Surgical therapy of primary hepatic angiosarcoma

Tripke, Verena; Heinrich, Stefan; Huber, Tobias; Mittler, Jens; Hoppe‐Lotichius, Maria; Straub, Beate K.; Lang, Hauke

doi:10.1186/s12893-018-0465-5

Cited by 32 publications

(28 citation statements)

References 23 publications

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“…31 Currently, radical surgical resection is considered the treatment of choice for primary hepatic angiosarcoma in humans. 40 In one study of 9 patients who underwent hepatic resection for primary hepatic angiosarcoma, median overall survival and disease-free survival were 59 and 11 mo, respectively. 40 However, the tumors in all 9 patients were histologic grade II, meaning that a patient who had metastases similar to the animal we described here (that is, grade III) would be a poor candidate for surgical resection.…”

Section: Discussionmentioning

confidence: 99%

“…40 In one study of 9 patients who underwent hepatic resection for primary hepatic angiosarcoma, median overall survival and disease-free survival were 59 and 11 mo, respectively. 40 However, the tumors in all 9 patients were histologic grade II, meaning that a patient who had metastases similar to the animal we described here (that is, grade III) would be a poor candidate for surgical resection. For advanced disease, chemotherapy currently offers minimal benefit in terms of survival time, with a few exceptions.…”

Section: Discussionmentioning

confidence: 99%

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Hepatic Hemangiosarcoma in a Cynomolgus Macaque (Macaca fascicularis)

et al. 2019

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An experimentally naïve, 9-y-old intact male cynomolgus macaque (Macaca fascicularis) was reported by the animal care staff for bleeding from an unknown origin. Cage-side assessment revealed that the patient had lost 5 to 10 mL of blood, which was pooled on the floor of the primary enclosure. He exhibited no visible outward signs of injury and was singly housed at the time. The macaque was sedated with ketamine (4 mg/kg IM) and dexmedetomidine (0.05 mg/kg IM) for examination and further diagnostics.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Hepatic Hemangiosarcoma in a Cynomolgus Macaque (Macaca fascicularis)

et al. 2019

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“…Another study in which 6 patients received transcatheter arterial chemoembolization or transcatheter arterial embolization alone for hepatic angiosarcoma resulted in all patients expiring within 1 year[ 11 ]. A recent study of 8 patients with R0-resected hepatic angiosarcoma showed median survival and disease-free survival of 59 and 11 mo which emphasizes the radical surgical resection is best approach for long-term survival[ 12 ].…”

Section: Discussionmentioning

confidence: 99%

Surgical treatment outcomes of primary hepatic sarcomas: A single-center experience

Kim

Rhu

Kim

et al. 2021

WJH

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BACKGROUND 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. AIM To investigate the surgical outcomes of primary hepatic sarcoma, we gathered and analyzed the cases of a single institute. METHODS 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. RESULTS 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). CONCLUSION Patients with primary hepatic sarcoma may gain survival benefit with surgical resection followed by adjuvant therapy, even though the outcome remains relatively poor.

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“…There did not appear to be a standard surgical approach, with similar proportions of wedge resection (33%), lobectomy (29%), and transplantation (29%) in patients with angiosarcoma and wedge resection (39%) or transplantation (39%) in patients with EHE. The extent of resection performed varies in the literature, but a report from Tripke et al advocates for anatomical hemihepatectomy or radical hepatectomy for curative intent in angiosarcoma 27 . Their report also stressed the importance of R0 resection, as the nine patients that achieved this result had a median overall survival of 59 months.…”

Section: Discussionmentioning

confidence: 99%

“…a Percentages are calculated per category, as not all patients had data for each category.F I G U R E 1Overall survival for pediatric and adult patients with hepatic vascular malignancies (P < .001)F I G U R E 2Overall survival for all patients with ([2-40], P = .09). Finally, there was a significantly longer mean overall survival (95% CI) for angiosarcoma tumors <10 cm versus ≥10 cm (23 months[16][17][18][19][20][21][22][23][24][25][26][27][28][29][30] vs 12 months[5][6][7][8][9][10][11][12][13][14][15][16][17][18][19], P = .001).The mean overall survival (95% CI) for all patients with EHE was 98 months (87-109). Similar to angiosarcoma, survivorship for patients with EHE improved if surgical resection was performed (122 months F I G U R E 3 Overall survival of all patients with (A) angiosarcoma and (B) malignant epithelioid hemangioendothelioma who received surgical treatment alone versus surgical and chemotherapeutic treatment versus chemotherapeutic treatment alone (P < .0001)[107-136]), and was worse if resection was not performed (…”

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confidence: 99%

Hepatic vascular malignancies in children are associated with increased rates of surgical resection and improved overall survival compared with adults

Commander

Cerullo

Leraas

et al. 2021

Pediatric Blood & Cancer

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Background Hepatic vascular malignancies (HVMs) are rare malignancies, with no standardized treatment regimens. The most common HVMs, angiosarcoma and malignant epithelioid hemangioendothelioma (EHE), are often grouped together in the literature complicating our ability to achieve reliable survival data and treatment strategies. Objective To compare the disease characteristics of HVMs, with a subanalysis on pediatric patients. Methods The 2016 National Cancer Database was queried for patients with HVMs using international classification of diseases‐oncology‐3 (ICD‐O‐3) codes yielding 699 patients. Descriptive statistics, chi‐square, Kaplan‐Meier, and log‐rank analyses were performed. Results We found 478 patients (68%) with angiosarcoma and 221 (32%) with EHE. The median (Q1, Q3) age for angiosarcoma patients was 65 years (56, 75) versus 54 years (37, 65) in EHE patients (P < .001). The rate of resection was lower in patients with angiosarcoma than EHE (13% vs 32%, P < .001). The mean 1‐, 3‐, and 5‐year overall survival for angiosarcoma patients was 17%, 8%, and 6%, respectively, versus 80%, 65%, and 62% in EHE patients (P < .0001). A subgroup analysis was performed on pediatric patients demonstrating six with angiosarcoma and 10 with EHE. The mean 1‐, 3‐, and 5‐year overall survival for pediatric angiosarcoma patients was 67%, 50%, and 50%, respectively, and 90%, 90%, and 90% for pediatric EHE patients. Conclusion In the largest study of HVMs to date, we found angiosarcoma has significantly worse overall survival than EHE. Pediatric patients appear to have improved survival and higher rates of resection. Larger studies of HVMs are needed to clearly differentiate tumor types, standardize care, and improve survivorship.

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Surgical therapy of primary hepatic angiosarcoma

Cited by 32 publications

References 23 publications

Hepatic Hemangiosarcoma in a Cynomolgus Macaque (Macaca fascicularis)

Hepatic Hemangiosarcoma in a Cynomolgus Macaque (Macaca fascicularis)

Surgical treatment outcomes of primary hepatic sarcomas: A single-center experience

Hepatic vascular malignancies in children are associated with increased rates of surgical resection and improved overall survival compared with adults

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