Outcomes of Combined Hepatocellular-Cholangiocarcinoma After Surgical and Nonsurgical Treatments: A 23-Year Study.

OBJECTIVES

Combined hepatocellular -cholangiocarcinoma is a rare primary liver cancer with an incidence that ranges from 0.4 % to 14.2 % among primary liver cancers, characterized by mixed clinicopathological features of hepatocellular carcinoma and cholangiocarcinoma. Here, we evaluated the incidence, diagnostic challenges, treatment modalities, and long -term outcomes of combined hepatocellular -cholangiocarcinoma at a single tertiary center.

MATERIALS AND

METHODS

This retrospective observational study, conducted from January 2000 through May 2023, included patients diagnosed with combined hepatocellular -cholangiocarcinoma per 2019 World Health Organization criteria. We analyzed data on overall survival, disease -free survival, recurrence, and treatment by using Kaplan -Meier and log -rank tests.

RESULTS

Of 21 initially identified patients, 13 met inclusion criteria of having combined hepatocellular -cholangiocarcinoma: 7 (53.8 % ) underwent liver transplant and were diagnosed incidentally, 2 under -went resection, 2 received systemic chemotherapy, and 2 received palliative care. Mean overall survival was 56.31 months (95 % CI, 19.12-93.49 ), with significant differences between groups (P < .001 ), showing results of 58 months (resection ), 72.57 months (transplant ), 15.50 months (chemotherapy ), and 0 months (palliative care ). Local recurrence occurred in 2 patients (15.4 % ). Mean disease -free survival was 110.66 months (95 % CI, 57.02 -164.30 ).

CONCLUSIONS

This 23 -year study highlights the diagnostic and therapeutic challenges of combined hepatocellular -cholangiocarcinoma, with a median overall survival of 18 months and frequent incidental diagnosis posttransplant. Multicenter studies are needed to standardize management and improve outcomes.