Faculty Collaboration Database

Treatment of hepatic epithelioid hemangioendothelioma: a single-institution experience with 25 cases. Arch Surg 2009 Nov;144(11):1035-9

Date

11/18/2009

Pubmed ID

19917940

DOI

10.1001/archsurg.2009.121

Scopus ID

2-s2.0-72749117859 (requires institutional sign-in at Scopus site)   53 Citations

Abstract

OBJECTIVE: To examine treatment of hepatic epithelioid hemangioendothelioma (EHE), a rare vascular tumor with a variable course. Treatment modalities at our institution include liver resection, transplantation, and catheter-based therapies.

DESIGN, PATIENTS, AND MAIN OUTCOME MEASURES: Retrospective review of 25 patients treated for hepatic EHE (1976-2007). We examined treatment modality, overall survival, complications, and clinicopathologic characteristics.

RESULTS: Of the 25 patients treated for hepatic EHE, 17 underwent liver transplantation (LT); 4, transcatheter arterial chemoembolization (TACE); 2, resection; and 2, TACE followed by LT. Twelve patients (48%) were male. The median age at diagnosis was 38 years (range, 9 months to 72 years). Mean overall survival was 167 (95% confidence interval [CI], 123-212) months, with 172 (124-220) months in the LT group and 83 (54-112) months in the TACE group. The 2 patients in the resection group remain alive after 19 and 71 months. The 2 patients treated with TACE followed by LT died after 13 and 113 months. Extrahepatic disease was identified as a predictor of outcome. Patients with extrahepatic disease treated with TACE fared better than those treated with surgical approaches (mean survival, 83.0 [95% CI, 54.2-111.8] vs 38.8 [23.7-53.8] months; P = .12).

CONCLUSIONS: Hepatic EHE is a rare tumor that can be treated with surgical or nonsurgical approaches. In our experience, LT is used for patients with advanced local disease, whereas TACE is the primary modality when extrahepatic disease or comorbid conditions prohibiting LT are present. To our knowledge, this is the largest single-institution experience describing the various therapeutic modalities in the treatment of hepatic EHE.

Author List

Cardinal J, de Vera ME, Marsh JW, Steel JL, Geller DA, Fontes P, Nalesnik M, Gamblin TC

Author

Thomas Clark Gamblin MD Professor in the Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Academic Medical Centers
Adolescent
Adult
Aged
Biopsy, Needle
Cause of Death
Chemoembolization, Therapeutic
Child
Child, Preschool
Cohort Studies
Female
Follow-Up Studies
Graft Survival
Hemangioendothelioma
Hepatectomy
Humans
Immunohistochemistry
Infant
Kaplan-Meier Estimate
Liver Neoplasms
Liver Transplantation
Male
Middle Aged
Neoplasm Staging
Postoperative Complications
Proportional Hazards Models
Rare Diseases
Retrospective Studies
Risk Assessment
Statistics, Nonparametric
Survival Analysis
Tomography, X-Ray Computed
Young Adult