Key result
Higher AST, higher total bilirubin, lower albumin, longer prothrombin time, lower platelet count, multiple tumor patterns, and advanced imaging stage were significantly associated with shorter overall survival in patients with primary hepatic angiosarcoma.
Why the study?
Primary hepatic angiosarcoma is extremely rare with most patients dying within 12 months, prompting investigation into whether initial clinical-radiological features and staging associate with outcomes.
Do initial clinical-radiological features and staging predict survival outcomes in patients with primary hepatic angiosarcoma?
Cohort (n=22)
No
Do initial clinical-radiological features and staging predict survival outcomes in patients with primary hepatic angiosarcoma?
p-value: p=<0.05
Initial clinical and radiological features, including liver function tests, platelet count, and imaging staging, can help predict survival outcomes in patients with primary hepatic angiosarcoma.
These parameters were associated with shorter survival; leaves open their utility for prognostication or trial stratification in this rare tumor.
OBJECTIVE: Primary hepatic angiosarcoma (PHA) is extremely rare and most patients die within 12 months of diagnosis. The object of the study is to determine the association of initial clinical-radiological features and staging with outcomes in patients with PHA. METHODS: The medical records of adult patients with PHA were retrieved from an electronic medical record database and a pathology database and retrospectively reviewed. During 10 years, 22 eligible patients were included. Data extracted focused on the information before the first formal treatment with a pathological proof, including demographic characteristics, medical history, laboratory data, preliminary images, histopathological records, treatment, and follow-up survival period. Two radiologists blindly re-analyzed preliminary images of all 22 patients together and recorded tumor features and imaging stage based on the American Joint Committee on Cancer (AJCC) 8th edition tumor-node-metastasis (TNM) Staging System for hepatocellular carcinoma. A radiologist compiled the initial clinical data and preliminary image stage to analyze the association with patients' survival outcome. RESULTS: Higher aspartate aminotransferase (AST), higher total bilirubin (TB), lower albumin (ALB), longer prothrombin time (PT) and lower platelet count of serum relative to the normal reference range were more common in patients who survived ≤ 90 days (all P < 0.05). Overall survival was much better in patients with single PHA than in those with other tumor patterns of multiple PHA (all P < 0.05). Overall survival determined by preliminary imaging showed significant differences between stage I and stage III (P = 0.044), stage I and stage IV (P = 0.011), and stage III and IV (P = 0.047). No patients were at stage II. CONCLUSIONS: Initial serum levels of ALT, TB, ALB, and PT, platelet count, single mass in liver, and preliminary imaging staging could help predict survival outcomes of patients with PHA.
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Yuan et al. (2019) conducted a cohort in Primary hepatic angiosarcoma (n=22). Initial clinical and radiological features (abnormal liver function tests, tumor pattern, and advanced imaging stage) vs. Normal laboratory values, single mass tumor pattern, and early imaging stage was evaluated on Overall survival (p=<0.05). Higher AST, higher total bilirubin, lower albumin, longer prothrombin time, lower platelet count, multiple tumor patterns, and advanced imaging stage were significantly associated with shorter overall survival in patients with primary hepatic angiosarcoma.
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