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Rojas S, Rey Chaves CE, Robledo S, Conde D, Sabogal Olarte JC. Primary hepatic angiosarcoma: a systematic review. Ann Med Surg (Lond) 2024; 86:1601-1605. [PMID: 38463049 PMCID: PMC10923304 DOI: 10.1097/ms9.0000000000001584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Accepted: 11/24/2023] [Indexed: 03/12/2024] Open
Abstract
Background Hepatic angiosarcoma is a rare type of tumour. In adults, the diagnosis remains challenging as the clinical manifestations are generally nonspecific and are usually made too late when complications or metastases are already present, associated with a poor prognosis. Due to the lack of agreement regarding the optimal treatment approach, a comprehensive analysis of the evidence in the literature on the surgical and survival outcomes in terms of disease-free survival time (DFS) and overall survival (OS) for patients treated for primary hepatic angiosarcoma is needed. Study design A systematic review of articles published in Pubmed, EMBASE, and Scopus, from 2000 to 2023 with the search terms hepatic angiosarcoma and liver resection or hepatectomy. Pooled individual data concerning the prognosis following various therapies was analyzed. Results A total of 15 articles involving 886 patients were eligible for inclusion. The male population represents 66.2% (n=586) of the population, with a median age of 57 years (41-66). The median survival rate was 7 months. The median OS after surgical resection was 17.18 months (SD 12.6) vs. 3.72 months (SD 4.6) for patients treated without a surgical approach. The median DFS was 15.2 months (SD 11). Conclusion Primary liver angiosarcoma remains a surgical challenge with a poor prognosis even with complete surgical resection and adjuvant therapy. Surgical management shows increased overall survival in comparison with non-surgical management. Early diagnosis could change the natural history of the disease. The literature available is scarce, and further studies are required to create standardized diagnostic and treatment protocols.
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Affiliation(s)
| | | | - Sofía Robledo
- Estudiante de pregrado, Pontificia Universidad Javeriana, Facultad de Medicina
| | - Danny Conde
- Cirugia Hepatobiliar y pancreática, Hospital Universitario Mayor Méderi, Universidad el Rosario
| | - Juan Carlos Sabogal Olarte
- Cirugía Hepatobiliar y páncreatica, Pontificia Universidad Javeriana, Facultad de Medicina, Hospital Universitario San Ignacio, Bogotá, Colombia
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Sergi CM. Pediatric Hepatic Angiosarcoma (PHAS) and Vinyl Chloride-A Ghost of the Past May Loom over East Palestine, OH, and beyond: A Critical Commentary. Diagnostics (Basel) 2023; 13:diagnostics13081412. [PMID: 37189513 DOI: 10.3390/diagnostics13081412] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2023] [Revised: 04/03/2023] [Accepted: 04/10/2023] [Indexed: 05/17/2023] Open
Abstract
Road accidents are not infrequent everywhere in the world, but when they involve poisonous and dangerous chemical compounds, they represent a hazard and an issue for public health. In this commentary, we briefly review a recent East Palestine event and one of the chemicals primarily involved with a predisposition to initiate a carcinogenetic process. The author reviewed, as a consultant, numerous chemical compounds for the International Agency for Research on Cancer, a trusted agency of the World Health Organization. Something is looming over the territories of East Palestine, Ohio, United States, draining water from the soil. We speculate that there is a dark and opprobrious fate for this area of the United States due to the potential increase in cases of pediatric hepatic angiosarcoma, which will also be revised in this commentary.
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Affiliation(s)
- Consolato M Sergi
- Anatomic Pathology Division, Children's Hospital of Eastern Ontario (CHEO), University of Ottawa, 401 Smyth Road, Ottawa, ON K1H 8L1, Canada
- Department of Laboratory Medicine and Pathology, University of Alberta, 8440 112 St., Edmonton, AB T6G 2B7, Canada
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Wang J, Sun LT. Primary hepatic angiosarcoma: A case report. World J Clin Cases 2022; 10:11590-11596. [PMID: 36387808 PMCID: PMC9649549 DOI: 10.12998/wjcc.v10.i31.11590] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Revised: 08/17/2022] [Accepted: 09/23/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Primary hepatic angiosarcoma (PHA) is a rare malignant tumor of the vascular endothelium. Clinical manifestations and laboratory and imaging examinations often lack specificity for PHA. We report a case of PHA, and describe the ultrasound characteristics and characteristic changes in laboratory values associated with PHA.
