Prognostic Impact of Sarcomatous Change of Hepatocellular Carcinoma in Patients Undergoing Liver Resection and Liver Transplantation View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2007-11-13

AUTHORS

Shin Hwang, Sung-Gyu Lee, Young-Joo Lee, Chul-Soo Ahn, Ki-Hun Kim, Kwang-Min Park, Ki-Myung Moon, Deok-Bog Moon, Tae-Yong Ha, Eun-Sil Yu, Ga-Won Choi

ABSTRACT

Sarcomatous change has been rarely observed in hepatocellular carcinoma (HCC), but it is usually associated with very aggressive tumor behavior and widespread metastasis. To assess the impact of sarcomatous changes, we analyzed the outcomes of 15 patients with sarcomatous HCC after resection (n = 11) or liver transplantation (LT) (n = 4). No imaging findings characteristic of sarcomatous changes were observed. According to modified pathological tumor-node metastasis staging, the HCC lesions were classified as stage II in five patients, stage III in six, stage IVa2 in two, and stage IVb in one. The Milan criteria were met in 7 of 15 patients, including 3 of 4 in the LT group. R0 resection was achieved in 9 of 11 resected patients, and their 3-year overall and disease-free survival rates were both 18.2%. In the LT group, 3-year overall and disease-free survival rates were 37.5 and 25%, respectively. In patients within the Milan criteria, 2-year overall survival rate was 25% after resection and 33% after LT, showing no prognostic difference. Extrahepatic metastasis as initial recurrence was detected in 80% after resection and 66.7% after LT. In conclusion, we found that the prognosis of patients with sarcomatous HCC was very unfavorable after either resection or LT and that, except for liver biopsy, no diagnostic method could distinguish between sarcomatous and ordinary HCC. Vigorous postoperative systemic surveillance may be helpful for timely detection and treatment of localized metastases. More... »

PAGES

718-724

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s11605-007-0393-7

DOI

http://dx.doi.org/10.1007/s11605-007-0393-7

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1046732065

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/17999122


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64 liver transplantation
65 metastasis
66 metastasis staging
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74 prognosis
75 prognosis of patients
76 prognostic differences
77 prognostic impact
78 rate
79 recurrence
80 resection
81 sarcomatous change
82 sarcomatous hepatocellular carcinoma
83 stage II
84 stage IVa2
85 staging
86 surveillance
87 survival rate
88 systemic surveillance
89 timely detection
90 transplantation
91 treatment
92 tumor behavior
93 tumor node metastasis (TNM) staging
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