Tumor component proportion determines the prognosis of patients with combined hepatocellular-cholangiocarcinoma.

Authors

Han Wang, You-Wen Qian, Xia Sheng, Chun-Yan Xia, Ying-Ying Zhou, Wen-Ming Cong, Miao-Xia He, Hui Dong

Published in

Hepatobiliary & pancreatic diseases international : HBPD INT. Jun 22, 2026. Epub Jun 22, 2026.

Abstract

The pathological diagnostic purpose of the tumor component proportion of combined hepatocellular-cholangiocarcinoma (CHC) remains a perplexing issue, hindering clinicians from characterizing its biological behavior and formulating intervention strategies.
A multicenter database of patients with CHC who underwent therapeutic hepatectomy was analyzed. Based on a > 70% hepatocellular carcinoma (HCC) or cholangiocarcinoma (CCA) component, the patients were stratified into three groups: CHC^HCC-dominant, CHC^balanced, and CHC^CCA-dominant. Survival outcomes were assessed using Kaplan-Meier analysis. Tumor markers and recurrence patterns were compared via Chi-square test, and prognostic factors were identified through Cox regression analysis. Postoperative adjuvant transarterial chemoembolization (PA-TACE) benefits were further evaluated.
Among 19 641 patients with primary liver cancer, 306 with CHC were classified: 93 (30.4%) in the CHC^HCC-dominant group, 101 (33.0%) in the CHC^balanced group, and 112 (36.6%) in the CHC^CCA-dominant group. The best and the worst prognoses were observed in the CHC^HCC-dominant group and CHC^CCA-dominant group, respectively (median RFS time: CHC^HCC-dominant group 1.02 years, CHC^balanced group 0.36 years, CHC^CCA-dominant group 0.30 years; median OS time: CHC^HCC-dominant group 3.16 years, CHC^balanced group 1.93 years, CHC^CCA-dominant group 1.86 years). The highest ratios of elevated alpha-fetoprotein and carbohydrate antigen 19-9 were recorded in the CHC^HCC-dominant group and the CHC^CCA-dominant group, respectively. CHC^HCC-dominant and CHC^CCA-dominant patients showed the most frequent intrahepatic and extrahepatic recurrences, respectively. PA-TACE improved early RFS (< 2 years) only in CHC^HCC-dominant patients. Multivariate analysis confirmed that tumor component proportion was an independent prognostic factor for all survival endpoints.
Predominant HCC or CCA components (> 70% tumor composition) critically shape CHC biology and prognosis. Tumor component proportion emerges as a novel parameter for therapeutic decision-making. We proposed a comprehensive flow chart integrating pathological sampling, histological component evaluation, clinical data mapping, and postoperative intervention strategies for CHC.

PMID:
42409696
Bibliographic data and abstract were imported from PubMed on 07 Jul 2026.

Read full publication at:
Please sign in to see all details.

Stats

1-terrible, 9-excellent. How would you rate this publication? Sign in in to submit your rating.

Post a comment

You need to be signed in to post comments. You can sign in here.

Comments

There are no comments yet.