BACKGROUND: Combined hepatocellular carcinoma and cholangiocarcinoma (cH CC-CC) is a rare subtype of primary liver cancer consisting of both hepatocellular carcinoma (HCC)and cholangiocarcinoma (CC). Because of the rarity of this tumor its feature is poorly understood. The present study aimed to evaluate the clinicopathological features and long-term prognosis of patients with cH CC-CC after surgery and to compare with those of the patients with stage-matched HCC and CC.METHODS: The clinicopathological features of the patients who underwent surgery for cH CC-CC at our center during the period of 2001-2010 were retrospectively analyzed and compared with those of stage-matched HCC and CC patients Cancer staging was performed according to the AJCC Cancer Staging Manual (6th ed.). Overall survival and disease-free survival were compared among the groups and prognostic factors of cH CC-CC were evaluated.RESULTS: Significant differences were observed in clinico pathological features among 42 patients with cH CC-CC, 90patients with HCC and 45 patients with CC. Similar to HCC patients, cH CC-CC patients had frequent hepatitis B virus antigen positivity, microscopic vessel invasion, cirrhosis and high level of serum alpha-fetoprotein. Similar to CC patients, cH CC-CC patients showed increased bile duct invasion and decreased capsule. The 1-, 3-, and 5-year overall survival and disease free survival of patients with cH CC-CC were not significantly different from those with stage-matched patients with CC;but significantly poorer than those with HCC. In subanalysis of patients with stage II, the overall survival in patients with cH CC-CC or CC was significantly poorer than that in patients , with HCC. We did not find the difference in patients with other stages. Univariate analysis of overall and disease-free survival of patients with cH CC-CC showed that the vascular invasion and intrahepatic metastasis were the significant predictive factors.CONCLUSION: Patients with cH CC-CC showed similar clinico- pathological features as those with HCC or CC, and patients with cH CC-CC or CC had a poorer prognosis compared with those with HCC, especially at matched stage II.. BACKGROUND: Combined hepatocellular carcinoma and cholangiocarcinoma (cH CC-CC) is a rare subtype of primary liver cancer consisting of both hepatocellular carcinoma (HCC) and cholangiocarcinoma (CC). Because of the rarity of this tumor its feature is poorly understood. The present study aimed to evaluate the clinicopathological features and long-term prognosis of patients with cH CC-CC after surgery and to compare with those of the patients with stage-matched HCC and CC. METHODS: The clinicopathological features of the patients who underwent surgery for cH CC-CC at our center during the period 2001-2010 were retrospectively analyzed and compared with those of stage-matched HCC and CC patients Cancer staging was performed according to the AJCC Cancer Staging Manual (6th ed.). Overall survival and disease- free survival were compared among the groups and prognostic factors of cH CC-CC were evaluated.RESULTS: Significant differences were observed in clinico pathological features among 42 patients with cH CC-CC, 90patients with HCC and 45 patients with CC. Similar to HCC patients, cH CC-CC patients had frequent hepatitis B virus antigen positivity, microscopic vessel invasion, cirrhosis and high level of serum alpha-fetoprotein. Similar to CC patients, cH CC-CC patients showed increased bile duct invasion and decreased capsule. The 1-, 3-, and 5-year overall survival and disease free survival of patients with cH CC-CC were not significantly different from those with stage- matched patients with CC; but significantly poorer than those with HCC. In subanalysis of patients with stage II, the overall survival in patients with cH CC-CC or CC was significantly poorer than that in patients, with HCC. We did not find the difference in patients with other stages. Univariate analysis of overall and disease-free survival of patients with cH CC-CC showed that the vascular invasion and intrahepatic metastasis were the significant predictive factors. CONCLUSION: Patients with cH CC-CCshowed similar clinico-pathological features as those with HCC or CC, and patients with cH CC-CC or CC had a poorer prognosis compared with those with HCC, especially at matched stage II.