Primary liver sarcoma: diagnosis and surgical treatment

Abstract

Objective To study the diagnosis and surgical treatment of primary sarcoma of liver in order to obtain a better understanding of this disease and to improve its clinical treatment. Methods The clinical data on the clinicopathological features, surgical treatments and prognosis of 17 patients with primary liver sarcoma who were treated from January 2001 to May 2016 were retrospectively analyzed. Results Of 17 patients with primary sarcoma of liver, elevation of preoperative serum AFP was detected in one patient (5.9%), HBsAg positivity in 3 patients (17.6%), elevation of CEA in 2 patients (11.8%) and abnormal liver function in 3 patients (17.6%). The main clinical symptoms included epigastric pain in 9 patients, epigastric distention in 7 patients, loss of appetite in 5 patients (including in one patient after resection of gastric carcinoma). Twelve of these 17 patients underwent resection (resection rate 64.7%). Five patients underwent laparotomy and biopsy. Among patients who were treated with surgical resection, 10 patients had R0 resection and 2 patients had R1 resection. Postoperatively, 5 of these patients underwent adjuvant selective hepatic arterial infusion chemotherapy (mitomycin+ fluorouracil+ epirubicin), and 4 patients were treated with adjuvant systemic chemotherapy (vincristin, cisplatin, cyclophosphamide and Doxorubicin). The postoperative 1, 3 and 5-year overall survival rates for all the patients were 58.8% (10/17), 29.4% (5/17) and 11.7% (2/17), respectively. In patients with liver resection, the survival rates were 83.3% (10/12), 41.6% (5/12) and 16.7% (2/12), and for R0 resection, 100.0% (10/10), 50.0% (5/10) and 20.0% (2/10), respectively. Conclusions The diagnosis of primary sarcoma of liver was difficult before operation. High survival rate could be achieved by radical resection and adjuvant chemotherapy. Key words: Primary liver sarcoma; Liver tumor; Hepatectomy; Chemotherapy