Long-term survival after surgery for primary hepatic sarcoma in adults.
OBJECTIVE
Patients with primary hepatic sarcomas benefit from resection, with possible long-term cure.


METHODS
Retrospective and prospective cohort study.


METHODS
University hospitals of Hamburg-Eppendorf and Düsseldorf, Germany.


METHODS
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.


METHODS
Tumor resection with curative intent ranging from nonanatomical resection to liver transplant.


METHODS
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.
Matthaei
Hanno
H
Klinik für Allgemein-, Viszeral-, und Kinderchirurgie, Universitätsklinikum Düsseldorf, Düsseldorf, Germany.
Krieg
Andreas
A
Schmelzle
Moritz
M
Boelke
Edwin
E
Poremba
Christopher
C
Rogiers
Xavier
X
Knoefel
Wolfram Trudo
WT
Peiper
Matthias
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017024:Chemotherapy, Adjuvant; D018572:Disease-Free Survival; D005260:Female; D006394:Hemangiosarcoma / Q000401:mortality / Q000601:surgery; D006801:Humans; D008113:Liver Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D012509:Sarcoma / Q000175:diagnosis / Q000401:mortality / Q000556:secondary / Q000601:surgery*; D015996:Survival Rate; D055815:Young Adult