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Clinicopathologic and MRI features of combined hepatocellular-cholangiocarcinoma in patients with or without cirrhosis

 Jongjin Yoon  ;  Jeong A Hwang  ;  Sunyoung Lee  ;  Ji E Lee  ;  Sang Y Ha  ;  Young N Park 
 LIVER INTERNATIONAL, Vol.41(7) : 1641-1651, 2021-07 
Journal Title
Issue Date
Bile Duct Neoplasms* / diagnostic imaging ; Bile Duct Neoplasms* / surgery ; Bile Ducts, Intrahepatic ; Carcinoma, Hepatocellular* / diagnostic imaging ; Cholangiocarcinoma* / diagnostic imaging ; Contrast Media ; Humans ; Liver Cirrhosis / diagnostic imaging ; Liver Neoplasms* / diagnostic imaging ; Magnetic Resonance Imaging ; Retrospective Studies
cirrhosis ; combined hepatocellular-cholangiocarcinoma ; magnetic resonance imaging ; prognosis
Background and aims: Differences in combined hepatocellular-cholangiocarcinomas (cHCC-CCAs) arising in high-risk patients with or without liver cirrhosis have not been elucidated. This study aimed to compare the clinicopathologic and imaging characteristics of cHCC-CCAs in patients with or without cirrhosis and to determine the prognostic factors for recurrence-free survival (RFS) after curative resections of single cHCC-CCAs.

Methods: This retrospective study included 113 patients with surgically resected single cHCC-CCAs who underwent preoperative magnetic resonance imaging from January 2008 to December 2019 at two tertiary referral centres. Clinical, pathologic and imaging features of tumours were compared in high-risk patients with or without cirrhosis. Imaging features were assessed using the Liver Imaging Reporting and Data System (LI-RADS) version 2018. RFS and associated factors were evaluated using Cox proportional hazards regression analysis, Kaplan-Meier analysis and log-rank test.

Results: cHCC-CCAs arising from cirrhotic livers had a smaller mean tumour size (2.9 cm vs. 4.5 cm; P < .001) and were more frequently categorized as LR-5 or 4 (41.2% vs. 20.0%; P = .024) than those arising from non-cirrhotic livers. In multivariable analysis, a tumour size of > 3 cm (hazard ratio [HR], 2.081; 95% confidence interval [CI], 1.180-3.668; P = .011) and the LR-M category (HR, 2.302; 95% CI, 1.198-4.424; P = .012) were independent predictors associated with worse RFS.

Conclusions: The tumour size and distribution of LI-RADS categories of cHCC-CCAs differed in high-risk patients with or without cirrhosis. And LR-M category was a worse prognosis predictor after curative resections than LR-5 or 4 category.
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1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Park, Young Nyun(박영년) ORCID logo https://orcid.org/0000-0003-0357-7967
Lee, Sunyoung(이선영) ORCID logo https://orcid.org/0000-0002-6893-3136
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