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World Journal of Surgical Oncology

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Open Access 01-12-2015 | Research

Surgical experience of adult primary hepatic sarcomas

Authors: Yu-Hung Lin, Chih-Che Lin, Allan M Concejero, Chee-Chien Yong, Fang-Ying Kuo, Chih-Chi Wang

Published in: World Journal of Surgical Oncology | Issue 1/2015

Abstract

Background

Primary hepatic sarcoma (PHS) is a rare primary liver malignancy. The histological types of PHS are diverse, and the clinical outcomes and management mainly depend on the histopathology. This study aims to evaluate the results of surgical intervention.

Methods

Between January 2003 and June 2009, 13 adult patients with pathologically proven PHS were identified by record review. The patients’ demographic profile, tumor characteristics, treatment modalities, and outcomes were reviewed and analyzed. The end of follow-up was December 2014.

Results

Nine (69%) underwent curative liver resection and two underwent liver transplantation; the others received non-operative treatments. The pathologic findings were six (46%) angiosarcomas, four (30.7%) undifferentiated sarcomas, one (7.6%) leiomyosarcoma, one (7.6%) malignant mesenchymoma, and one (7.6%) hepatic epithelioid hemangioendothelioma. The median follow-up was 31.4 (2.8 ~ 142.5) months. The 1-, 2-, and 5-year survival of surgical patients were 72.7%, 63.6%, and 36.4%, respectively. Importantly, the 1-, 2-, and 5-year survival rates of non-angiosarcoma patients were superior to those of angiosarcoma (85.7% vs. 33.3%, 71.4% vs. 16.7%, and 57.1% vs. 0%, respectively, P = 0.023).

Conclusions

Surgical intervention provides the possibility of long-term survival from PHS. Angiosarcoma is associated with a more dismal outcome than non-angiosarcoma.

Weitz J, Klimstra DS, Cymes K, Jarnagin WR, D’Angelica M, La Quaglia MP, et al. Management of primary liver sarcomas. Cancer. 2007;109(7):1391–6.CrossRefPubMed

Liver Cancer Study Group of Japan. Primary liver cancer in Japan. Clinicopathologic features and results of surgical treatment. Ann Surg. 1990;211(3):277–87.

Molina E, Hernandez A. Clinical manifestations of primary hepatic angiosarcoma. Dig Dis Sci. 2003;48(4):677–82.CrossRefPubMed

Forbes A, Portmann B, Johnson P, Williams R. Hepatic sarcomas in adults: a review of 25 cases. Gut. 1987;28(6):668–74.CrossRefPubMedCentralPubMed

Chang WW, Agha FP, Morgan WS. Primary sarcoma of the liver in the adult. Cancer. 1983;51(8):1510–7.CrossRefPubMed

Matthaei H, Krieg A, Schmelzle M, Boelke E, Poremba C, Rogiers X, et al. Long-term survival after surgery for primary hepatic sarcoma in adults. Arch Surg. 2009;144(4):339–44. discussion 44.CrossRefPubMed

Poggio JL, Nagorney DM, Nascimento AG, Rowland C, Kay P, Young RM, et al. Surgical treatment of adult primary hepatic sarcoma. Br J Surg. 2000;87(11):1500–5.CrossRefPubMed

Almogy G, Lieberman S, Gips M, Pappo O, Edden Y, Jurim O, et al. Clinical outcomes of surgical resections for primary liver sarcoma in adults: results from a single centre. Eur J Surg Oncol. 2004;30(4):421–7.CrossRefPubMed

Walker NI, Horn MJ, Strong RW, Lynch SV, Cohen J, Ong TH, et al. Undifferentiated (embryonal) sarcoma of the liver. Pathologic findings and long-term survival after complete surgical resection. Cancer. 1992;69(1):52–9.CrossRefPubMed

10.

Wang CC, Iyer SG, Low JK, Lin CY, Wang SH, Lu SN, et al. Perioperative factors affecting long-term outcomes of 473 consecutive patients undergoing hepatectomy for hepatocellular carcinoma. Ann Surg Oncol. 2009;16(7):1832–42.CrossRefPubMed

11.

Wang CC, Yap AQ, Chen CL, Concejero AM, Lin YH. Comparison of major hepatectomy performed under intermittent Pringle maneuver versus continuous Pringle maneuver coupled with in situ hypothermic perfusion. World J Surg. 2011;35(4):842–9.CrossRefPubMed

12.

Lin CC, Chen CL, Cheng YF, Chiu KW, Jawan B, Hsaio CC. Major hepatectomy in children: approaching blood transfusion-free. World J Surg. 2006;30(6):1115–9.CrossRefPubMed

13.

Chen CL, Fan ST, Lee SG, Makuuchi M, Tanaka K. Living-donor liver transplantation: 12 years of experience in Asia. Transplantation. 2003;75(3 Suppl):S6–11.CrossRefPubMed

14.

Makuuchi M, Sano K. The surgical approach to HCC: our progress and results in Japan. Liver Transpl. 2004;10(2 Suppl 1):S46–52.CrossRefPubMed

15.

Yong CC, Chen YS, Wang SH, Lin CC, Liu PP, Liu YW, et al. Deceased-donor liver transplantation: 10 years’ experience at Change Gung Memorial Hospital-Kaohsiung Medical Center. Chang Gung Med J. 2005;28(3):133–41.PubMed

16.

de Villa VH, Chen CL, Chen YS, Wang CC, Lin CC, Cheng YF, et al. Right lobe living donor liver transplantation—addressing the middle hepatic vein controversy. Ann Surg. 2003;238(2):275–82.PubMedCentralPubMed

17.

