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Clinical Experience with Primary Hepatic Epithelioid Hemangioendothelioma: Retrospective Study of 33 Patients

World Journal of Surgery volume 36, pages 2677–2683 (2012)Cite this article

Abstract

Background

This multicenter-based retrospective study aimed to investigate the prognostic factors and report our experiences with the diagnosis and treatment of hepatic epithelioid hemangioendothelioma (HEHE), a rare malignant vascular tumor.

Methods

A total of 33 patients with HEHE from two centers between 2004 and 2011 were retrospectively reviewed with respect to their clinical, radiologic, and pathologic characteristics; treatment modalities and outcomes; and potential prognostic factors.

Results

A total of 17 patients underwent liver resections (LRs) alone, 12 patients had transcatheter arterial chemoembolization (TACE) alone, three patients had LR followed by TACE, and one patient underwent liver transplantation (LT). The difference of overall survival (OS) between LR and TACE was not significant (p = 0.499). Older patients [≥47 years, n = 17; p = 0.035, hazard ratio (HR) = 7.0), those with symptoms (n = 17; p = 0.001, HR = 86.5], and those with an elevated serum CA19-9 level (>37 U/ml, n = 5; p = 0.018, HR = 5.0) had a poorer OS, according to univariate analysis. The presence of symptoms was validated as a prognostic factor (p = 0.012) by multivariate analysis.

Conclusions

Liver resection and TACE have comparable outcomes in HEHE patients. The presence of symptoms indicates a poor prognosis. Older age and elevated serum CA19-9 are potential negative impact factors on outcome.

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Acknowledgments

We thank Wei-De Zhang for his active contribution to this article. This study was jointly supported by the National Natural Science Funds of China (No. 30973499), the National S&T Major Project (No. 2008ZX10002-026), and the Dawn Program of the Shanghai Education Commission (No. 07SG04).

Disclosure

There are no financial disclosures from any of the authors.

Author information

Affiliations

  1. Liver Cancer Institute and Zhongshan Hospital, Fudan University, 136 Yi Xue Yuan Road, Shanghai, 200032, People’s Republic of China

    Long-Rong Wang, Jia-Min Zhou, Yi-Ming Zhao, Hong-Wei He, Zong-Tao Chai, Miao Wang, Hui-Chuan Sun, Wei-Zhong Wu, Qing-Hai Ye, Jian Zhou, Jia Fan, Zhao-You Tang & Lu Wang

  2. Key Laboratory of Carcinogenesis and Cancer Invasion, Ministry of Education, 136 Yi Xue Yuan Road, Shanghai, 200032, People’s Republic of China

    Long-Rong Wang, Jia-Min Zhou, Yi-Ming Zhao, Hong-Wei He, Zong-Tao Chai, Miao Wang, Hui-Chuan Sun, Wei-Zhong Wu, Qing-Hai Ye, Jian Zhou, Jia Fan, Zhao-You Tang & Lu Wang

  3. Department of Pathology, Zhongshan Hospital, Fudan University, 136 Yi Xue Yuan Road, Shanghai, People’s Republic of China

    Yuan Ji

  4. Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, 225 Chang Hai Road, Shanghai, People’s Republic of China

    Yi Chen & Chen Liu

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  1. Long-Rong Wang
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  2. Jia-Min Zhou
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  6. Miao Wang
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  7. Yuan Ji
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  8. Yi Chen
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  9. Chen Liu
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  10. Hui-Chuan Sun
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  11. Wei-Zhong Wu
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  12. Qing-Hai Ye
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  13. Jian Zhou
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  14. Jia Fan
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  15. Zhao-You Tang
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  16. Lu Wang
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Corresponding author

Correspondence to Lu Wang.

Additional information

Long-Rong Wang, Jia-Min Zhou, Yi-Ming Zhao, and Hong-Wei He contributed equally to this article.

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Wang, LR., Zhou, JM., Zhao, YM. et al. Clinical Experience with Primary Hepatic Epithelioid Hemangioendothelioma: Retrospective Study of 33 Patients. World J Surg 36, 2677–2683 (2012). https://doi.org/10.1007/s00268-012-1714-x

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Keywords

  • Overall Survival
  • Liver Transplantation
  • Liver Resection
  • Tace
  • Liver Resection Group