BACKGROUND AND OBJECTIVES: Primary liver sarcomas (PLS) are rare. Published series are limited by small numbers of patients. METHODS: We reviewed the National Cancer Database (2004-2014) for patients who underwent surgical resection of PLS. RESULTS: Of 237 patients identified, the majority were female (60.8%), with median age of 52 years. Histologies were: epithelioid hemangioendothelioma (n = 67), angiosarcoma (n = 64), leiomyosarcoma (n = 33), embryonal rhabdomyosarcoma (n = 31), carcinosarcoma (n = 16), giant cell sarcoma (n = 14), spindle cell sarcoma (n = 12). Ninety-seven (40.9%) patients underwent lobectomies or extended lobectomies, 41 patients (17.3%) underwent transplantation. Surgical margins were negative in 82.9%. Tumors were well differentiated in 11.3%. Histology type correlated with outcome with the best prognosis for epithelioid hemangioendothelioma (OS: not reached, similar for resection and transplantation) and the worst for angiosarcoma (OS:16.6 mo with resection; 6 mo with transplantation; P = 0.04). Resections with microscopically negative margins were associated with improved survival (58.7 vs 11.3 mo for positive margins; P < 0.001). Chemotherapy and radiation therapy were used in a minority of patients (32.9% and 4.3% respectively) with no improvement in outcomes. CONCLUSIONS: Both hepatic resection and liver transplantation can be associated with long term survival for selected primary liver sarcomas such as epitheliod hemangioendotheliomas. Histology type and the ability to resect the tumor with negative margins correlate with outcomes and the decision to operate should be carefully weighed for subtypes with particularly dismal prognosis such as angiosarcomas.
BACKGROUND AND OBJECTIVES:Primary liver sarcomas (PLS) are rare. Published series are limited by small numbers of patients. METHODS: We reviewed the National Cancer Database (2004-2014) for patients who underwent surgical resection of PLS. RESULTS: Of 237 patients identified, the majority were female (60.8%), with median age of 52 years. Histologies were: epithelioid hemangioendothelioma (n = 67), angiosarcoma (n = 64), leiomyosarcoma (n = 33), embryonal rhabdomyosarcoma (n = 31), carcinosarcoma (n = 16), giant cell sarcoma (n = 14), spindle cell sarcoma (n = 12). Ninety-seven (40.9%) patients underwent lobectomies or extended lobectomies, 41 patients (17.3%) underwent transplantation. Surgical margins were negative in 82.9%. Tumors were well differentiated in 11.3%. Histology type correlated with outcome with the best prognosis for epithelioid hemangioendothelioma (OS: not reached, similar for resection and transplantation) and the worst for angiosarcoma (OS:16.6 mo with resection; 6 mo with transplantation; P = 0.04). Resections with microscopically negative margins were associated with improved survival (58.7 vs 11.3 mo for positive margins; P < 0.001). Chemotherapy and radiation therapy were used in a minority of patients (32.9% and 4.3% respectively) with no improvement in outcomes. CONCLUSIONS: Both hepatic resection and liver transplantation can be associated with long term survival for selected primary liver sarcomas such as epitheliod hemangioendotheliomas. Histology type and the ability to resect the tumor with negative margins correlate with outcomes and the decision to operate should be carefully weighed for subtypes with particularly dismal prognosis such as angiosarcomas.
Authors: Arianeb Mehrabi; Arash Kashfi; Hamidreza Fonouni; Peter Schemmer; Bruno M Schmied; Peter Hallscheidt; Peter Schirmacher; Jurgen Weitz; Helmut Friess; Markus W Buchler; Jan Schmidt Journal: Cancer Date: 2006-11-01 Impact factor: 6.860
Authors: Juürgen Weitz; David S Klimstra; Karina Cymes; William R Jarnagin; Michael D'Angelica; Michael P La Quaglia; Yuman Fong; Murray F Brennan; Leslie H Blumgart; Ronald P Dematteo Journal: Cancer Date: 2007-04-01 Impact factor: 6.860
Authors: Giuseppe Orlando; Rene Adam; Darius Mirza; Goran Soderdahl; Robert J Porte; Andreas Paul; Andrew K Burroughs; Christian A Seiler; Michele Colledan; Ivo Graziadei; Juan-Carlos Garcia Valdecasas; François-René Pruvot; Vincent Karam; Jan Lerut Journal: Transplantation Date: 2013-03-27 Impact factor: 4.939
Authors: Karl Y Bilimoria; David J Bentrem; Andrew K Stewart; David P Winchester; Clifford Y Ko Journal: J Clin Oncol Date: 2009-07-27 Impact factor: 44.544
Authors: Jan P Lerut; Giuseppe Orlando; Rene Adam; Marcello Schiavo; Jurgen Klempnauer; Darius Mirza; Emmanuel Boleslawski; Andrew Burroughs; Carlos Fernandez Sellés; Daniel Jaeck; Robert Pfitzmann; Mauro Salizzoni; Gunner Söderdahl; Rudi Steininger; Andre Wettergren; Vincenzo Mazzaferro; Yves Patrice Le Treut; Vincent Karam Journal: Ann Surg Date: 2007-12 Impact factor: 12.969