Effect of liver transplantation in combined hepatocellular and cholangiocellular carcinoma: a case series

BACKGROUND: Liver transplantation is a treatment option for combined hepatocellular and cholangiocellular carcinoma (cHCC-CC) but its prognostic significance remains unclear. The present study aimed to evaluate the therapeutic effects of liver transplantation on cHCC-CC and analyze the clinicopathological factors affecting prognosis. METHODS: Retrospective analysis of the clinicopathological data of a case series of 21 patients with cHCC-CC who underwent orthotopic liver transplantation from April 2000 to April 2011 was performed. Cumulative survival rate and tumor-free survival rate were calculated using the Kaplan-Meier method followed by the log-rank test. RESULTS: The operative survival rate of the 21 patients was 100%; the 30 day mortality was 4.8% (1/21) and 90-day mortality was 9.5% (2/21); 1-, 2-, 3-, and 5-year overall cumulative survival rates were 64%, 47%, 39%, and 39%, respectively; and the corresponding cumulative tumor-free survival rates were 64%, 37%, 30%, and 30%, respectively. Cumulative tumor diameter, lymph node metastasis, macroscopic portal vein tumor thrombus, and mixed states according to Allen typing were identified as the primary influencing factors of poor prognosis (all P < 0.05). CONCLUSION: Liver transplantation may be an effective therapeutic method for the treatment of cHCC-CC. Strict screening of potential liver transplantation candidates with cHCC-CC can help reduce the risks of tumor recurrence and metastasis.