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Research article
Yaw-Sen Chen
Corresponding Author
ORCiD: https://orcid.org/0000-0001-8498-3830
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Background: Combined hepatocellular carcinoma and cholangiocarcinoma (cHCC-CC) is an infrequent type of primary liver cancer that comprises hepatocellular carcinoma (HCC) and cholangiocarcinoma (CC). This study investigated the clinicopathological features and prognosis among cHCC-CC, HCC, and CC groups.
Methods: We prospectively collected the data of 608 patients who underwent surgical resection for liver cancer between 2011 and 2018 at E-Da Hospital, I-Shou University, Kaohsiung, Taiwan. Overall, 505 patients with cHCC-CC, HCC, and CC were included, and their clinicopathological features, overall survival (OS), and recurrence were recorded. OS and recurrence rates were analyzed using the Kaplan–Meier analysis.
Results: In the entire cohort, the median age was 61 years and 80% were men. Thirty-five (7.0%) had cHCC-CC, 419 (82.9%) had HCC, and 51 (10.1%) had CC. The clinicopathological features of the cHCC-CC group were more identical to those of the HCC group than the CC group. OS was significantly lower in the cHCC-CC group than in the HCC group but was not significantly higher in the cHCC-CC group than in the CC group. The median OS of cHCC-CC, HCC, and CC groups was 50.1 months [95% confidence interval (CI): 38.7–61.2], 62.3 months (CI: 42.1–72.9), and 36.2 months (CI: 15.4–56.5), respectively. Cumulative OS rates at 1, 3, and 5 years in cHCC-CC, HCC, and CC groups were 88.5%, 62.2%, and 44.0%; 91.2%, 76.1%, and 68.0%; and 72.0%, 48.1%, and 34.5%, respectively. After propensity score matching (PSM), OS in the cHCC-CC group was not significantly different from that in the HCC or CC group. However, OS was significantly higher in the HCC group than in the CC group before and after PSM. Furthermore, the disease-free survival was not significantly different among cHCC-CC, HCC, and CC groups before and after PSM.
Conclusion: The clinicopathological features of the cHCC-CC group were more identical to those of the HCC group than the CC group. The OS rate was significantly lower in the cHCC-CC group than the HCC group. However, after PSM, OS and disease-free survival in the cHCC-CC group were not significantly different from those in the HCC or CC group.
Keywords
Combined hepatocellular carcinoma and cholangiocarcinoma, Overall survival, Recurrence, Prognosis
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CURRENT STATUS: Published
View the published article at BMC Gastroenterology.
Version 3
Posted 04 Jan, 2021
No community comments so far
Submission checks complete
On 17 Dec, 2020
Editorial decision: Accept
On 15 Dec, 2020
No comments provided
Editorial decision: Minor revision
On 10 Dec, 2020
Review #3 received
Received 05 Dec, 2020
Review #2 received
Received 28 Nov, 2020
Reviewer #3 agreed
On 09 Nov, 2020
Reviewer #2 agreed
On 07 Nov, 2020
Reviewers invited
Invitations sent on 04 Nov, 2020
Reviewer #1 agreed
On 04 Nov, 2020
Review #1 received
Received 04 Nov, 2020
Editor assigned
On 28 Oct, 2020
Editor invited
On 27 Oct, 2020
Submission checks complete
On 24 Oct, 2020
No comments provided
Editorial decision: Major revision
On 23 Sep, 2020
Review #3 received
Received 18 Sep, 2020
Review #2 received
Received 23 Aug, 2020
Reviewer #3 agreed
On 21 Aug, 2020
Reviewer #2 agreed
On 14 Aug, 2020
Review #1 received
Received 06 Aug, 2020
Reviewer #1 agreed
On 19 Jul, 2020
Reviewers invited
Invitations sent on 30 Jun, 2020
Editor assigned
On 26 Jun, 2020
Submission checks complete
On 17 Jun, 2020
Editor invited
On 17 Jun, 2020
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Subject Areas
Gastroenterology & Hepatology
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A new preprint design is coming!
