Mixed HCC-CC: partial hepatectomy equally effective as LT

  • Li DB & al.
  • HBPD INT
  • 25 Oct 2018

  • curated by Jim Kling
  • Univadis Clinical Summaries
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Takeaway

  • A meta-analysis shows similar outcomes after partial hepatectomy vs liver transplant (LT) for combined hepatocellular cholangiocarcinoma, also known as mixed HCC-CC.

Why this matters

  • Previous studies on this topic were based on small series or case reports.
  • Given no difference in outcomes, the authors believe partial hepatectomy is the better choice, especially given organ shortages.

Study design

  • Meta-analysis of 42 observational studies (n=1691; n=1390 partial hepatectomy).
  • Funding: Foundation of Xiamen Science and Technology Bureau.

Key results

  • After partial hepatectomy, median 5-year OS rate was 29%, with a median survival of 23 months (range, 8-60 months) and a 65% recurrence rate.
  • After partial hepatectomy, 3 studies showed that decreased OS was associated with vascular invasion (HR, 1.82; P=.005), lymph node metastasis (HR, 2.84; P<.00001 tumor size>5 cm (HR, 2.70; P<.0001 and tumor stage iii or higher p=".02).</li">
  • After LT, median 5-year OS was 41%, with a median survival of 26 months (range, 17-43 months) and a 54% recurrence rate.
  • After LT, 1 study showed that decreased OS was associated with tumor size >2.5 cm (HR, 3.22; P=.048).
  • There was no significant difference between 5-year survival rates with partial hepatectomy vs LT (HR, 0.85; 95% CI, 0.41-1.76).

Limitations

  • Retrospective studies.

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