Prognostic Factors of Survival and Comparison of Surgically Resected Combined Hepatocellular-cholangiocellular Carcinoma, Hepatocellular Carcinoma, and Intrahepatic Cholangiocarcinoma

Background: Hepatocellular carcinoma (HCC) and cholangiocarcinoma (CC) are the most common primary malignancies of the liver. The combined form of these two tumors (i.e., cHC-CC) is a considerably rare type of liver cancer displaying both malignant components. Objectives: The present study aimed to explore the factors affecting survival in patients with HCC, ICC, and cHC-ICC through referring to statistical analysis, including demographics, histopathological, and operative and laboratory findings. Methods: In this research, 53 patients were evaluated retrospectively, who had undergone an operation for primary liver tumors in a single tertiary center. Data were analyzed in terms of demographics, operation, tumor features, histopathological analysis, and their relationship with survival. Results: The study groups consisted of 20 ( 37.7%) and 33 (62.3%) females and males, respectively, with a mean age of 62.3 years. It was revealed that the survival rate was significantly higher in HCC, compared to other groups (P<0.05). Moreover, alpha-fetoprotein (AFP) was significantly higher in the HCC group than in the intrahepatic cholangiocarcinoma (ICC) group, and carbohydrate antigen 19-9 levels and the presence of jaundice and perineural invasion were significantly higher in the ICC group, compared to HCC patients. In the HCC group, macroscopic vascular invasion, perineural invasion, and T staging were statistically significant. It was also found that in the ICC group, the macroscopic vascular invasion was statistically significant, and in the cHC-ICC group, the increased levels of AFP showed a statistically significant effect on survival (P<0.05). Conclusion: To the best of our knowledge, the current research was one of the very few studies performed focusing on each group of liver tumors in a single study. Based on the findings of this research, there were statistically significant results in all three groups and their comparison with each other.