Journal of Hepatocellular Carcinoma (Sep 2021)

Primary Liver Sarcomatoid Carcinoma: A Case Series and Literature Review

  • Ji W,
  • Xing Y,
  • Ma J,
  • Zhao Z,
  • Xu H,
  • Zheng S,
  • Li W,
  • Li X

Journal volume & issue
Vol. Volume 8
pp. 1117 – 1127

Abstract

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Wei Ji,1 Yunlong Xing,2 Jinshu Ma,3 Zhuo Zhao,4 Hongqin Xu,5 Shuang Zheng,6 Wei Li,1 Xu Li5 1Cancer Center, The First Hospital of Jilin University, Changchun, People’s Republic of China; 2Plastic Surgery, China-Japan Union Hospital, Jilin University, Changchun, People’s Republic of China; 3Department of Pathology, China-Japan Union Hospital, Jilin University, Changchun, People’s Republic of China; 4Cardiology Department, The Second Hospital of Jilin University, Changchun, People’s Republic of China; 5Department of Hepatology, The First Hospital of Jilin University, Changchun, People’s Republic of China; 6Department of Radiology, The First Hospital of Jilin University, Changchun, People’s Republic of ChinaCorrespondence: Xu LiDepartment of Hepatology, The First Hospital of Jilin University, No. 71, Xinmin Street, Changchun, 130021, People’s Republic of ChinaTel +86 158 0430 1765Email [email protected]: Primary liver sarcomatoid carcinoma (PLSC) is rare. To improve the understanding of PLSC, cases were described and reviewing the literature.Methods: A retrospective analysis was performed on 14 cases of PLSC diagnosed by pathology in Northeastern China from 2010 to 2020. An individual participant data analysis based on reported cases was conducted to determine epidemiological characteristics, clinical characteristics, and prognoses of PLSC.Results: A total of 136 cases involved our 14 cases and 122 cases from previous reports. The percentages of sarcomatoid hepatocellular carcinoma, sarcomatoid cholangiolocellular carcinoma, and mixed and unclassified types were 36.8%, 41.9%, 5.9%, and 15.4%, respectively. A total of 95.6% PLSC was found in Asia. There was a lower percentage of hepatitis-infected patients in Japan, when compared with the Republic of Korea (38.5% vs 70.0%, P< 0.05). Five cases were initially misdiagnosed as a hepatic abscess by imaging. A total of 36.7% cases had metastases when being diagnosed, and 68.9% cases relapsed during the follow-up. The median disease-free survival and overall survival (OS) were 3 months and 5 months, respectively. Only radical surgery (hazard ratio = 0.308, 95% confidence interval 0.186– 0.512, P< 0.001) indicated a better OS.Conclusion: PLSC was more prevalent in Asia and there were possibilities of misdiagnoses. Surgery is still an effective treatment and can significantly prolong the OS. Only limited strategies for recurrent or advanced PLSC, immunotherapy may be possible treatment.Keywords: liver, sarcomatoid carcinoma, pathology, immunotherapy

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