Liver Transplantation for Combined Hepatocellular-Cholangiocarcinoma: A Retrospective Registry-Based Study Using the Korean Organ Transplant Registry (KOTRY)

Sang-Hoon Kim; Shin Hwang; Bong-Wan Kim; Dong Jin Joo; Kwang-Woong Lee; Gyu-Seong Choi; Je Ho Ryu; Dong-Sik Kim; Dongho Choi; Jai Young Cho; Young Kyoung You; Dongho Choi; Tae-Seok Kim; PyoungJae Park

doi:10.12659/AOT.949241

16 December 2025 : Original article

Liver Transplantation for Combined Hepatocellular-Cholangiocarcinoma: A Retrospective Registry-Based Study Using the Korean Organ Transplant Registry (KOTRY)

Sang-Hoon Kim^{BCDEF 1}, Shin Hwang^{ABG 1*}, Bong-Wan Kim^{ABG 2}, Dong Jin Joo^{ABD 3}, Kwang-Woong Lee^{ABD 4}, Gyu-Seong Choi^{AD 5}, Je Ho Ryu^{ABD 6}, Dong-Sik Kim^{ABD 7}, Dongho Choi^{ABD 8}, Jai Young Cho^{ABD 9}, Young Kyoung You^{ABD 10}, Dongho Choi^{ABD 11}, Tae-Seok Kim^{ABD 12}, PyoungJae Park^{ABD 13}

DOI: 10.12659/AOT.949241

Ann Transplant 2025; 30:e949241

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Table 2 Univariate and multivariate analyses for risk factor of overall survival.

Variable	Comparison	Univariate			Multivariate
Variable	Comparison	HR	95% CI	P	HR	95% CI	P
Age	<60 vs ≥60 years	0.81	0.17–3.85	0.79
Sex	Male vs female	0.04	0.00–49.60	0.37
Etiology of liver disease	non-HBV vs HBV	2.02	0.25–16.07	0.51
Pre-LT ICU hospitalization	No vs yes	0.93	0.12–7.44	0.94
MELD	≤20 vs ≥20	4.17	1.16–14.91	0.03	4.27	1.07–17.08	0.04
Child-Pugh classification	A vs B or C	0.92	0.26–3.24	0.89
Pre-LT Milan criteria	Within vs beyond	0.83	0.23–2.94	0.77
Pre-LT down staging	No vs yes	2.00	0.42–9.46	0.38
Viable tumor number	Solitary vs multiple	0.77	0.22–2.67	0.68
Maximum tumor diameter	≤5 vs >5 cm	0.05	0.00–319.21	0.59
Sum of tumor diameter	≤8 vs >8 cm	0.99	0.13–7.89	0.99
Serosa invasion	No vs yes	1.25	0.26–5.87	0.78
Peliosis or hemorrhage in mass	No vs yes	0.92	0.24–3.57	0.90
Fibrous capsule formation	No vs yes	0.35	0.04–2.79	0.32
Septal formation	No vs yes	0.78	0.10–6.19	0.82
Fatty change in tumor	No vs yes	0.04	0.00–162.33	0.56
Capsule invasion	No vs yes	0.29	0.04–2.31	0.24
Bile duct invasion	No vs yes	2.86	0.60–13.51	0.19
Perineural invasion	No vs yes	4.36	1.08–17.55	0.04	5.14	1.07–24.69	0.04
Portal vein tumor thrombosis	No vs yes	6.77	1.34–34.13	0.02	13.43	2.17–83.21	0.005
Macrovascular invasion	No vs yes	5.33	1.02–28.00	0.048	Stepwise eliminated
Microvascular invasion	No vs yes	6.97	1.43–33.86	0.02	Stepwise eliminated
Lymph node metastasis	No vs yes	0.05	0.00–130.99	0.63
Satellite nodule	No vs yes	0.32	0.04–2.55	0.28
Tumor differentiation (E-S grade)	I–III vs IV	2.54	0.63–10.33	0.19
Everolimus within 1 month after LT	No vs yes	0.05	0.00–1415.69	0.63
Everolimus within 6 months after LT	No vs yes	0.94	0.26–3.32	0.92
Everolimus within 1 year after LT	No vs yes	0.84	0.24–2.98	0.79
HR – hazard ratio; CI – confidence interval; HBV – hepatitis B virus; LT – liver transplantation; ICU – intensive care unit; MELD – model for end-stage liver disease; E-S – Edmondson-Steiner.

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Liver Transplantation for Combined Hepatocellular-Cholangiocarcinoma: A Retrospective Registry-Based Study Using the Korean Organ Transplant Registry (KOTRY)

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