title: Experiences with surgically treated primary or secondary hepatic sarcoma.
abstract: OBJECTIVE
  Liver resection in hepatic sarcoma is rare, but other alternative treatment options are scarce. Surgery offers the only aggressive approach to achieve a tumour-free state. The aim of this investigation was to evaluate the outcome and survival of these patients at a single hepato-biliary university hospital.
  
  
  METHODS
  Between January 2004 and July 2013, 896 anatomical liver resections were performed. Eleven liver resections (1.2%) were performed due to primary hepatic sarcoma or hepatic sarcoma metastases. The demographic and clinical parameters were collected from the institutional patients' records.
  
  
  RESULTS
  In eight patients (83%), liver resection was performed due to hepatic sarcoma metastases. The surgical procedures were as follows: two patients (18%) had segmentectomy, six patients (55%) had hemihepatectomy or extended hemihepatectomy and three patients (27%) had multivisceral resections. In nine patients (82%), the resection margins were tumour free. In 55% (n = 6) of the patients, the maximal tumour diameter was greater than 10 cm. The postoperative morbidity was low with a Clavien-Dindo score of 2 (range 0-5). One patient died on postoperative day 2 after multivisceral resection. During the follow-up of 932 days (range 2-2.220 days) the 1-, 2- and 3-year survival rates were 91, 63 and 45%, respectively. Tumour recurrence was detected in seven patients (63%).
  
  
  CONCLUSIONS
  Liver resections in patients with primary or secondary hepatic sarcoma are rare. The main goal in these patients is to achieve complete tumour resection because chemotherapy offers no suitable alternative, but the long-term survival rates are limited because of high a recurrence rate even after aggressive surgical approaches.
authors.affiliation: Department of General, Visceral and Vascular Surgery, Jena University Hospital, Am Klinikum 1, 07747, Jena, Germany. rene.fahrner@med.uni-jena.de.
authors.forename: René
authors.initials: R
authors.lastname: Fahrner
authors.affiliation: Department of General, Visceral and Vascular Surgery, Jena University Hospital, Am Klinikum 1, 07747, Jena, Germany.
authors.forename: Sandra G C
authors.initials: SGC
authors.lastname: Dennler
authors.affiliation: Department of General, Visceral and Vascular Surgery, Jena University Hospital, Am Klinikum 1, 07747, Jena, Germany.
authors.forename: Felix
authors.initials: F
authors.lastname: Dondorf
authors.affiliation: Department of General, Visceral and Vascular Surgery, Jena University Hospital, Am Klinikum 1, 07747, Jena, Germany.
authors.forename: Michael
authors.initials: M
authors.lastname: Ardelt
authors.affiliation: Department of General, Visceral and Vascular Surgery, Jena University Hospital, Am Klinikum 1, 07747, Jena, Germany.
authors.forename: Falk
authors.initials: F
authors.lastname: Rauchfuss
authors.affiliation: Department of General, Visceral and Vascular Surgery, Jena University Hospital, Am Klinikum 1, 07747, Jena, Germany.
authors.forename: Utz
authors.initials: U
authors.lastname: Settmacher
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012509:Sarcoma / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D015996:Survival Rate; D016896:Treatment Outcome
keywords: Liver resection; Metastases; Outcome; Sarcoma