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JLC : Journal of Liver Cancer



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Review Article Surgical treatment of combined hepatocellular and cholangiocarcinoma
Chul Soo Ahn
Journal of Liver Cancer 2007;7(1):22-27
Published online: June 30, 2007
Division of Hepatopancreatobiliary Surgery and Liver Transplantation, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
Corresponding author:  Chul Soo Ahn,
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Combined hepatocellular and cholangiocarcinoma (HCC-CC) is an uncommon form of primary liver cancer (PLC) with features of hepatocellular and biliary epithelial differentiation. According to publishing records HCC-CC accounts for 0.4% to 14.2% of all PLC cases. Large number of HCC-CC is associated with chronic viral hepatitis or cirrhosis, especially in asian countries. The tumor markers of HCC-CC (AFP, CA19-9) shows the intermediate level between hepatocellular carcinoma (HCC) and cholangiocarcinoma (CC). The clinical features of HCC-CC resembled with HCC but its post operative result and metastatic pattens are similar to that of CC. Surgical results of this tumor can yield results that are intermediate between HCC and CC in characteristics. But complete resection is the only effective therapy and can result in long term survival. And there are hot debates for the additional hilar lymph node dissection. The survival rate of HCC-CC is higher than CC but lower than HCC. The recurrence after resection has been frequently reported. Most of them are intrahepatic recurrences as HCCs but extrahepatic recurrences are much more frequent like CC. The CC component of HCC-CC seem to determine the prognosis. So more effective approaches for treating recurrent disease, such as local ablation therapy and or combination systemic chemotherapy and neoadjuvant chemoradiation, should be applied for long term and better results.

JLC : Journal of Liver Cancer