Retrospective Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. May 27, 2021; 13(5): 584-594
Published online May 27, 2021. doi: 10.4254/wjh.v13.i5.584
Surgical treatment outcomes of primary hepatic sarcomas: A single-center experience
Sang Jin Kim, Jinsoo Rhu, Jong Man Kim, Gyu Seung Choi, Jae-Won Joh
Sang Jin Kim, Department of Surgery, Korea University College of Medicine, Seoul, Republic of Korea, Division of Hepatobiliopancreas and Transplant Surgery, Korea University Ansan Hospital, Ansan 15355, South Korea
Jinsoo Rhu, Jong Man Kim, Gyu Seung Choi, Jae-Won Joh, Department of Surgery, Samsung Medical Center, Seoul 06351, South Korea
Author contributions: Kim SJ is first author and participated in literature search, data acquisition, analysis, and wring manuscript; Kim JM is corresponding author and participated in research design, data analysis, interpretation; Rhu J participated in data acquisition and analysis; Choi GS and Joh JW participated in acquisition of data and supervision.
Institutional review board statement: The study was reviewed and approved by the IRB of Samsung Medical Center (IRB number 2020-09-077).
Informed consent statement: Acquiring participant’s consent seems to be realistically impossible and does not influence integrity of research. And there would be no reasons that participant would deny providing his or her consent; research involves no more than minimal risk to the patients. Therefore, the IRB of Samsung Medical Center approved that the participant’s consent can be waivered.
Conflict-of-interest statement: The authors have no conflicts of interest to declare.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement—checklist. The manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Jong Man Kim, MD, PhD, Associate Professor, Department of Surgery, Samsung Medical Center, 50 Ilwon Dong Gangnam Gu, Seoul 06351, South Korea.
Received: January 14, 2021
Peer-review started: January 14, 2021
First decision: February 13, 2021
Revised: February 24, 2021
Accepted: April 25, 2021
Article in press: April 25, 2021
Published online: May 27, 2021

Primary hepatic sarcoma is a rare tumor originated from mesenchymal tissue. There are various pathologic types of primary hepatic sarcoma and the treatment outcome of this tumor was usually disappointing. Unlike hepatocellular carcinoma, outcome of primary hepatic sarcoma is not well-known due to it’s rarity. However, with development of medical technology, surgical treatment may lead to better survival.


To investigate the surgical outcomes of primary hepatic sarcoma, we gathered and analyzed the cases of a single institute.


From August 2001 to September 2016, a total of nine patients were surgically treated for primary hepatic sarcoma after exclusion of cases with open and closure, early loss to follow-up and sarcomatoid hepatocellular carcinoma and sarcomatoid cholangiocellular carcinoma. Baseline characteristics, tumor characteristics such as tumor pathology, size and number, surgical and adjuvant treatments were reviewed. Tumor recurrence, and patient survival were analyzed with retrospective approach.


The enrolled participants included five patients with angiosarcoma and four patients with undifferentiated sarcoma. All patients experienced tumor recurrence at a median of 52 post-operative days. Only two patients survived and the 5-year survival rate was 29.6%. One patient with angiosarcoma who received central hepatectomy for primary tumor and received radiofrequency ablation for recurrent tumor still lives for 11 years. One patient with undifferentiated sarcoma received Rt. lobectomy for primary tumor followed by chemotherapy and radiation therapy still lives around 30 mo even though she got additional operation for recurrent tumor. Two patients who received living donor liver transplantation due to angiosarcoma died. Only adjuvant therapy was associated with survival gain (P = 0.002).


Patients with primary hepatic sarcoma may gain survival benefit with surgical resection followed by adjuvant therapy, even though the outcome remains relatively poor.

Keywords: Liver, Angiosarcoma, Undifferentiated sarcoma, Operation, Survival, Recurrence

Core Tip: This is a retrospective study to analyze the outcomes of primary hepatic sarcoma. A total of nine patients were included, five of them are with angiosarcoma and four are with undifferentiated sarcoma. While all patients experienced tumor recurrence, one patient with angiosarcoma and another patient with undifferentiated sarcoma still survive for 11 years and 30 mo respectively, after receiving effective local treatment for recurrent tumors. Although the outcome of primary hepatic sarcoma is known to be poor, surgical treatment with appropriate adjuvant therapy may support the long-term survival.