Yonsei Med J.  2011 Sep;52(5):753-760. 10.3349/ymj.2011.52.5.753.

Clinicopathological Characteristics in Combined Hepatocellular-Cholangiocarcinoma: A Single Center Study in Korea

  • 1Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea. drpjy@yuhs.ac
  • 2Department of Surgery, Yonsei University College of Medicine, Seoul, Korea.
  • 3Liver Cancer Special Clinic, Yonsei University College of Medicine, Seoul, Korea.
  • 4Department of Surgery, Korea University College of Medicine, Seoul, Korea.
  • 5Liver Cirrhosis Clinical Research Center, Seoul, Korea.
  • 6Brain Korea 21 Project Medical Science, Seoul, Korea.


Combined hepatocellular-cholangiocarcinoma (CHCC) is an uncommon form of cancer, and its clinicopathological features have rarely been reported in detail. This study was undertaken to evaluate the clinicopathological characteristics and prognostic factors of CHCC.
The clinicopathological features of patients diagnosed with CHCC at Severance Hospital between January 1996 and December 2007 were retrospectively studied by comparing them with the features of patients with hepatocellular carcinoma (HCC) or cholangiocarcinoma (CC) who had undergone a hepatic resection during the same period.
Forty-three patients diagnosed with CHCC were included in this study (M : F=35 : 8, median age, 55 years). According to the parameters of the American Joint Committee on Cancer staging, there were 6 (14.0%), 9 (20.9%), 25 (58.1%), and 3 (7.0%) patients with stages I, II, III, and IV cancer, respectively. Thirty-two of the 43 patients underwent resection with curative intent. After resection, 27 patients (84.4%) had tumor recurrence during the follow-up period of 18 months (range: 6-106 months), and the median time to recurrence was 13 months. Overall median survival periods after hepatic resection of CHCC, HCC and CC were 34, 103 and 38.9 months, respectively (p<0.001). The median overall survival for all patients with CHCC was 21 months, and the 5-year survival rate was 18.1%. The presence of portal vein thrombosis and distant metastasis were independent prognostic factors of poor survival.
Even after curative hepatic resection, the presence of a cholangiocellular component appeared to be a poor prognostic indicator in patients with primary liver cancer.


Combined hepatocellular and cholangiocarcinoma; hepatocellular carcinoma; cholangiocarcinoma

MeSH Terms

Carcinoma, Hepatocellular/mortality/*pathology
Diagnosis, Differential
Kaplan-Meier Estimate
Liver Neoplasms/mortality/*pathology
Middle Aged
Neoplasm Recurrence, Local/pathology
Republic of Korea/epidemiology
Retrospective Studies


  • Fig. 1 Kaplan-Meier overall survival rate of combined hepatocellular-cholangiocarcinoma (CHCC) (n=43).

  • Fig. 2 Kaplan-Meier overall survival rate of combined hepatocellular-cholangiocarcinoma (CHCC) (n=32), HCC (n=368) and CC (n=128). HCC, hepatocellular-carcinoma; CC, cholangiocarcinoma.

Cited by  2 articles

Adrenal metastasis in sequentially developed combined hepatocellular carcinoma-cholangiocarcinoma: A case report
Adianto Nugroho, Kwang-Woong Lee, Kyung-Bun Lee, Hyo-Shin Kim, Hyeyoung Kim, Nam-Joon Yi, Kyung-Suk Suh
Ann Hepatobiliary Pancreat Surg. 2018;22(3):287-291.    doi: 10.14701/ahbps.2018.22.3.287.

Clinicopathological characteristics and prognostic factors in combined hepatocellular carcinoma and cholangiocarcinoma
Sang Eun Park, Sung Ha Lee, Jae Do Yang, Hong Pil Hwang, Si Eun Hwang, Hee Chul Yu, Woo Sung Moon, Baik Hwan Cho
Korean J Hepatobiliary Pancreat Surg. 2013;17(4):152-156.    doi: 10.14701/kjhbps.2013.17.4.152.


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