Results of hepatic resection for primary hepatic angiosarcoma in adults

Background: Primary hepatic angiosarcoma is an uncommon but aggressive malignancy with poor prognosis. The purpose of this study was to evaluate surgical outcomes of patients with the disease. Material/Methods: Medical records of 6 patients who underwent surgical resection for primary hepatic angiosarcoma at our institution between 1998 and 2006 were reviewed retrospectively. Results: There were 5 men and 1 woman who ranged in age from 44 to 77 years, with a mean of 55.5 years. The most common symptoms at diagnosis were pain in the right upper quadrant, abdominal distension, weakness and weight loss. None of these patients presented with intra-abdominal hemorrhage from tumor rupture. Right hepatectomy was performed in 3 cases, extended right hepatectomy in 1 case, and left hepatectomy in the remaining 2 cases. All 6 patients had solitary masses. One patient died of perioperative complication, and another patient with microscopic tumor residuals died of disease recurrence at 6 months. Of the other 4 patients with pathological free margins, 3 died of disease recurrence at 10, 14 and 17 months, and the remaining 1 has been alive without recurrence for 29 months. Conclusions: Although the overall outcome of surgical resection remains unsatisfactory, complete surgical resection may prolong survival of patients with solitary primary hepatic angiosarcoma without spontaneous rupture.