Clinicopathological analysis of 42 patients with sarcomatoid hepatocellular carcinoma

Abstract

Objective To study the clinicopathological features of sarcomatoid hepatocellular carcinoma (SHC). Methods The clinical data of 42 patients with SHC who underwent surgical resection in the Peking University People's Hospital (n=33) and the Department of Pathology of the Peking University Health Science Center (n=9) from January 2008 to May 2017 were retrospectively analyzed. Results The average age was 58.3 (aged 32~84) years; the ratio of male to female was 2.2∶1; the average diameter of the lesions was 8.2 cm; the median AFP value was 45.2 ng/ml. The median survival time was 10.5 months, the average progression-free survival time was 2.9 months, and the 5-year survival rate was 25.0%. On histopathology, the tumor consisted of various degrees of different differentiated carcinomas with aligned sarcomatoid spindle cells. Immunohistochemical results in the sarcomatoid region expressed both mesenchymal markers and epithelial-derived markers. Conclusions SHC tumors were highly aggressive, with high rates of lymph node metastasis and poor prognosis. The diagnosis of SHC mainly depended on histopathology. Immunohistochemistry was very important for its diagnosis and differential diagnosis. Surgical resection was the treatment modality of choice to achieve prolonged survival time. Key words: Sarcomatoid hepatocellular carcinoma (SHC); Pathology; Diagnosis; Treatment