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: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jong Man Kim, MD, PhD, Associate Professor, Department of Surgery, Samsung Medical Center, 50 Ilwon Dong Gangnam Gu, Seoul 06351, South Korea. yjongman21@gmail.com
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
ARTICLE HIGHLIGHTS
Research background

Primary hepatic sarcoma is a malignant tumor which arises from hepatic mesenchymal tissue. It consists of angiosarcoma, undifferentiated (embryonal) sarcoma, leiomyosarcoma, and epithelioid hemangioendothelioma.

Research motivation

Due to it’s rarity and various prognosis, the treatment plan of primary hepatic sarcoma is not established yet.

Research objectives

We aim to analyze the tumor characteristics, treatment and prognosis of the primary hepatic sarcoma cases which was surgically resected in a single center.

Research methods

After exclusion of cases with open and closure, early loss to follow-up and sarcomatoid tumors, total nine cases of primary hepatic sarcoma were surgically resected from August 2001 to September 2016. The research data collection and analysis were achieved with retrospective approach. Baseline patient’s characteristics, tumor characteristics and treatment modality with tumor recurrence and patient’s survival were analyzed. The analysis was done separately according to tumor pathologic type.

Research results

Among five angiosarcoma and four undifferentiated sarcoma patients, only two patients survived and all patients experienced tumor recurrences (5-year survival rate: 29.6%). Follow-up post-operative durations of survived angiosarcoma patient and undifferentiated sarcoma patient were 11 years and 30 mo, respectively. Adjuvant therapy had a positive role on survival gain (P = 0.002). However, this study has a limitation of a retrospective approach and a small case number.

Research conclusions

In spite of known poor prognosis, surgical resection of primary hepatic sarcoma may help extending the life expectancy of patient. Aggressive adjuvant treatment after resection may aid the better outcome.

Research perspectives

Accumulation of primary hepatic sarcoma data followed by finding of specific prognostic factor should be researched. New era of adjuvant therapies, such as immunotherapy for primary hepatic sarcoma is also needed to be developed.