Long-Term Outcomes of Liver Transplantation versus Liver Resection for Combined Hepatocellular-Cholangiocarcinoma: An Updated Systematic Review and Meta-Analysis
A partir d'une revue systématique de la littérature publiée jusqu'en octobre 2025 (6 études), cette méta-analyse évalue la survie globale à 5 ans après une greffe du foie par rapport à une résection hépatique chez des patients atteints d'un hépatocholangiocarcinome
Background: Combined hepatocellular cholangiocarcinoma (cHCC-CCA) is a rare and aggressive primary liver cancer. Liver resection (LR) has long been the standard treatment for cHCC-CCA, but it is associated with high recurrence rates and poor long-term prognosis. The significance of liver transplantation (LT) remains controversial. This systematic review and meta-analysis aimed to compare the long-term survival and recurrence outcomes between LT and LR for cHCC-CCA to assess the potential benefit of LT.
Methods: A systematic search of Web of Science, Medline Ovid, Scopus, and Cochrane CENTRAL was conducted using predefined terms related to cHCC-CCA. Records were screened according to PRISMA. Study quality was assessed using the Newcastle-Ottawa Scale (NOS). The primary outcome was 5-year Overall Survival (OS). Recurrence-free survival (RFS) was a secondary outcome. Meta-analysis was performed using random-effects models.
Results: Six retrospective studies met inclusion criteria. NOS scores ranged from 7 to 9. For OS, pooled analyses yielded ORs of 0.67 (95% CI: 0.39–1.15, p = 0.15) at 1 year, 0.70 (95% CI: 0.42–1.17, p = 0.15) at 3 years, and 0.55 (95% CI: 0.38–0.81, p = 0.002) at 5 years. For RFS, pooled analyses yielded ORs of 0.48 (95% CI: 0.30–0.78, p = 0.003) at 1 year and 0.40 (95% CI: 0.27–0.59, p < 0.001) at 5 years.
Conclusion: LT may be associated with favorable long-term survival and recurrence outcomes compared with LR for cHCC-CCA. These findings suggest that LT could be considered in carefully selected patients.
European Journal of Surgical Oncology , résumé, 2026