A pooled analysis of treatment and prognosis of hepatic angiosarcoma in adults

Li, Debang; Si, Xiaoying; Wan, Tao; Zhou, Yanming

doi:10.1016/j.hbpd.2018.04.005

Cited by 22 publications

(26 citation statements)

References 64 publications

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“…All patients invariably died after a median of six/seven months due to tumour recurrence. Similar results have been shown in and outside the transplant setting (61,(68)(69)(70)(71)(72)(73)(74). Both European and American experiences confirm that HHS is an absolute contra-indication to LT (11,72).…”

Section: Hhssupporting

confidence: 77%

“…HHS occurs most in the sixth and seventh decades of life and more frequently in males (male-to-female ratio: 3/1). It is rarely seen in children (42,(61)(62)(63). HHS received much attention due to the association with many environmental carcinogens (Thorotrast, vinyl chloride monomer, radium, pesticides, external radiation, cyclophosphamide, arsenical compounds, use of androgenic/anabolic steroids and iron) (9,23,39,40).…”

Section: Hhsmentioning

confidence: 99%

“…Signs of portal hypertension and liver failure are often present. Hepatosplenomegaly, thrombocytopenia, pain, jaundice, ascites, peripheral oedema, acute abdomen, due to the rather frequent tumour rupture, can all be present (11,61).…”

Section: Hhsmentioning

confidence: 99%

“…Similar to HEHE, the search for effective medical therapy, based on the expression of different angiogenic growth factors receptors and other vascular-targeted agents, is a priority in order to improve the outcome of this very aggressive disease. Different drug combinations and immunotherapy using anti-PD1, occasionally combined with classic chemotherapies, have been used with sporadic (partial) response (61,76,77).…”

Section: Hhsmentioning

confidence: 99%

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Vascular tumours of the liver: a particular story

Lerut

Iesari

2018

Transl. Gastroenterol. Hepatol

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Vascular tumours of the liver represent an underrated chapter of medical and surgical hepatology. These tumours cover a wide spectrum ranging from the frequent and most benign hepatic haemangioma (HH), via the rare and intermediately aggressive hepatic epithelioid haemangioendothelioma (HEHE) to the rare and most malignant hepatic haemangiosarcoma (HHS). In contrast to the treatment algorithms for hepatocellular and cholangiocellular cancer, the diagnostic and therapeutic approaches to HEHE and HHS are not well developed. The related uncertainty is explained by their rare occurrence and their protean clinical, morphological (imaging) and histopathological presentation and behaviour. This article gives an update about these particular tumours based on the analysis of the recent literature and of the studies on vascular tumours published by the European Liver Intestine Transplantation Association (ELITA)-European Liver Transplant Registry (ELTR). It focuses also on the place of liver transplantation (LT) in the respective therapeutic algorithms. The differential diagnosis between these vascular and other tumour types may be very difficult. Correct diagnosis is of utmost importance and is based on a high index of clinical suspicion and on the integration of clinical, radiological, histological [including immunohistochemistry (IHC) and molecular biology findings]. Surgery, be it partial or total hepatectomy (LT), should be proposed whenever possible, because it is the therapeutic mainstay. In HEHE, LT provides excellent results, with long-term diseasefree survivals (DFS) reaching 75%. Good results can be obtained even in case of (frequent) extrahepatic spread. Based on the extensive ELITA-ELTR study a HEHE-LT prognostic score has been proposed in order to estimate the risk of recurrence after LT. In contrast, results of surgery and LT are extremely poor for HHS, for the almost invariably rapid recurrence (within 6 months) and related death within 2 years. LT remains a contraindication for HHS. Due to the still important recurrence rate after surgical resection (25% in HEHE and almost 100% in HHS), there is an urgent need to develop pharmacological treatments targeting angiogenic and non-VEGF angiogenic pathways. To date, some prospective pilot studies and case reports have shown some short-term stabilisation of the disease in small groups of patients. In order to make progress, combination of surgery, anti-angiogenic and immunotherapy seems worthwhile. To complete the panel of vascular liver tumours, infantile haemangioendothelioma, haemangiopericytoma, nodular regenerative hyperplasia (NRH) and hepatic small vessel neoplasms (HSVN) are also discussed.

