Clinical Manifestations and Outcomes of Patients with Sarcomatoid Hepatocellular Carcinoma

Liao, Shutsung; Su, Tung‐Hung; Jeng, Yung‐Ming; Liang, Po-Chin; Chen, Ding‐Shinn; Chen, Chien‐Hung; Kao, Jia‐Horng

doi:10.1002/hep.30162

Cited by 64 publications

(118 citation statements)

References 33 publications

(60 reference statements)

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“…As such, several terms have been used to describe sarcomatoid HCC, including spindle cell carcinoma, metaplastic carcinoma, carcinosarcoma, and pleomorphic carcinoma. 3 In this study, patients with sarcomatoid HCC had worse outcomes compared with patients who had conventional HCC across all Barcelona Clinic Liver Cancer stages. 13 In the report by Jerningan et al, the majority of sarcomatoid HCC tumors were undifferentiated (60%) and had a median size of >5 cm (60%), which was consistent with findings from the current study.…”

Section: Discussionmentioning

confidence: 73%

“…3,7 To our knowledge, there have been few reports to date regarding sarcomatoid HCC, with the largest study reporting only 40 cases from Taiwan. 3,7 To our knowledge, there have been few reports to date regarding sarcomatoid HCC, with the largest study reporting only 40 cases from Taiwan.…”

Section: Discussionmentioning

confidence: 99%

“…22,23 In a previous analysis, Jernigan et al reported 20 cases of spindle cell HCC, which the authors noted was the least common subtype of HCC. 3 In the study by Liao et al, 3 fibrosis score, tumor size, treatment modality, and tumor grade were not accounted for, which was a major shortcoming because there were large differences in clinicopathologic characteristics noted among patients with sarcomatoid and conventional HCC. 13 There has been a paucity of data regarding the long-term outcomes of patients with sarcomatoid HCC.…”

Section: Discussionmentioning

confidence: 99%

“…[1][2][3] While there is evidence that certain subtypes of HCC are associated with a worse prognosis, disease recurrence, and specific gene mutations compared with "conventional" HCC, to our knowledge, current guidelines are devoid of recommendations based on HCC subtype. [1][2][3] While there is evidence that certain subtypes of HCC are associated with a worse prognosis, disease recurrence, and specific gene mutations compared with "conventional" HCC, to our knowledge, current guidelines are devoid of recommendations based on HCC subtype.…”

Section: Introductionmentioning

confidence: 99%

“…3,7,8 Due to its rarity, there have been limited data regarding the outcomes of patients with sarcomatoid HCC, with those few studies focusing on the radiologic or histopathologic features of the disease. 3,7,8 Due to its rarity, there have been limited data regarding the outcomes of patients with sarcomatoid HCC, with those few studies focusing on the radiologic or histopathologic features of the disease.…”

Section: Introductionmentioning

confidence: 99%

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Management and outcomes among patients with sarcomatoid hepatocellular carcinoma: A population‐based analysis

Tsilimigras

Farooq

et al. 2019

Cancer

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Background Few data are available regarding the management and outcomes among patients with sarcomatoid hepatocellular carcinoma (HCC) due to its rarity. Methods Patients diagnosed with sarcomatoid HCC from 2004 through 2015 were identified in the National Cancer Data Base. Overall survival (OS) was calculated among patients with sarcomatoid versus conventional HCC using a 1:3 propensity score matching based on sex, age, and American Joint Committee on Cancer (AJCC) stage of disease. Results The final analytic cohort included 104 patients with sarcomatoid HCC and 312 patients with conventional HCC. Patients with sarcomatoid HCC more often had a larger median tumor size (8.5 cm vs 5.4 cm; P < .001) and poorly or undifferentiated tumors (52.9% vs 13.8%; P < .001) compared with patients who had conventional HCC. 5‐year OS was worse among patients with sarcomatoid versus conventional HCC (5.7% vs 30.1%; P < .001). Subgroup analysis demonstrated worse 5‐year OS among patients with sarcomatoid versus conventional HCC among patients treated with either curative‐intent or palliative therapies. Stage‐specific subgroup analysis indicated a worse OS among patients with AJCC stage I, stage II, or stage III sarcomatoid HCC. On multivariable analysis, uninsured status, advanced AJCC stage (stage III/stage IV), and histological sarcomatoid subtype were independently associated with worse outcomes (all P < .05). Conclusions Sarcomatoid HCC is a very rare variant of HCC, which was associated with larger tumor size and worse tumor grade on presentation. On propensity score matched analyses that controlled for known confounding factors, patients with sarcomatoid HCC had a worse stage‐for‐stage long‐term survival compared with patients who had conventional HCC.

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Section: Discussionmentioning

confidence: 73%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Management and outcomes among patients with sarcomatoid hepatocellular carcinoma: A population‐based analysis

Tsilimigras

Farooq

et al. 2019

Cancer

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Sarcomatoid hepatocellular carcinoma: From clinical features to cancer genome

Zhang

Feng

et al. 2021

Cancer Medicine

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Sarcomatoid hepatocellular carcinoma is distinct from ordinary hepatocellular carcinoma: Clinicopathologic, transcriptomic and immunologic analyses

Morisue

Kojima

Suzuki

et al. 2021

Intl Journal of Cancer

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Sarcomatoid hepatocellular carcinoma (SHCC), which was a rare histological subtype of hepatocellular carcinoma (HCC), is currently subclassified as poorly differentiated HCC because of insufficient evidence to define SHCC as a subtype of HCC. We aimed to assess the feasibility of classifying SHCC as a histological subtype of HCC by comprehensively identifying novel and distinct characteristics of SHCC compared to ordinary HCC (OHCC). Fifteen SHCCs (1.4%) defined as HCC with at least a 10% sarcomatous component, 15 randomly disease-stage-matched OHCCs and 163 consecutive OHCCs were extracted from 1106 HCCs in the Pathology Database (1997-2019) of our hospital. SHCC patients showed poor prognosis, and the tumors could be histologically subclassified into the pleomorphic, spindle and giant cell types according to the subtype of carcinomas with sarcomatoid or undifferentiated morphology in other organs. The transcriptomic analysis revealed distinct characteristics of SHCC featuring the upregulation of genes associated with epithelial-to-mesenchymal transition and inflammatory responses. The fluorescent multiplex immunohistochemistry results revealed

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Clinical Manifestations and Outcomes of Patients with Sarcomatoid Hepatocellular Carcinoma

Cited by 64 publications

References 33 publications

Management and outcomes among patients with sarcomatoid hepatocellular carcinoma: A population‐based analysis

Management and outcomes among patients with sarcomatoid hepatocellular carcinoma: A population‐based analysis

Sarcomatoid hepatocellular carcinoma: From clinical features to cancer genome

Sarcomatoid hepatocellular carcinoma is distinct from ordinary hepatocellular carcinoma: Clinicopathologic, transcriptomic and immunologic analyses

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