholangiocarcinoma: a single-institution experience. JNCCN J Natl Compr Cancer Netw 16 (2018), 1193–1199.
Salimon, M., Prieux-Klotz, C., Tougeron, D., et al. Gemcitabine plus platinum-based chemotherapy for first-line treatment of hepatocholangiocarcinoma: an AGEO French multicentre retrospective study. Br J Cancer 118 (2018), 325–330.
Kim, M., Hwang, S., Ahn, C.S., et al. Postresection prognosis of combined hepatocellular carcinoma-cholangiocarcinoma cannot be predicted by the 2019 World Health Organization classification. Asian J Surg 44 (2021), 1389–1395.
Murtha-Lemekhova, A., Fuchs, J., Feiler, S., et al. Is metabolic syndrome a risk factor in hepatectomy? A meta-analysis with subgroup analysis for histologically confirmed hepatic manifestations. BMC Med, 2022, 20.
Amini, N., Margonis, G.A., Kim, Y., Wilson, A., Gani, F., Pawlik, T.M., Complication timing impacts 30-d mortality after hepatectomy. J Surg Res 203 (2016), 495–506.
Margonis, G.A., Sasaki, K., Andreatos, N., et al. Prognostic impact of complications after resection of early stage hepatocellular carcinoma. J Surg Oncol 115 (2017), 791–804.
Brustia R, Fleres F, Tamby E, et al. Postoperative collections after liver surgery: Risk factors and impact on long-term outcomes. J Visc Surg. September 2019. https://doi.org/10.1016/j.jviscsurg.2019.09.005.
van Keulen, A.M., Büttner, S., Erdmann, J.I., et al. Major complications and mortality after resection of intrahepatic cholangiocarcinoma: a systematic review and meta-analysis. Surgery, 2022, 10.1016/J.SURG.2022.11.027.
Wang, M Da, Tang, S.C., Li, C., et al. Association of concurrent metabolic syndrome with long-term oncological prognosis following liver resection for hepatocellular carcinoma among patients with chronic hepatitis B virus infection: a multicenter study of 1753 patients. Ann Surg Oncol 30 (2023), 346–358.
Nguyen-Khac, V., Brustia, R., Rhaiem, R., et al. Liver resection for single large hepatocellular carcinoma: a prognostic factors study. Ann Hepatol, 27, 2022.
Sessa, A., Mulé, S., Brustia, R., et al. Macrotrabecular-massive hepatocellular carcinoma: light and shadow in current knowledge. J Hepatocell Carcinoma 9 (2022), 661–670.
Assalino M, Terraz S, Grat M, et al. Liver transplantation for hepatocellular carcinoma after successful treatment of macrovascular invasion. Transpl Int. January 2020:tri.13586.
Izquierdo-Sanchez, L., Lamarca, A., La Casta, A., et al. Cholangiocarcinoma landscape in Europe: diagnostic, prognostic and therapeutic insights from the ENSCCA Registry. J Hepatol 76 (2022), 1109–1121.
Moazzam, Z., Alaimo, L., Endo, Y., et al. Combined tumor burden score and carbohydrate antigen 19-9 grading system to predict outcomes among patients with intrahepatic cholangiocarcinoma. J Am Coll Surg 236 (2023), 804–813.
Zhang, G., Chen, B.-W., Yang, X.-B., et al. Prognostic analysis of patients with combined hepatocellular-cholangiocarcinoma after radical resection: a retrospective multicenter cohort study. World J Gastroenterol 28 (2022), 5968–5981.
Ma, K.W., Ho Chok, K.S., Importance of surgical margin in the outcomes of hepatocholangiocarcinoma. World J Hepatol 9 (2017), 635–641.
Gentile, D., Donadon, M., Lleo, A., et al. Surgical treatment of hepatocholangiocarcinoma: a systematic review. Liver Cancer 9 (2020), 15–27.
Zeng, J., Zeng, J., Lin, K., et al. Development of a machine learning model to predict early recurrence for hepatocellular carcinoma after curative resection. Hepatobiliary Surg Nutr 11 (2022), 176–187.
Famularo S, Piardi T, Molfino S, et al. Factors affecting local and intra hepatic distant recurrence after surgery for HCC: an alternative perspective on microvascular invasion and satellitosis. A Western European multicentre study. J Gastrointest Surg. January 2020. https://doi.org/10.1007/s11605-019-04503-7.
Bagante, F., Spolverato, G., Cucchetti, A., et al. Defining when to offer operative treatment for intrahepatic cholangiocarcinoma: a regret-based decision curves analysis. Surgery 160 (2016), 106–117.
Kang, S.H., Choi, Y.R., Lee, W., et al. Laparoscopic liver resection versus open liver resection for intrahepatic cholangiocarcinoma: 3-year outcomes of a cohort study with propensity score matching. Surg Oncol 33 (2020), 63–69.
Gentile, D., Donadon, M., Di Tommaso, L., et al. Is the outcome after hepatectomy for transitional hepatocholangiocarcinoma different from that of hepatocellular carcinoma and mass-forming cholangiocarcinoma? A case-matched analysis. Updates Surg 72 (2020), 671–679.
Chalmers, I., Glasziou, P., Avoidable waste in the production and reporting of research evidence. Lancet 374 (2009), 86–89.