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Clinical Medicine: Pathology

Synopsis: An open access, peer reviewed electronic journal that covers histopathology, haematology, biochemistry, virology, parasitology, infection control and medical microbiology.


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Clinical Medicine: Pathology is an international, open access, peer reviewed journal which considers manuscripts on histopathology, haematology, biochemistry, virology, parasitology, infection control and medical microbiology.

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ISSN: 1178-1181


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Combined Hepatocellular Cholangiocarcinomas; Analysis of a Large Database

Authors: Mitchell S. Wachtel, Yan Zhang, Tom Xu, Maurizio Chiriva-Internati and Eldo E Frezza
Publication Date: 19 Mar 2008
Clinical Medicine: Pathology 2008:1 43-47

Mitchell S. Wachtel1, Yan Zhang2, Tom Xu2, Maurizio Chiriva-Internati3 and Eldo E Frezza4

1Department of Pathology. 2Department of Family Medicine. 3Department of Microbiology and Immunology. 4Department of Surgery, Texas Tech University Health Sciences Center.

Abstract

Aim: Combined hepatocellular cholangiocarcinoma (combined tumor) has been described as either a variant of hepatoma or a variant of cholangiocarcinoma. Prior studies evaluated fewer than 50 patients with combined tumors, precluding multivariate analyses. Posited was the notion that analysis of a large database would yield more definite answers.

Methods: This study used SEER (Surveillance, Epidemiology, and End Results Program of the National Cancer Institute) to analyze 282 combined tumors, 2,035 intrahepatic cholangiocarcinomas, and 19,336 hepatomas between the years 1973–2003. Multinomial logit regression calculated point estimates and 95% confidence intervals (c.i.) for relative risk (rr). Cox regression calculated point estimates and 95% confidence intervals (c.i.) for hazard ratios (ĥ).

Results: Men less often had cholangiocarcinomas than they had combined tumors (rr = 0.63, c.i. = 0.49–0.81). Hepatomas less often than combined tumors presented with distant spread (rr = 0.56, c.i. = 0.43–0.72). Men (rr = 1.50, c.i. = 1.17–1.93) and patients with a known Asian or Pacific birthplace (rr = 2.36, c.i. = 1.56–3.56) more often had hepatomas than they had combined tumors. Among patients not known to have an Asian/Pacific birthplace, a diagnosis of cholangiocarcinoma (ĥ = 0.72, c.i. = 0.63–0.82) or hepatoma (ĥ = 0.75, c.i. = 0.66–0.86) provided a better prognosis than did a diagnosis of combined tumor.

Conclusion: Combined tumors differ from hepatomas and cholangiocarcinomas in terms of distribution and survival patterns in the population; they should be considered neither cholangiocarcinomas nor hepatomas.

Categories: Cancer , Pathology


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