Clinical Experience with Primary Hepatic Epithelioid Hemangioendothelioma: Retrospective Study of 33 Patients
Clinical Experience with Primary Hepatic Epithelioid Hemangioendothelioma: Retrospective Study of 33 Patients
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DOI：
10.1007/s00268-012-1714-x
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发表时间：
2012-11-01
影响因子：
2.6
通讯作者：
Wang, Lu
中科院分区：
文献类型：
--
作者：
Wang, Long-Rong;Zhou, Jia-Min;Wang, Lu
本研究回顾性分析了2004年至2011年两个中心共33例肝上皮样血管内皮瘤（HEHE）患者的临床、影像学和病理学特征、治疗方式和预后，并分析了HEHE的预后因素。17例患者仅行肝切除术（LRs），12例患者仅行肝动脉化疗栓塞术（TACE），3例患者行肝切除术后行TACE，1例患者行肝移植术（LT）。LR和TACE之间的总生存期（OS）差异不显著（p = 0.499）。老年患者[a/1000日元47岁，n = 17; p = 0.035，风险比（HR）= 7.0），有症状者（n = 17; p = 0.001，HR = 86.5），血清CA 19 -9水平升高者（> 37 U/ml，n = 5; p = 0.018，HR = 5.0）的OS较差。多变量分析证实症状的存在是一个预后因素（p = 0.012）。肝切除术和TACE在HEHE患者中具有可比性的结局。症状的存在表明预后不良。高龄和血清CA 19 -9升高是影响预后的潜在负性因素。
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.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.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 [a parts per thousand yen47 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.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.