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Hepatic epithelioid haemangioendothelioma: is transplantation the only treatment option?
- Source :
-
HPB : the official journal of the International Hepato Pancreato Biliary Association [HPB (Oxford)] 2010 Oct; Vol. 12 (8), pp. 546-53. Date of Electronic Publication: 2010 Sep 02. - Publication Year :
- 2010
-
Abstract
- Background: Hepatic epithelioid haemangioendothelioma (HEH) is a rare vascular neoplasm with unpredictable clinical behaviour.<br />Aim: To compare overall survival (OS) and disease-free survival (DFS) between liver resection (LR) and orthotopic liver transplantation (OLT) for the treatment of HEH.<br />Methods: Retrospective review of 30 patients with HEH treated at Mayo Clinic during 1984 and 2007.<br />Results: Median age was 46 years with a female predominance of 2:1. Treatment included LR (n= 11), OLT (n= 11), chemotherapy (n= 5) and no treatment (n= 3). LR was associated with a 1-, 3- and 5-year OS of 100%, 86% and 86% and a DFS of 78%, 62% and 62%, respectively. OLT was associated with a 1-, 3- and 5-year OS of 91%, 73% and 73% and a DFS 64%, 46% and 46%, respectively. Metastases were present in 37% of patients but did not significantly affect OS. Important predictors of a favourable OS and DFS were largest tumour ≤ 10 cm and multifocal disease with ≤ 10 nodules.<br />Conclusion: LR and OLT achieve comparable results in the treatment of HEH. LR is appropriate for patients with resectable disease and favourable prognostic factors. OLT is appropriate for patients with unresectable disease and possibly those with unfavourable prognostic factors. Metastases may not be a contraindication to surgical treatment.<br /> (© 2010 International Hepato-Pancreato-Biliary Association.)
- Subjects :
- Adult
Aged
Antineoplastic Agents therapeutic use
Chi-Square Distribution
Disease-Free Survival
Female
Hemangioendothelioma, Epithelioid mortality
Hemangioendothelioma, Epithelioid pathology
Humans
Kaplan-Meier Estimate
Liver Neoplasms mortality
Liver Neoplasms pathology
Male
Middle Aged
Palliative Care
Proportional Hazards Models
Retrospective Studies
Risk Assessment
Risk Factors
Survival Rate
Time Factors
Treatment Outcome
United States
Young Adult
Hemangioendothelioma, Epithelioid surgery
Hepatectomy adverse effects
Hepatectomy mortality
Liver Neoplasms surgery
Liver Transplantation adverse effects
Liver Transplantation mortality
Subjects
Details
- Language :
- English
- ISSN :
- 1477-2574
- Volume :
- 12
- Issue :
- 8
- Database :
- MEDLINE
- Journal :
- HPB : the official journal of the International Hepato Pancreato Biliary Association
- Publication Type :
- Academic Journal
- Accession number :
- 20887322
- Full Text :
- https://doi.org/10.1111/j.1477-2574.2010.00213.x