Intrahepatic cholangiocarcinoma and combined hepatocellular-cholangiocarcinoma: a Western experience.

Background: Intrahepatic cholangiocarcinoma (ICC) is an unusual tumour. Methods: The clinicopathological data of 67 patients with ICC and combined hepatocel- lular–cholangiocarcinoma (HCC–ICC) are presented. Results: HCV–HBV infection was present in 37.3% and chronic liver disease in 38.7% of cases, a rate higher than in the normal population; in these patients the cancer was small, often asymptomatic and of combined type. Liver resection was performed in 51 patients; at 1, 3 and 5 years, overall survival was 87.9%, 59.0%, and disease-free survival was 47.7% and 78.8%, 51.4%, and 46.7%, respectively. The better results were in the group of cirrhotic patients in whom ICC was diagnosed by a screening program for HCC (5-year survival 76.6%). Nodal metastasis showed negative prognostic value for both overall and disease-free survival; in N+ patients mean survival was 14.7 months after liver resection and lymph node dissection. Conclusion: Viral infection and cirrhosis may be considered risk conditions for ICC and combined HCC–ICC; in resected patients survival was good. Nodal metastases must not be considered a contraindication for liver resection.