Primary hepatic sarcomatoid carcinoma: clinical features and prognosis of 28 resected cases

Abstract

Purpose: Primary hepatic sarcomatoid carcinoma (SC) is an extremely rare malignancy composed of both carcinomatous and spindle cell sarcomatous components. Our aim was to clarify the clinical features and prognosis of patients with this disease.

Methods: Between January 1996 and August 2012, 28 patients were histologically diagnosed as primary hepatic SC after surgical resection. Their demographic, clinicopathological, and survival data were retrospectively reviewed.

Results: There were 22 men (78.6 %) and 6 women (21.4 %), with a median age of 53 years (range 29-73 years). The median overall survival was 11.5 months, and the 1-, 2-, and 3-year overall survival rates were 50, 21.4, 14.3 %, respectively. The patients who received radical resection had obviously better survival compared with those underwent palliative resection (15.6 vs. 7.6 months, P = 0.001). Multivariate analysis revealed that TNM stage [HR 8.737, 95 % CI 1.263-60.430, P = 0.042] and local invasion [HR 4.734, 95 % CI 1.382-16.220, P = 0.013] were independent risk factors for overall survival.

Conclusions: Primary hepatic SC is highly aggressive malignancy with extremely poor prognosis. Radical resection at an early stage may contribute to a relatively favorable prognosis for this uncommon disease.

Fig. 1

a Comparison of disease-free survival between patients with vascular invasion and without vascular invasion (P < 0.001). b Comparison of disease-free survival between patients with local invasion and without local invasion (P = 0.037)

Fig. 2

a Comparison of overall survival between patients with TNM stage I/II and TNM stage III/IV (P < 0.001). b Comparison of disease-free survival between patients with local invasion and without local invasion (P = 0.013)