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《Chinese Journal of Clinical Medicine》 2018-04
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Clinical analysis of double primary hepatocellular carcinoma and intrahepatic cholangiocarcinoma

LI Xiao-long;PAN Hu-xiao;SHI Guo-ming;HUANG Cheng;CAI Jia-bin;SUN Hui-chuan;JI Yuan;ZHOU Jian;FAN Jia;SHEN Ying-hao;Department of Liver Surgery,Zhongshan Hospital,Fudan University;Department of General Surgery,Jiangyin Chinese Medicine External Therapy Special Hospital of Hepatobiliary;Department of Pathology,Zhongshan Hospital,Fudan University;  
Objective:To explore the clinicopathological features and prognosis of double primary hepatocellular carcinoma and intrahepatic cholangiocarcinoma(dpHCC-ICC).Methods: We retrospectively analyzed the clinical data of 26 dpHCC-ICC patients who underwent hepatectomy at our center.Data of clinical manifestations,preoperative diagnosis,pathological features,treatments,and prognosis were included.The data of patients with dpHCC-ICC and those with combined hepatocellular carcinoma and cholangiocarcinoma(CHC-CC)at the same time were compared.Results:Eighteen patients(69%)were male,with an average age of(56.2 ± 14.6)years old.Seventeen patients(65%)were HBsAg positive.All patients were Child-Pugh class A grade.There were 11,13,and 2 patients of the Barcelona Clinic Liver Cancer Classification(BCLC)A,B,and C,respectively.The median tumor diameter was 3.3 cm(2.0-7.1 cm).Tumor number:19 cases(73%)with 2 tumor nodules and 7 cases(27%)with more than 2 tumor nodules.All patients underwent R0 resection and were pathologically confirmed as dpHCC-ICC.All patients had complete follow-up after operation,and the 1-,3-,and 5-year survival rates were 92%,73%,and 62%,respectively.For dpHCC-ICC,preoperative GGT 60 U/L and ALB 35 g/L were independent risk factors for the recurrence-free survival(RFS)after surgery and microvascular invasion(MVI)was an independent risk factor for the overall survival(OS).There was no significant difference in survival between the dpHCC-ICC and CHC-CC patients during the same period.However,in the BCLC-B subpopulation,the RFS of dpHCC-ICC was superior to the classical CHC-CC(P=0.041).Conclusions:dpHCC-ICC is a clinically rare liver tumor that is difficult to diagnose preoperatively.Definite diagnosis requires postoperative histopathological examination.The main treatment of dpHCC-ICC is surgical resection.For dpHCC-ICC,preoperative GGT 60 U/L and ALB35 g/L are independent risk factors for the RFS and MVI is an independent risk factor for the OS.
【Fund】: 上海市自然科学基金(17ZR1405400)~~
【CateGory Index】: R735.7;R735.8
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