Published online May 27, 2021. doi: 10.4254/wjh.v13.i5.584
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 malignant tumor which arises from hepatic mesenchymal tissue. It consists of angiosarcoma, undifferentiated (embryonal) sarcoma, leiomyosarcoma, and epithelioid hemangioendothelioma.
Due to it’s rarity and various prognosis, the treatment plan of primary hepatic sarcoma is not established yet.
We aim to analyze the tumor characteristics, treatment and prognosis of the primary hepatic sarcoma cases which was surgically resected in a single center.
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.
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.
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.
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.