The Annual Changes and Clinicopathologic Features of Cholangiocellular Carcinoma in Patients with Hepatitis C Virus in the Kansai Medical University Hospital

Naoyoshi Terakawa, Sohei Satoi, Hiroaki Yanagimoto, Hidekazu Yamamoto, Tomohisa Yamamoto, Soichiro Takai, A-Hon Kwon, Shin Yamamoto*, Yoshitsugu Kubota* and Yasuo Kamiyama

Department of Surgery and Third Department of Internal Medicine*, Kansai Medical University

Introduction: The 3% incidence of cholangiocellular carcinoma (CCC) in primary liver cancer in Japan has remained unchanged in the last ten years, but the incidence of underlying type C hepatitis has increased recently. We compared the clinicopathologic features of CCC patients with positive hepatitis C virus (HCV) antibody to CCC patients with negative HCV. Methods: Of 35 patients with CCC admitted to Kansai Medical University between 1992 and 2001, 17 patients with CCC underwent liver resection (HCV group: n=7, non-HCV group: n=10). We studied the annual changes in HCV antibody incidence and compared the clinical background and surgical prognosis in CCC patients with HCV positive and negative antibody. Results: From 1992 to 1996, 9 patients were diagnosed with CCC (HCV positive; n=2, 22%). From 1997 to 2001, 13 of 26 patients with CCC were found to have HCV positive antibody (50%). In resected cases, significant differences existed in AST between groups (59±10 vs. 30±5 U/l, p<0.05). The retention rate of indocyanine green dye at 15 min in the HCV group was higher than in the non-HCV group but not significant. Most patients in the HCV group underwent limited liver resection due to underlying liver damage, meaning curative resection was done less often in the HCV group. No differences were seen in tumor factors (size, number, vascular invasion, lymph node metastasis, or TNM staging) between groups. Overall survival in the HCV group tended to be lower than in the non-HCV group. Conclusion: The incidence of CCC with HCV antibody has been increasing. Patients mostly underwent limited surgery due to underlying liver disease, probably resulting in a poor prognosis.

Key words
cholangiocellular carcinoma, hepatitis C virus, liver function, overall survival rate

Reprint requests
Naoyoshi Terakawa Department of Surgery, Kansai Medical University
10-15 Fumizono, Moriguchi, 570-8507 JAPAN

Accepted
June 30, 2004

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