Liver Transplantation for Combined Hepatocellular-Cholangiocarcinoma: A Retrospective Registry-Based Study Using the Korean Organ Transplant Registry (KOTRY)
Year: 2025
Type: article
Study design: Observational Study
Abstract: BACKGROUND Combined hepatocellular-cholangiocarcinoma (cHCC-CC) is a rare primary liver tumor with poor prognosis. This retrospective study aimed to evaluate the outcomes and prognostic factors of 40 patients who underwent liver transplantation (LT) for cHCC-CC using data from the Korean Organ Transplant Registry (KOTRY). MATERIAL AND METHODS A cohort of 40 LT recipients diagnosed with cHCC-CC was selected from the KOTRY database between 2014 and 2019. Survival analyses were performed according to key clinicopathological variables, and risk factor analyses were conducted for overall survival (OS) and recurrence-free survival (RFS). RESULTS During a median follow-up of 21.4 months, 10 patients (25.0%) died and 9 patients (22.5%) experienced tumor recurrence. The 1-, 2-, and 3-year OS rates were 91.8%, 76.2%, and 59.3%, respectively, and the corresponding RFS rates were 88.8%, 70.5%, and 50.2%. Patients with a MELD score <20 (P=0.017) and a single tumor <3 cm (P=0.046) showed significantly better OS. On multivariate analysis, MELD score ≥20 (P=0.04), perineural invasion (P=0.04), and portal vein tumor thrombosis (P=0.005) were independent risk factors for poor OS, whereas microvascular invasion (P=0.01) was an independent risk factor for poor RFS. CONCLUSIONS LT can be a feasible treatment option for patients with early-stage cHCC-CC, providing favorable long-term survival. As most prognostic factors identified were pathology-related, further studies are needed to refine the selection criteria for LT candidates in this population.
Source: Annals of Transplantation
DOI: 10.12659/aot.949241
Institutions: Asan Medical Center, University of Ulsan, Ajou University, Yonsei University, Severance Hospital, Yonsei University Health System, Seoul National University, Samsung Medical Center, Sungkyunkwan University, Pusan National University Yangsan Hospital, Pusan National University, Korea University, Korea University Medical Center, Daegu Catholic University, Hanyang University, Seoul National University Bundang Hospital, Catholic University of Korea, Keimyung University Dongsan Medical Center, Keimyung University, Korea University Guro Hospital
Language: English
Subfield: Hepatology
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
OpenAlex ID: W4416146070