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Poor outcomes after liver transplantation in patients with incidental cholangiocarcinoma irrespective of tumor localization.
[cholangiocarcinoma]
After
liver
transplantation
for
cholangiocarcinoma
(
CCC
)
,
patients
have
a
poor
prognosis
without
use
of
specific
therapeutic
strategies
.
Accordingly
,
recipients
with
incidental
CCC
might
have
the
highest
risk
of
recurrent
disease
;
however
,
sparse
data
on
the
long
-term
outcome
of
unselected
patients
with
incidental
CCC
have
been
published
.
The
aim
of
this
study
was
to
evaluate
the
post-transplantation
outcomes
of
patients
with
incidental
CCC
with
special
focus
on
tumor
localization
.
There
were
11
primary
liver
transplantations
in
patients
with
incidental
CCC
of
1310
liver
transplantation
procedures
performed
between
December
1994
and
August
2013
.
All
patients
with
incidental
CCC
received
a
chemotherapy
regiment
including
gemcitabine
/
5
fluorouracil
,
doxorubicin
,
and
mitomycin
.
The
patients
were
switched
from
calcineurin
inhibitors
to
mammalian
target
of
rapamycin
inhibitor-based
immunosuppression
shortly
after
CCC
diagnosis
.
Intra-
and
extrahepatic
tumors
were
found
in
6
and
5
patients
,
respectively
.
At
median
follow-up
examination
of
26
.
3
months
there
were
8
CCC
recurrences
and
7
patient
deaths
.
Overall
survival
after
liver
transplantation
for
incidental
CCC
was
88
.
9
%
at
1
year
,
44
.
4
%
at
2
years
,
and
14
.
8
%
at
3
years
.
The
corresponding
rates
of
recurrence-free
survival
were
45
.
7
%
,
45
.
7
%
,
and
0
.
0
%
,
respectively
.
Post-transplantation
CCC
recurrences
were
universal
with
0
%
3
-
year
recurrence-free
survival
both
in
patients
with
intra-
and
extrahepatic
tumors
(
P
=
.
475
)
.
Incidental
CCC
in
liver
transplantation
is
associated
with
poor
outcomes
irrespective
of
tumor
localization
.
Introduction
of
new
adjuvant
multimodal
treatment
concepts
is
necessary
to
improve
the
prognosis
for
this
subgroup
of
patients
.
Diseases
Validation
Diseases presenting
"liver transplantations in patients"
symptom
cholangiocarcinoma
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