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Treatment sequencing strategy for hepatic epithelioid haemangioendothelioma.
- Source :
-
HPB : the official journal of the International Hepato Pancreato Biliary Association [HPB (Oxford)] 2014 Jul; Vol. 16 (7), pp. 677-85. Date of Electronic Publication: 2013 Dec 06. - Publication Year :
- 2014
-
Abstract
- Background: The biology of hepatic epithelial haemangioendothelioma (HEHE) is variable, lying intermediate to haemangioma and angiosarcoma. Treatments vary owing to the rarity of the disease and frequent misdiagnosis.<br />Methods: Between 1989 and 2013, patients retrospectively identified with HEHE from a single academic cancer centre were analysed to evaluate clinicopathological factors and initial treatment regimens associated with survival.<br />Results: Fifty patients with confirmed HEHE had a median follow-up of 51 months (range 1-322). There was no difference in 5-year survival between patients presenting with unilateral compared with bilateral hepatic disease (51.4% versus 80.7%, respectively; P = 0.1), localized compared with metastatic disease (69% versus 78.3%, respectively; P = 0.7) or an initial treatment regimen of Surgery, Chemotherapy/Embolization or Observation alone (83.3% versus 71.3% versus 72.4%, respectively; P = 0.9). However, 5-year survival for patients treated with chemotherapy at any point during their disease course was decreased compared with those who did not receive any chemotherapy (43.6% versus 82.9%, respectively; P = 0.02) and was predictive of a decreased overall survival on univariate analysis [HR 3.1 (CI 0.9-10.7), P = 0.02].<br />Conclusions: HEHE frequently follows an indolent course, suggesting that immediate treatment may not be the optimal strategy. Initial observation to assess disease behaviour may better stratify treatment options, reserving surgery for those who remain resectable/transplantable. Prospective cooperative trials or registries may confirm this strategy.<br /> (© 2013 International Hepato-Pancreato-Biliary Association.)
- Subjects :
- Academic Medical Centers
Adolescent
Adult
Aged
Aged, 80 and over
Antineoplastic Agents therapeutic use
Embolization, Therapeutic
Female
Hemangioendothelioma, Epithelioid mortality
Hemangioendothelioma, Epithelioid secondary
Hepatectomy
Humans
Liver Neoplasms mortality
Liver Neoplasms pathology
Liver Transplantation
Male
Middle Aged
Multivariate Analysis
Patient Selection
Proportional Hazards Models
Registries
Retrospective Studies
Risk Factors
Texas
Time Factors
Treatment Outcome
Watchful Waiting
Young Adult
Hemangioendothelioma, Epithelioid therapy
Liver Neoplasms therapy
Subjects
Details
- Language :
- English
- ISSN :
- 1477-2574
- Volume :
- 16
- Issue :
- 7
- Database :
- MEDLINE
- Journal :
- HPB : the official journal of the International Hepato Pancreato Biliary Association
- Publication Type :
- Academic Journal
- Accession number :
- 24308564
- Full Text :
- https://doi.org/10.1111/hpb.12202