CASE SUMMARY A 75-year-old woman presented with right upper quadrant abdominal pain for half a month. Magnetic resonance imaging (MRI) at a local hospital revealed multiple liver space-occupying lesions, and she was admitted to our hospital for further diagnosis. Contrast-enhanced ultrasound (CEUS) revealed multiple slightly hyperechoic nodules in the liver, which were suspected to be of malignant vascular origin. Contrast-enhanced computed tomography revealed multiple low-density nodules in the liver, considered to be metastatic hematopoietic malignancies. Contrast-enhanced MRI showed that the multiple liver nodules shared features with infectious lesions. Laboratory examination revealed normal alpha-fetoprotein levels, slightly increased other liver enzymes, decreased platelets, and significantly increased D-dimer levels. Liver biopsy and histopathology confirmed the presence of PHA.
CONCLUSION CEUS can provide valuable clues for the diagnosis of PHA and greatly improve the success rate of puncture biopsy.
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Affiliation(s)
- Jian Wang
- Cancer Center, Department of Ultrasound Medicine, Zhejiang Provincial People’s Hospital, Affiliated People’s Hospital, Hangzhou Medical College, Hangzhou 310014, Zhejiang Province, China
| | - Li-Tao Sun
- Cancer Center, Department of Ultrasound Medicine, Zhejiang Provincial People’s Hospital, Affiliated People’s Hospital, Hangzhou Medical College, Hangzhou 310014, Zhejiang Province, China
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Treatment Outcomes for Primary Hepatic Angiosarcoma: National Cancer Database Analysis 2004-2014. Curr Oncol 2022; 29:3637-3646. [PMID: 35621682 PMCID: PMC9139369 DOI: 10.3390/curroncol29050292] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2022] [Revised: 05/13/2022] [Accepted: 05/16/2022] [Indexed: 11/16/2022] Open
Abstract
Background: To determine the risk of mortality and factors associated with survival amongst patients diagnosed with primary hepatic angiosarcoma (PHA). Methods: All patients diagnosed with hepatocellular carcinoma (HCC) or PHA from 2004 to 2014 were identified from the National Cancer Database (NCDB). Further analysis was performed within the cohort of patients with PHA to assess the impact of surgery, chemotherapy, radiation, and facility type on overall survival (OS). A multivariable analysis using the Cox proportional methods and a survival analysis using the Kaplan−Meier method were used. Results: A total of 117,633 patients with HCC were identified, out of whom 346 patients had PHA. Patients with PHA had a mean age of 62.9 years (SD 13.7), the majority were men (64.7%), white (85.8%), and had a Charlson comorbidity index (CCI) of zero (66.2%). A third of the patients with PHA (35.7%) received chemotherapy, and 14.6% underwent a surgical resection. The median survival was 1.9 months (1.8−2.4 months) compared to patients with HCC (10.4 months, 10.2−10.5) (aHR-2.41, 95% CI: 2.10−2.77, p < 0.0001). Surgical resection was associated with a higher median survival (7.7 versus 1.8 months, aHR-0.23, 95% CI: 0.15−0.37, p < 0.0001). A receipt of chemotherapy was associated with a higher median survival than no chemotherapy (5.1 versus 1.2 months, aHR-0.44, 95% CI: 0.32−0.60, p < 0.0001), although the survival benefit did not persist long term. Conclusion: PHA is associated with poor outcomes. A surgical resection and chemotherapy are associated with improved survival outcomes; however, the long-term benefits of chemotherapy are limited.
