Prolonged Survival of a Patient with Advanced-Stage Combined Hepatocellular-Cholangiocarcinoma

Sven H Loosen, Nadine T Gaisa, Maximilian Schmeding, Christoph Heining, Sebastian Uhrig, Theresa H Wirtz, Sebastian Kalverkamp, Jan Spillner, Frank Tacke, Albrecht Stenzinger, Hanno Glimm, Stefan Fröhling, Christian Trautwein, Christoph Roderburg, Thomas Longerich, Ulf Peter Neumann, Tom Luedde*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Combined hepatocellular-cholangiocarcinoma (cHCC/CCA) represents a rare type of primary liver cancer with a very limited prognosis. Although just recently genomic studies have contributed to a better understanding of the disease's genetic landscape, therapeutic options, especially for advanced-stage patients, are limited and often experimental, as no standardized treatment protocols have been established to date. Here, we report the case of a 38-year-old male patient who was diagnosed with extensive intrahepatic cHCC/CCA in an otherwise healthy liver without signs of chronic liver disease. An interdisciplinary stepwise therapeutic approach including locoregional liver-targeted therapy, systemic chemotherapy, liver transplantation, surgical pulmonary metastasis resection, and next-generation sequencing-based targeted therapy led to a prolonged overall survival beyond 5 years with an excellent quality of life. This case report comprises several provocative treatment decisions that are extensively discussed in light of the existing literature on this rare but highly aggressive malignancy.

Original languageEnglish
Pages (from-to)658-667
Number of pages10
JournalCase Reports in Gastroenterology
Issue number3
Publication statusPublished - 10 Dec 2020


  • Combined hepatocellular-cholangiocarcinoma
  • Liver transplantation
  • Chemotherapy
  • Next-generation sequencing
  • Targeted therapy

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