Long-term survival after surgery for primary hepatic sarcoma in adults.
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Long-term survival after surgery for primary hepatic sarcoma in adults. / Matthaei, Hanno; Krieg, Andreas; Schmelzle, Moritz; Boelke, Edwin; Poremba, Christopher; Rogiers, Xavier; Knoefel, Wolfram Trudo; Peiper, Matthias.
in: ARCH SURG-CHICAGO, Jahrgang 144, Nr. 4, 4, 2009, S. 339-344.Publikationen: SCORING: Beitrag in Fachzeitschrift/Zeitung › SCORING: Zeitschriftenaufsatz › Forschung › Begutachtung
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TY - JOUR
T1 - Long-term survival after surgery for primary hepatic sarcoma in adults.
AU - Matthaei, Hanno
AU - Krieg, Andreas
AU - Schmelzle, Moritz
AU - Boelke, Edwin
AU - Poremba, Christopher
AU - Rogiers, Xavier
AU - Knoefel, Wolfram Trudo
AU - Peiper, Matthias
PY - 2009
Y1 - 2009
N2 - HYPOTHESIS: Patients with primary hepatic sarcomas benefit from resection, with possible long-term cure. DESIGN: Retrospective and prospective cohort study. SETTING: University hospitals of Hamburg-Eppendorf and Düsseldorf, Germany. PATIENTS: Between 1985 and 2006, 22 patients (8 men and 14 women; median age at initial diagnosis, 54 years [range, 19-80 years]) were surgically treated for primary hepatic sarcomas. INTERVENTION: Tumor resection with curative intent ranging from nonanatomical resection to liver transplant. MAIN OUTCOME MEASURES: Effects on overall survival were analyzed using the log-rank test. RESULTS: The majority of tumors were more than 5 cm (n = 19), with a median tumor size of 7 cm (range, 4-14 cm); of intermediate differentiation (G2; n = 15); and classified as leiomyosarcoma (n = 7). Ten patients received a hemihepatectomy. In 4 patients, a bisegmentectomy was performed and in 2 patients, a segmentectomy, while 4 patients received a nonanatomical resection. Liver transplant was performed in 2 patients. In 18 patients, complete tumor resection (R0) was achieved. Perioperative mortality was 0%. Median follow-up was 88 months (range, 6-246 months). Local recurrence occurred in 6 patients. Distant metastases were diagnosed in 10 patients, predominantly in the lung (n = 6). The 5-year survival after surgery was 65%, with 41% of the patients living more than 10 years without disease. Patients with angiosarcoma had a poor prognosis (P = .03). CONCLUSIONS: Although primary hepatic sarcoma is a rare malignant tumor, no standard treatment is established. A long-term survival is possible after complete tumor resection in a preselected population with early-stage disease.
AB - HYPOTHESIS: Patients with primary hepatic sarcomas benefit from resection, with possible long-term cure. DESIGN: Retrospective and prospective cohort study. SETTING: University hospitals of Hamburg-Eppendorf and Düsseldorf, Germany. PATIENTS: Between 1985 and 2006, 22 patients (8 men and 14 women; median age at initial diagnosis, 54 years [range, 19-80 years]) were surgically treated for primary hepatic sarcomas. INTERVENTION: Tumor resection with curative intent ranging from nonanatomical resection to liver transplant. MAIN OUTCOME MEASURES: Effects on overall survival were analyzed using the log-rank test. RESULTS: The majority of tumors were more than 5 cm (n = 19), with a median tumor size of 7 cm (range, 4-14 cm); of intermediate differentiation (G2; n = 15); and classified as leiomyosarcoma (n = 7). Ten patients received a hemihepatectomy. In 4 patients, a bisegmentectomy was performed and in 2 patients, a segmentectomy, while 4 patients received a nonanatomical resection. Liver transplant was performed in 2 patients. In 18 patients, complete tumor resection (R0) was achieved. Perioperative mortality was 0%. Median follow-up was 88 months (range, 6-246 months). Local recurrence occurred in 6 patients. Distant metastases were diagnosed in 10 patients, predominantly in the lung (n = 6). The 5-year survival after surgery was 65%, with 41% of the patients living more than 10 years without disease. Patients with angiosarcoma had a poor prognosis (P = .03). CONCLUSIONS: Although primary hepatic sarcoma is a rare malignant tumor, no standard treatment is established. A long-term survival is possible after complete tumor resection in a preselected population with early-stage disease.
KW - Adult
KW - Humans
KW - Male
KW - Aged
KW - Female
KW - Middle Aged
KW - Aged, 80 and over
KW - Young Adult
KW - Survival Rate
KW - Disease-Free Survival
KW - Neoplasm Recurrence, Local
KW - Chemotherapy, Adjuvant
KW - Hemangiosarcoma mortality
KW - Liver Neoplasms diagnosis
KW - Sarcoma diagnosis
KW - Adult
KW - Humans
KW - Male
KW - Aged
KW - Female
KW - Middle Aged
KW - Aged, 80 and over
KW - Young Adult
KW - Survival Rate
KW - Disease-Free Survival
KW - Neoplasm Recurrence, Local
KW - Chemotherapy, Adjuvant
KW - Hemangiosarcoma mortality
KW - Liver Neoplasms diagnosis
KW - Sarcoma diagnosis
M3 - SCORING: Zeitschriftenaufsatz
VL - 144
SP - 339
EP - 344
IS - 4
M1 - 4
ER -