Chen CL, Chen YS, de Villa VH, Wang CC, Lin CL, Goto S, et al. Minimal blood loss living donor hepatectomy. Transplantation. 2000;69(12):2580–6.CrossRefPubMed

18.

Neoptolemos JP, Stocken DD, Dunn JA, Almond J, Beger HG, Pederzoli P, et al. Influence of resection margins on survival for patients with pancreatic cancer treated by adjuvant chemoradiation and/or chemotherapy in the ESPAC-1 randomized controlled trial. Ann Surg. 2001;234(6):758–68.CrossRefPubMedCentralPubMed

19.

Kim HR, Rha SY, Cheon SH, Roh JK, Park YN, Yoo NC. Clinical features and treatment outcomes of advanced stage primary hepatic angiosarcoma. Ann Oncol. 2009;20(4):780–7.CrossRefPubMed

20.

Timaran CH, Grandas OH, Bell JL. Hepatic angiosarcoma: long-term survival after complete surgical removal. Am Surg. 2000;66(12):1153–7.PubMed

21.

Arima-Iwasa S, Chijiiwa K, Makino I, Tanabe R, Ohuchida J, Kondo K. A case of hepatic angiosarcoma surviving for more than 16 months after hepatic resection. Hepatogastroenterology. 2007;54(74):533–5.PubMed

22.

Yu RS, Chen Y, Jiang B, Wang LH, Xu XF. Primary hepatic sarcomas: CT findings. Eur Radiol. 2008;18(10):2196–205.CrossRefPubMed

23.

Koyama T, Fletcher JG, Johnson CD, Kuo MS, Notohara K, Burgart LJ. Primary hepatic angiosarcoma: findings at CT and MR imaging. Radiology. 2002;222(3):667–73.CrossRefPubMed

24.

Ikeda K, Maehara M, Ohmura N, Kurokawa H, Koda K, Yokoyama H, et al. Spontaneous rupture of a necrotic hepatic angiosarcoma: findings on dual-phase computed tomography and angiography. Radiat Med. 2006;24(5):369–72.CrossRefPubMed

25.

Kojiro M, Nakashima T, Ito Y, Ikezaki H, Mori T, Kido C. Thorium dioxide-related angiosarcoma of the liver. Pathomorphologic study of 29 autopsy cases. Arch Pathol Lab Med. 1985;109(9):853–7.PubMed

26.

Nelson V, Fernandes NF, Woolf GM, Geller SA, Petrovic LM. Primary liposarcoma of the liver: a case report and review of literature. Arch Pathol Lab Med. 2001;125(3):410–2.PubMed

27.

Peterson MS, Baron RL, Rankin SC. Hepatic angiosarcoma: findings on multiphasic contrast-enhanced helical CT do not mimic hepatic hemangioma. AJR Am J Roentgenol. 2000;175(1):165–70.CrossRefPubMed

28.

Lyburn ID, Torreggiani WC, Harris AC, Zwirewich CV, Buckley AR, Davis JE, et al. Hepatic epithelioid hemangioendothelioma: sonographic, CT, and MR imaging appearances. AJR Am J Roentgenol. 2003;180(5):1359–64.CrossRefPubMed

29.

Radin DR, Craig JR, Colletti PM, Ralls PW, Halls JM. Hepatic epithelioid hemangioendothelioma. Radiology. 1988;169(1):145–8.CrossRefPubMed

30.

Ferrozzi F, Bova D, Zangrandi A, Garlaschi G. Primary liver leiomyosarcoma: CT appearance. Abdom Imaging. 1996;21(2):157–60.CrossRefPubMed

31.

Buetow PC, Buck JL, Pantongrag-Brown L, Marshall WH, Ros PR, Levine MS, et al. Undifferentiated (embryonal) sarcoma of the liver: pathologic basis of imaging findings in 28 cases. Radiology. 1997;203(3):779–83.CrossRefPubMed

32.

Yoon W, Kim JK, Kang HK. Hepatic undifferentiated embryonal sarcoma: MR findings. J Comput Assist Tomogr. 1997;21(1):100–2.CrossRefPubMed

33.

Shivathirthan N, Kita J, Iso Y, Hachiya H, Kyunghwa P, Sawada T, et al. Primary hepatic leiomyosarcoma: case report and literature review. World J Gastrointest Oncol. 2011;3(10):148–52.CrossRefPubMedCentralPubMed

34.

Sakellaridis T, Panagiotou I, Georgantas T, Micros G, Rontogianni D, Antiochos C. Undifferentiated embryonal sarcoma of the liver mimicking acute appendicitis. Case report and review of the literature. World J Surg Oncol. 2006;4:9.CrossRefPubMedCentralPubMed

35.

Husted TL, Neff G, Thomas MJ, Gross TG, Woodle ES, Buell JF. Liver transplantation for primary or metastatic sarcoma to the liver. Am J Transplant. 2006;6(2):392–7.CrossRefPubMed

36.

Gores GJ, Heimbach JK, Rosen CB. Liver transplantation for non-hepatocellular carcinoma malignancies. Liver Transplant. 2010;16(S2):S22–5.CrossRef

Title: Surgical experience of adult primary hepatic sarcomas
Authors: Yu-Hung Lin
Chih-Che Lin
Allan M Concejero
Chee-Chien Yong
Fang-Ying Kuo
Chih-Chi Wang
Publication date: 01-12-2015
Publisher: BioMed Central
Published in: World Journal of Surgical Oncology / Issue 1/2015
Electronic ISSN: 1477-7819
DOI: https://doi.org/10.1186/s12957-015-0489-6

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Surgical experience of adult primary hepatic sarcomas

Abstract

Background

Methods

Results

Conclusions

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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