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Strainienė S, Jauniškis K, Savlan I, Pamedys J, Stundienė I, Liakina V, Valantinas J. Paraneoplastic Phenomena of Disseminated Intravascular Coagulopathy in Hepatic Angiosarcoma – Rare, Challenging and Fatal. Case Report and Literature Review. Acta Med Litu 2021; 28:330-343. [PMID: 35474934 PMCID: PMC8958659 DOI: 10.15388/amed.2021.28.2.1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Revised: 05/18/2021] [Accepted: 05/25/2021] [Indexed: 12/18/2022] Open
Abstract
Background. Hepatic angiosarcoma is an uncommon, malignant, primary liver tumor, comprising 2% of liver cancers and accounting for < 1% of all sarcomas. Patients usually present with nonspecific symptoms, such as fatigue, weight loss, right upper quadrant pain, anemia, which leads to late diagnosis of an advanced stage tumor. The median life expectancy after the diagnosis of hepatic angiosarcoma is about 6 months, with only 3% of patients surviving more than 2 years. Liver failure and hemoperitoneum are the leading causes of death in patients with liver angiosarcoma. In rarer cases, it might cause paraneoplastic syndromes such as disseminated intravascular coagulopathy. The treatment of angiosarcomas is complicated as there are no established and effective treatment guidelines due to the tumor’s low frequency and aggressive nature. Case summary. We present the case of a 68-year old woman who was admitted to the hospital due to fatigue and severe anemia (hemoglobin 65 g/l). Laboratory results also revealed high-grade thrombocytopenia (8 × 109/l). The abdominal ultrasound and computed tomography scan showed multiple lesions throughout the liver, spleen and kidneys. After the histological examination of the liver biopsy, the patient was diagnosed with hepatic angiosarcoma. The treatment with first-line chemotherapy (doxorubicin) was initiated despite ongoing paraneoplastic syndrome – disseminative intravascular coagulopathy. However, the disease was terminal, and the patient died 2 months since diagnosed. Conclusions. Hepatic angiosarcoma is a rare and terminal tumor. Therefore, knowledge about its manifestations and effective treatment methods is lacking. Disseminative intravascular coagulopathy is a unique clinical characteristic of angiosarcoma seen in a subset of patients.
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Zeng D, Cheng J, Gong Z, Chen J, Long H, Zhu B. A pooled analysis of primary hepatic angiosarcoma. Jpn J Clin Oncol 2020; 50:556-567. [PMID: 32083280 DOI: 10.1093/jjco/hyaa017] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Accepted: 01/27/2020] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Angiosarcoma is an aggressive and malignant neoplasm. Primary hepatic angiosarcoma is extremely rare and accounts for only approximately 5% of all angiosarcomas. Therefore, many doctors do not know enough about this disease; this lack of knowledge motivated us to perform this study. METHODS We carried out a systematic review of the literature published worldwide from 1990 to 2019 to study the main characteristics, demographics, treatment and prognosis of primary hepatic angiosarcoma. RESULT A total of 219 patients were included in this study. Patients were mainly middle-aged and elderly at diagnosis, with an average age at onset of 56.7 years. The vast majority of patients (61.5%) presented with abdominal pain or distension. Of 143 patients with clear records of metastasis, 31.5% (45 patients) had distant metastasis. The median overall survival time was only 6 months, and the 1- and 2-year survival rates were 30.4 and 17.3%, respectively. Sex, age, tumor size and metastasis at diagnosis showed no correlation with survival rate. Hepatic rupture was a significant predictor of survival. Surgery is a major treatment choice, and adjuvant chemotherapy can improve the prognosis of patients. Hepatic artery embolization is mainly used in cases of tumor rupture. However, liver transplantation is not advised. CONCLUSION We presented an overview of the demographics, tumor characteristics and treatment outcomes of the largest number of primary hepatic angiosarcoma patients investigated to date. We highlight the use of routine physical examinations and surgery combined with adjuvant chemotherapy to improve the outcomes in these cases.
