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