Treatment modalities and long-term outcomes of hepatic hemangioendothelioma in the United States. Issue 10 (October 2022)

• Record Type: Journal Article
• Authors: Kaltenmeier, Christof; Stacchiotti, Silvia; Gronchi, Alessandro; Sapisochin, Gonzalo; Liu, Hao; Ashwat, Eishan; Gunabushanam, Vikraman; Reddy, Dheera; Thompson, Ann; Geller, David; Tohme, Samer; Zureikat, Amer; Molinari, Michele
• Is Part Of: HPB. Volume 24:Issue 10(2022)
• Page Start: 1688
• Page End: 1696
• Publication Date: 2022-10
• Subjects: Liver -- Diseases -- Periodicals; Biliary tract -- Diseases -- Periodicals; Pancreas -- Diseases -- Periodicals; 616.362005
• DOI: 10.1016/j.hpb.2022.03.013
• Languages: English
• ISSNs: 1365-182X

Abstract

Abstract: 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.