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Affiliation(s)
- Dong Zeng
- Institute of Cancer, Xinqiao Hospital, Third Military Medical University, Chongqing 400037, P.R. China
| | - Jianan Cheng
- Institute of Cancer, Xinqiao Hospital, Third Military Medical University, Chongqing 400037, P.R. China
| | - Zhihua Gong
- Institute of Cancer, Xinqiao Hospital, Third Military Medical University, Chongqing 400037, P.R. China
| | - Jianghong Chen
- Department of General Surgery, Xinqiao Hospital, Third Military Medical University, Chongqing 400037, P.R. China
| | - Haixia Long
- Institute of Cancer, Xinqiao Hospital, Third Military Medical University, Chongqing 400037, P.R. China
| | - Bo Zhu
- Institute of Cancer, Xinqiao Hospital, Third Military Medical University, Chongqing 400037, P.R. China
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Yuan WH, Li AFY, Hsu HC, Hu YS, Lee RC. Initial clinical radiological findings and staging to predict prognosis of primary hepatic angiosarcoma: A retrospective analysis. PLoS One 2019; 14:e0225043. [PMID: 31710641 PMCID: PMC6844487 DOI: 10.1371/journal.pone.0225043] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2019] [Accepted: 10/27/2019] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE Primary hepatic angiosarcoma (PHA) is extremely rare and most patients die within 12 months of diagnosis. The object of the study is to determine the association of initial clinical-radiological features and staging with outcomes in patients with PHA. METHODS The medical records of adult patients with PHA were retrieved from an electronic medical record database and a pathology database and retrospectively reviewed. During 10 years, 22 eligible patients were included. Data extracted focused on the information before the first formal treatment with a pathological proof, including demographic characteristics, medical history, laboratory data, preliminary images, histopathological records, treatment, and follow-up survival period. Two radiologists blindly re-analyzed preliminary images of all 22 patients together and recorded tumor features and imaging stage based on the American Joint Committee on Cancer (AJCC) 8th edition tumor-node-metastasis (TNM) Staging System for hepatocellular carcinoma. A radiologist compiled the initial clinical data and preliminary image stage to analyze the association with patients' survival outcome. RESULTS Higher aspartate aminotransferase (AST), higher total bilirubin (TB), lower albumin (ALB), longer prothrombin time (PT) and lower platelet count of serum relative to the normal reference range were more common in patients who survived ≤ 90 days (all P < 0.05). Overall survival was much better in patients with single PHA than in those with other tumor patterns of multiple PHA (all P < 0.05). Overall survival determined by preliminary imaging showed significant differences between stage I and stage III (P = 0.044), stage I and stage IV (P = 0.011), and stage III and IV (P = 0.047). No patients were at stage II. CONCLUSIONS Initial serum levels of ALT, TB, ALB, and PT, platelet count, single mass in liver, and preliminary imaging staging could help predict survival outcomes of patients with PHA.
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Affiliation(s)
- Wei-Hsin Yuan
- Division of Radiology, Taipei Municipal Gan-Dau Hospital (managed by Taipei Veterans General Hospital), Taipei, Taiwan, Republic of China
- School of Medicine, National Yang Ming University, Taipei, Taiwan, Republic of China
- Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan, Republic of China
- * E-mail: , (WHY); (RCL)
| | - Anna Fen-Yau Li
- School of Medicine, National Yang Ming University, Taipei, Taiwan, Republic of China
- Department of Pathology, Taipei Veterans General Hospital, Taipei, Taiwan, Republic of China
| | - Hui-Chen Hsu
- Department of Medical Imaging, Taiwan Adventist Hospital, Taipei, Taiwan, Republic of China
| | - Yong-Sin Hu
- School of Medicine, National Yang Ming University, Taipei, Taiwan, Republic of China
- Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan, Republic of China
| | - Rheun-Chuan Lee
- School of Medicine, National Yang Ming University, Taipei, Taiwan, Republic of China
- Department of Radiology, Taipei Veterans General Hospital, Taipei, Taiwan, Republic of China
- * E-mail: , (WHY); (RCL)
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Cao J, Wang J, He C, Fang M. Angiosarcoma: a review of diagnosis and current treatment. Am J Cancer Res 2019; 9:2303-2313. [PMID: 31815036 PMCID: PMC6895451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2019] [Accepted: 10/03/2019] [Indexed: 06/10/2023] Open
Abstract
Angiosarcoma is a highly malignancy of endothelial tumor and represents 1-2% of all soft tissue sarcomas in humans. The aetiology of angiosarcoma is not clear but there are definite risk factors including chronic lymphoedema, history of radiation, environmental carcinogens and certain familial syndromes. Ultrasound, CT and MR are diagnostic tools, but final diagnosis requires pathological and immunohistochemical confirmation. The conventional options of treatment include surgery, radiotherapy and chemotherapy. Targeted medicines and immunotherapy have been studied as promising treatment of angiosarcoma. The goal of this review is to summarize the current data regarding of angiosarcoma and its clinical presentation and management, providing a useful clinical tool to explore the optimal treatment.