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See the published version of this preprint at BMC Gastroenterology.
This is a preprint, a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Yaw-Sen Chen
Corresponding Author
ORCiD: https://orcid.org/0000-0001-8498-3830
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Published
View the published article at BMC Gastroenterology.
Version 3
Posted 04 Jan, 2021
No community comments so far
Submission checks complete
On 17 Dec, 2020
Editorial decision: Accept
On 15 Dec, 2020
No comments provided
Editorial decision: Minor revision
On 10 Dec, 2020
Review #3 received
Received 05 Dec, 2020
Review #2 received
Received 28 Nov, 2020
Reviewer #3 agreed
On 09 Nov, 2020
Reviewer #2 agreed
On 07 Nov, 2020
Reviewers invited
Invitations sent on 04 Nov, 2020
Reviewer #1 agreed
On 04 Nov, 2020
Review #1 received
Received 04 Nov, 2020
Editor assigned
On 28 Oct, 2020
Editor invited
On 27 Oct, 2020
Submission checks complete
On 24 Oct, 2020
No comments provided
Editorial decision: Major revision
On 23 Sep, 2020
Review #3 received
Received 18 Sep, 2020
Review #2 received
Received 23 Aug, 2020
Reviewer #3 agreed
On 21 Aug, 2020
Reviewer #2 agreed
On 14 Aug, 2020
Review #1 received
Received 06 Aug, 2020
Reviewer #1 agreed
On 19 Jul, 2020
Reviewers invited
Invitations sent on 30 Jun, 2020
Editor assigned
On 26 Jun, 2020
Submission checks complete
On 17 Jun, 2020
Editor invited
On 17 Jun, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
Subject Areas
Gastroenterology & Hepatology
License:
This work is licensed under a CC BY 4.0 License. Read Full License
View the published article at BMC Gastroenterology.
Background: Combined hepatocellular carcinoma and cholangiocarcinoma (cHCC-CC) is an infrequent type of primary liver cancer that comprises hepatocellular carcinoma (HCC) and cholangiocarcinoma (CC). This study investigated the clinicopathological features and prognosis among cHCC-CC, HCC, and CC groups.
Methods: We prospectively collected the data of 608 patients who underwent surgical resection for liver cancer between 2011 and 2018 at E-Da Hospital, I-Shou University, Kaohsiung, Taiwan. Overall, 505 patients with cHCC-CC, HCC, and CC were included, and their clinicopathological features, overall survival (OS), and recurrence were recorded. OS and recurrence rates were analyzed using the Kaplan–Meier analysis.
Results: In the entire cohort, the median age was 61 years and 80% were men. Thirty-five (7.0%) had cHCC-CC, 419 (82.9%) had HCC, and 51 (10.1%) had CC. The clinicopathological features of the cHCC-CC group were more identical to those of the HCC group than the CC group. OS was significantly lower in the cHCC-CC group than in the HCC group but was not significantly higher in the cHCC-CC group than in the CC group. The median OS of cHCC-CC, HCC, and CC groups was 50.1 months [95% confidence interval (CI): 38.7–61.2], 62.3 months (CI: 42.1–72.9), and 36.2 months (CI: 15.4–56.5), respectively. Cumulative OS rates at 1, 3, and 5 years in cHCC-CC, HCC, and CC groups were 88.5%, 62.2%, and 44.0%; 91.2%, 76.1%, and 68.0%; and 72.0%, 48.1%, and 34.5%, respectively. After propensity score matching (PSM), OS in the cHCC-CC group was not significantly different from that in the HCC or CC group. However, OS was significantly higher in the HCC group than in the CC group before and after PSM. Furthermore, the disease-free survival was not significantly different among cHCC-CC, HCC, and CC groups before and after PSM.
Conclusion: The clinicopathological features of the cHCC-CC group were more identical to those of the HCC group than the CC group. The OS rate was significantly lower in the cHCC-CC group than the HCC group. However, after PSM, OS and disease-free survival in the cHCC-CC group were not significantly different from those in the HCC or CC group.
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