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Importance of surgical margin in the outcomes of hepatocholangiocarcinoma

World Journal of Hepatology 2017年第13期9卷 635-641页

作者： Ka Wing Ma Kenneth Siu Ho Chok Department of Surgery Queen Mary Hospital Department of Surgery and State Key Laboratory for Liver Research the University of Hong Kong

AIM To evaluate the significance of resection margin width in the management of hepatocholangiocarcinoma(HCC-CC).METHODS Data of consecutive patients who underwent hepatectomy for hepatic malignancies in the period from1995 to 2014 were reviewed.Patients with pathologically confirmed HCC-CC were included for analysis.Demographic,biochemical,operative and pathological data were analyzed against survival outcomes. RESULTSForty-two patients were included for analysis.The median age was 53.5 years.There were 29 males.Hepatitis B virus was identified in 73.8%of the patients.Most patients had preserved liver function.The median preoperative indocyanine green retention rate at 15 min was 10.2%.The median tumor size was 6.5 cm.Major hepatectomy was required in over 70%of the patients.Hepaticojejunostomy was performed in 6 patients.No hospital death occurred.The median hospital stay was 13 d.The median follow-up period was 32 mo.The 5-year disease-free survival and overall survival were 23.6%and 35.4%respectively.Multifocality was the only independent factor associated with diseasefree survival[P<0.001,odds ratio 4,95%confidence interval(CI):1.9-8.0].In patients with multifocal tumor(n=20),resection margin of≥1 cm was associated with improved 1-year disease-free survival(40%vs 0%;log-rank,P=0.012).CONCLUSIONHCC-CC is a rare disease with poor prognosis.Resection margin of 1 cm or above was associated with improved survival outcome in patients with multifocal HCC-CC.

关键词： hepatocholangiocarcinoma Hepatocellular cholangiocarcinoma Survival Hepatectomy Resection margin

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Esophageal metastasis of stem cell-subtype hepatocholangio carcinoma:Rare presentation of a rare tumor

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World Journal of Gastroenterology 2018年第7期24卷 870-875页

作者： Maeva Salimon Nicolas Chapelle Tamara Matysiak-Budnik Jean-Francois Mosnier Eric Frampas Yann Touchefeu Institut des Maladies de l’Appareil Digestif Nantes University HospitalNantes 44000France Department of Pathology Nantes University HospitalNantes 44000France Department of Radiology Nantes University HospitalNantes 44000France

hepatocholangiocarcinoma(c HCC-ICC) is a rare primary hepatic tumor defined by the presence of histological features of both hepatocellular carcinoma(HCC) and intrahepatic cholangiocarcinoma(ICC). Its prevalence ranges from 1%-5% of all primary liver cancers. We report the case of a 55-year-old cirrhotic male patient admitted to our university hospital for dysphagia, revealing a 10 cm lower-third esophageal metastasis of an unresectable c HCC-ICC with stemcell features. Computed tomography and abdominal magnetic resonance imaging scans revealed multiple hepatic lesions combining features of both HCC and ICC, associated with synchronous bone metastasis. Histological and immunohistochemical analyses of biopsies from the esophageal lesion and the hepatic tumor confirmed the diagnosis of c HCC-ICC with a stem cell-subtype, according to the World HealthOrganization classification. After a multidisciplinary meeting, the patient was treated with chemotherapy. He received two cycles of a gemcitabine plus cisplatin regimen before bone progression, and he died 3 mo after the initial diagnosis.

关键词： hepatocholangiocarcinoma Stem cellsubtype Esophageal metastasis Chemotherapy Gemcitabine plus platinum-based chemotherapy

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