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Affiliation(s)
- Jun Cao
- Department of Comprehensive Medical Oncology, Key Laboratory of Head and Neck Cancer Translational Research of Zhejiang Province, Cancer Hospital of University of Chinese Academy of Sciences, Zhejiang Cancer HospitalHangzhou, Zhejiang, China
| | - Jiale Wang
- Second Clinical Medical College, Zhejiang Chinese Medical UniversityHangzhou, Zhejiang, China
| | - Chiyu He
- Second Clinical Medical College, Zhejiang Chinese Medical UniversityHangzhou, Zhejiang, China
| | - Meiyu Fang
- Department of Comprehensive Medical Oncology, Key Laboratory of Head and Neck Cancer Translational Research of Zhejiang Province, Cancer Hospital of University of Chinese Academy of Sciences, Zhejiang Cancer HospitalHangzhou, Zhejiang, China
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9
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Diethylnitrosamine (DENA) recapitulates formation of hepatic angiosarcoma in pigs. PLoS One 2019; 14:e0214756. [PMID: 31095587 PMCID: PMC6522042 DOI: 10.1371/journal.pone.0214756] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2018] [Accepted: 03/19/2019] [Indexed: 02/06/2023] Open
Abstract
Background & aim Primary hepatic angiosarcoma is a rare tumor with poor prognosis. The aim of this study was to generate a new angiosarcoma model to improve research on hepatic angiosarcoma. Methods Pigs sus scrofa were treated with different regimens of diethylnitrosamine (DENA). Tissues were analyzed by histology and immunohistochemistry. Serum parameters were determined. Angiosarcoma tissue was investigated for chromosomal aberrations by aCGH analysis. Results Animals of almost all different treatment regimens developed a multitude of variable liver lesions. Different tumor types such as granulation tissue type, cellular-like, hyalinization necrosis-like, angiosarcoma-like, dysplastic nodule-like, hepatocellular-like, glandular structure-like, and leiomyoma-like lesions were observed. Weekly treatment with 15 mg/kg for up to 52 weeks or a single shot of 200 mg/kg DENA led to the development of hepatic angiosarcomas. aCGH analysis of angiosarcoma tissue revealed increased alterations in tumors compared to non-tumorous tissue. Most of the chromosomal alterations were found on chromosomes 6, 7, 12, and 14. Conclusion In this preliminary study treatment of sus scrofa with weekly injections of 15 mg/kg DENA results in a new model for primary hepatic angiosarcoma. This model may help to shed light on the pathomechanisms of primary hepatic angiosarcoma and might therefore open new treatment options.
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Bleeding Liver Masses: Imaging Features With Pathologic Correlation and Impact on Management. AJR Am J Roentgenol 2019; 213:8-16. [PMID: 30973778 DOI: 10.2214/ajr.19.21240] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
OBJECTIVE. The purposes of this article are to discuss a variety of liver masses that can present with hemorrhage, including their characteristic imaging features, and to propose a diagnostic approach. CONCLUSION. A broad spectrum of pathologic conditions can present as spontaneous hemorrhage within or surrounding the liver and may present acutely or as a chronic or incidental finding. Imaging characteristics and clinical history can often narrow the differential diagnosis and guide management.