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Section: Hhssupporting

confidence: 77%

Section: Hhsmentioning

confidence: 99%

Section: Hhsmentioning

confidence: 99%

Section: Hhsmentioning

confidence: 99%

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Vascular tumours of the liver: a particular story

Lerut

Iesari

2018

Transl. Gastroenterol. Hepatol

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“…Two earlier studies reported that larger tumor size does not impair OS of AS [ 3 , 20 ]. In contrast, a pooled analysis incorporating 75 articles involving 186 patients suggested that tumor size (< 10 cm) was the only significant favorable factor for OS of hepatic AS in adults [ 28 ]. Several other documents presented tumor size was a critical predictor [ 7 , 10 , 18 , 26 , 29 ].…”

Section: Discussionmentioning

confidence: 99%

Survival predictors of metastatic angiosarcomas: a surveillance, epidemiology, and end results program population-based retrospective study

Ren

Wang

et al. 2020

BMC Cancer

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Background Angiosarcomas (AS) have poor prognosis and often metastasize to distant sites. The potential predictors of metastatic angiosarcomas (MAS) have not been extensively investigated. The main objective of this study was to identify survival predictors of MAS. Methods Surveillance, Epidemiology, and End Results (SEER) datasets were used to identify patients with MAS from 2010 to 2016. Risk predictors were determined with the aid of Kaplan-Meier and Cox regression model analyses. Results A total of 284 MAS patients met the study entry criteria. Among these, 121 patients (42.6%) were diagnosed with metastasis in bone, 26 in brain (9.2%), 86 in liver (30.3%) and 171 in lung (60.2%). Overall, 96 patients (33.8%) had two or more metastatic sites. The 1- and 3-year overall survival (OS) rates were 20.8 and 3.8% while 1- and 3-year cancer-specific survival (CSS) rates were 22.0 and 5.2%, respectively. Cox regression analysis revealed chemotherapy, radiation treatment (RT) and tumor size ≤10 cm as independent favorable predictors of OS. In terms of CSS, tumor grade IV, tumor size > 10 cm and absence of chemotherapy were independent adverse predictors. Surgery did not prolong survival outcomes (both OS and CSS) in the current cohort. Conclusion MAS is associated with extremely poor survival. Chemotherapy, RT, and tumor size are independent predictors of OS. Chemotherapy and tumor size are independent prognostic factors of CSS. Chemotherapy is therefore recommended as the preferred treatment option for MAS patients.

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Clinical characteristics, imaging features, and outcomes of primary hepatic angiosarcoma: A single‐center study and literature review

Wu,

Kuo,

Sun

et al. 2024

Adv in Digestive Medicine

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Primary hepatic angiosarcoma (PHA) accounts for 0.5% to 2% of all primary hepatic malignancies, and histopathology findings are required to diagnose PHA accurately. This study investigated 12 patients with PHA at a single medical center in southern Taiwan. We analyzed the clinical characteristics, imaging features, histopathology findings, and survival outcomes of patients with PHA. Of the 12 patients, abdominal pain and fullness were the most common symptoms, and their liver biochemistry data and tumor markers were mostly within the normal limits. The liver tumors tended to present as multifocal or diffuse nodules with bilobar involvement. The median overall survival (OS) of the 12 patients after diagnosis was 9 months. Improved OS was observed in the surgery group compared with the nonsurgery group (15 vs. 2 months, p = .003). The median OS of patients in the surgery ± systemic therapy group was superior to that of patients in the systemic therapy group and in the no‐therapy groups (15 vs. 5 vs. 2 months, respectively; p = .012). Complete surgical resection remains the optimal treatment choice, and combined surgery and systemic therapy seem beneficial but require further investigation.

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A pooled analysis of treatment and prognosis of hepatic angiosarcoma in adults

Cited by 22 publications

References 64 publications

Vascular tumours of the liver: a particular story

Vascular tumours of the liver: a particular story

Survival predictors of metastatic angiosarcomas: a surveillance, epidemiology, and end results program population-based retrospective study

Clinical characteristics, imaging features, and outcomes of primary hepatic angiosarcoma: A single‐center study and literature review

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