Transplantation proceedings · 2026
Outcomes of Liver Transplantation in Patients With Incidental Combined Hepatocellular-Cholangiocarcinoma: A Follow-Up Study.
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Marin-Castro Pedro, Waisberg Daniel Reis, Pinheiro Rafael Soares, Arantes Rubens Macedo, Santos Vinicius Rocha, Martino Rodrigo Bronze, Ducatti Liliana, Haddad Luciana Bertocco, Song Alice Tung, Lee Andre Dong, Alvarez Paola Espinoza, Rocha Joel Avancini, Tanigawa Ryan Yukimatsu, Alves Venancio Avancini Ferreira, Andraus Wellington
Аннотация
INTRODUCTION: Surgical resection is the standard treatment for combined hepatocellular carcinoma-cholangiocarcinoma (cHCC-CC). However, recent studies suggest that liver transplantation (LT) may be a viable alternative for selected patients, with encouraging survival outcomes. The objective of this study is to report the outcomes of LT in patients with incidental cHCC-CC.
METHODS: This single-center retrospective study included adult patients who underwent LT for hepatocellular carcinoma (HCC) and were found to have an incidental histopathological diagnosis of cHCC-CC between January 2015 and December 2024.
RESULTS: During the study period, 1321 LT were performed, of which 24 patients (2.57%) had a histopathological diagnosis of cHCC-CC. The mean age was 58.5 years (range: 31-71), and 75% of patients were male. Regarding radiological findings, 16 patients had a LI-RADS 5 classification. On explant analysis, 3 patients (12.5%) had a single nodule confirmed as cHCC-CC on histopathology. In the remaining cases, the disease was multifocal (ranging from 2 to 25 nodules), with HCC as the predominant lesion and at least one nodule identified as cHCC-CC. During follow-up, 2 patients developed pulmonary recurrence of HCC, with a mean time between LT and recurrence of 314 days.
CONCLUSIONS: Liver transplantation may represent a therapeutic option for selected patients with cHCC-CC. However, these results should be interpreted with caution due to the retrospective design of the study and the limited number of cases analyzed.
METHODS: This single-center retrospective study included adult patients who underwent LT for hepatocellular carcinoma (HCC) and were found to have an incidental histopathological diagnosis of cHCC-CC between January 2015 and December 2024.
RESULTS: During the study period, 1321 LT were performed, of which 24 patients (2.57%) had a histopathological diagnosis of cHCC-CC. The mean age was 58.5 years (range: 31-71), and 75% of patients were male. Regarding radiological findings, 16 patients had a LI-RADS 5 classification. On explant analysis, 3 patients (12.5%) had a single nodule confirmed as cHCC-CC on histopathology. In the remaining cases, the disease was multifocal (ranging from 2 to 25 nodules), with HCC as the predominant lesion and at least one nodule identified as cHCC-CC. During follow-up, 2 patients developed pulmonary recurrence of HCC, with a mean time between LT and recurrence of 314 days.
CONCLUSIONS: Liver transplantation may represent a therapeutic option for selected patients with cHCC-CC. However, these results should be interpreted with caution due to the retrospective design of the study and the limited number of cases analyzed.