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Tripke V, Heinrich S, Huber T, Mittler J, Hoppe-Lotichius M, Straub BK, Lang H. Surgical therapy of primary hepatic angiosarcoma. BMC Surg 2019; 19:5. [PMID: 30630447 PMCID: PMC6329081 DOI: 10.1186/s12893-018-0465-5] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Accepted: 12/20/2018] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Primary hepatic angiosarcoma (PHA) is a rare tumor entity. Radical surgical resection is currently considered the best treatment choice. The aim of this analysis is to report our experience with surgery for PHA. METHODS All resections of PHA from 01/2002 until 06/2017 were identified from our prospective institutional database. All cases were re-confirmed by a second pathologist. We analyzed completeness of resection, overall (OS) and disease-free survival (DFS). RESULTS Nine patients with PHA underwent hepatic resection. Median follow-up after surgery was 15.5 months (range: 3-144). At last follow-up 4/9 patients were alive, three of them without recurrence 15, 21 and 144 months after surgery. Five patients developed PHA recurrence. Four of these died 3 to 17 months after surgery. One patient with PHA recurrence is alive 15 months after surgery. Another patient without PHA recurrence died 59 months after surgery from pancreatic cancer. Median OS and DFS after resection was 18 months (range: 3-144 months) and 10 months (range: 2-144 months), respectively. After R-0 resection (n = 8), the median OS and DFS was 59 and 11 months. CONCLUSIONS Resection of PHA is the only approach to achieve complete tumor removal and offers a chance for long-term survival and should be evaluated in cases of PHA.
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Affiliation(s)
- Verena Tripke
- Department of General, Visceral and Transplantation Surgery, University Hospital of Mainz, Langenbeckstrasse 1, 55131, Mainz, Germany
| | - Stefan Heinrich
- Department of General, Visceral and Transplantation Surgery, University Hospital of Mainz, Langenbeckstrasse 1, 55131, Mainz, Germany
| | - Tobias Huber
- Department of General, Visceral and Transplantation Surgery, University Hospital of Mainz, Langenbeckstrasse 1, 55131, Mainz, Germany
| | - Jens Mittler
- Department of General, Visceral and Transplantation Surgery, University Hospital of Mainz, Langenbeckstrasse 1, 55131, Mainz, Germany
| | - Maria Hoppe-Lotichius
- Department of General, Visceral and Transplantation Surgery, University Hospital of Mainz, Langenbeckstrasse 1, 55131, Mainz, Germany
| | - Beate K Straub
- Institute of Pathology, University Hospital of Mainz, Mainz, Germany
| | - Hauke Lang
- Department of General, Visceral and Transplantation Surgery, University Hospital of Mainz, Langenbeckstrasse 1, 55131, Mainz, Germany.
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Li DB, Si XY, Wan T, Zhou YM. A pooled analysis of treatment and prognosis of hepatic angiosarcoma in adults. Hepatobiliary Pancreat Dis Int 2018; 17:198-203. [PMID: 29724676 DOI: 10.1016/j.hbpd.2018.04.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2017] [Accepted: 04/09/2018] [Indexed: 02/05/2023]
Abstract
BACKGROUND Hepatic angiosarcoma is a rare malignant vascular tumor presenting unique treatment challenges. The aim of the present study was to determine the treatment and prognosis of this entity. DATA SOURCES A systematic literature search was conducted using PubMed, Embase and Chinese Biomedical Literature database, to identify articles published from January 1980 to July 2017. Search terms were "hepatic angiosarcoma" and "liver angiosarcoma". Additional articles were retrieved through manual search of bibliographies of the relevant articles. Pooled individual data concerning the prognosis following various therapeutic modalities were analyzed. RESULTS A total of 75 articles involving 186 patients were eligible for inclusion. The median overall survival (OS) was 8 months, with 1-, 3-, and 5-year OS rates of 36.6%, 22.3%, and 12.0%, respectively. The median OS after partial hepatectomy (n = 86), chemotherapy (n = 36), liver transplantation (n = 17), and supportive care (n = 46) were 15, 10, 5 and 1.3 months, respectively. Small tumor size (<10 cm) was the only significant favorable factor for OS after partial hepatectomy (P = 0.012). CONCLUSIONS Despite the dismal prognosis, partial hepatectomy could prolong the survival of hepatic angiosarcoma patients, particularly those with tumors <10 cm. Chemotherapy could be an option for unresectable disease. Liver transplantation is not a recommendable option for the management of this malignancy.
