Portal de Periódicos da CAPES

Treatment modalities and long-term outcomes of hepatic hemangioendothelioma in the United States

2022; Elsevier BV; Volume: 24; Issue: 10 Linguagem: Inglês

10.1016/j.hpb.2022.03.013

1477-2574

Christof Kaltenmeier, Silvia Stacchiotti, Alessandro Gronchi, Gonzalo Sapisochín, Hao Liu, Eishan Ashwat, Vikraman Gunabushanam, Dheera Reddy, Ann Thompson, David A. Geller, Samer Tohme, Amer H. Zureikat, Michele Molinari,

Histiocytic Disorders and Treatments

Background We analyzed the outcomes of patients with hepatic epithelioid hemangioendothelioma (HEHE) in the United States after stratification by their most definitive treatment. Methods The National Cancer Data Base was used to identify patients with HEHE between 2004 and 2018. Patients were divided in four treatment groups: no surgical therapy, ablation, liver resection or liver transplantation. Demographics and clinical characteristics were compared, and Kaplan Meier functions and Cox-regression were used for unadjusted and adjusted survival analyses. Results Among a total of 334 patients, 218 (65.2%) were managed non-surgically, 74 (22.1%) underwent hepatic resections, 35 (10.4%) underwent liver transplantation and 7 (2.1%) underwent ablations. The overall median survival was 111 months (95%CI 73–149) after liver transplantation, 69 months (95%CI 45–92) after hepatic resection, 38 months (95%CI 0–78) after ablation and 80 months (95%CI 70–90) for patients managed by watchful waiting (P < 0.001). After adjustment, patients who underwent liver transplantation were found to have a better survival when compared to other therapies (Hazard Ratio: 0.61, 95% Confidence Interval: 0.38–0.97, p = 0.035). Conclusions This study reports the outcomes of the largest cohort of patients with HEHE. The longest survival was observed after liver transplantation, followed by non-surgical management and hepatic resection. Because of selection bias, future studies to better characterize what criteria should be used for the selection of treatment modalities for HEHE are urgently needed.