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Affiliation(s)
- De-Bang Li
- Department III of General Surgery, The First Hospital of Lanzhou University, Lanzhou 730000, China
| | - Xiao-Ying Si
- Department of Hepatobiliary & Pancreatovascular Surgery, First Affiliated Hospital of Xiamen University, Xiamen 361003, China
| | - Tao Wan
- Department of Hepatobiliary & Pancreatovascular Surgery, First Affiliated Hospital of Xiamen University, Xiamen 361003, China
| | - Yan-Ming Zhou
- Department of Hepatobiliary & Pancreatovascular Surgery, First Affiliated Hospital of Xiamen University, Xiamen 361003, China.
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Chen YY, Chen CC. Progression of an Unusual Primary Liver Tumor. Gastroenterology 2018; 154:1590-1591. [PMID: 28870532 DOI: 10.1053/j.gastro.2017.08.059] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2017] [Accepted: 08/29/2017] [Indexed: 12/18/2022]
Affiliation(s)
- Yang-Yuan Chen
- Division of Gastroenterology, Changhua Christian Hospital, Changhua, Taiwan
| | - Cheng-Che Chen
- Division of Gastroenterology, Changhua Christian Hospital, Changhua, Taiwan
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Tsunematsu S, Muto S, Oi H, Naka T, Kitagataya T, Sasaki R, Taya Y, Baba U, Tsukamoto Y, Uemura K, Kimura T, Ohara Y. Surgically Diagnosed Primary Hepatic Angiosarcoma. Intern Med 2018; 57:687-691. [PMID: 29151516 PMCID: PMC5874340 DOI: 10.2169/internalmedicine.9318-17] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Primary hepatic angiosarcoma is a rare tumor originating from endothelial cells in the liver and accounts for approximately 1% of all hepatic malignant tumors. It is difficult to diagnose due to the lack of specific symptoms or tumor markers. No effective treatment exists, but complete surgical resection may achieve a good outcome. Since most primary hepatic angiosarcomas are already at an advanced stage at diagnosis, few reports describe tumors smaller than 2 cm. We report a case of surgery for a 1.7-cm sized primary hepatic angiosarcoma. Further studies are required to improve the preoperative diagnosis of primary hepatic angiosarcoma.
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Affiliation(s)
- Seiji Tsunematsu
- Department of Gastroenterology and Hepatology, Hokkaido Medical Center, Japan
| | - Shuichi Muto
- Department of Gastroenterology and Hepatology, Hokkaido Medical Center, Japan
| | - Hiroki Oi
- Department of Gastroenterology and Hepatology, Hokkaido Medical Center, Japan
| | - Tomoaki Naka
- Department of Surgical Pathology, Hokkaido University Hospital, Japan
| | - Takashi Kitagataya
- Department of Gastroenterology and Hepatology, Hokkaido Medical Center, Japan
| | - Rui Sasaki
- Department of Gastroenterology and Hepatology, Hokkaido Medical Center, Japan
| | - Yoko Taya
- Department of Gastroenterology and Hepatology, Hokkaido Medical Center, Japan
| | - Urara Baba
- Department of Gastroenterology and Hepatology, Hokkaido Medical Center, Japan
| | - Yuki Tsukamoto
- Department of Gastroenterology and Hepatology, Hokkaido Medical Center, Japan
| | | | - Toshio Kimura
- Department of Gastroenterology and Hepatology, Hokkaido Medical Center, Japan
| | - Yukio Ohara
- Department of Gastroenterology and Hepatology, Hokkaido Medical Center, Japan
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