For patients with rare liver cancer, study offers survival clues
Primary liver sarcoma is a rare type of liver cancer with a poor survival rate – an average length of less than two years. Only 1.8 percent of all liver cancer diagnoses are primary liver sarcoma, and patients with the disease appreciate, and need, any improvements in treatment and care. Now they and their doctors may have a roadmap for such improvements.
Mary L. Guye, M.D., a fellow in City of Hope’s Division of Surgical Oncology, analyzed medical data of 541 patients in the Surveillance Epidemiology and End Results database who were diagnosed with primary liver sarcoma from 1988 through 2009. Under the guidance of Gagandeep Singh, M.D., chief of the Division of Surgical Oncology, she evaluated survival outcomes to better understand what factors influenced – and even predicted – survivorship.
The study findings were recently presented at the 2013 Gastrointestinal Cancers Symposium in San Francisco.
“Patients who are amenable to surgery have the best survival outcomes,” said Guye, author of the study. “Those who received both surgery and radiation had the best overall survival. Those who received radiation alone did just as poorly as those who received no treatment at all.”
Analysis of the medical data revealed that:
- Patients who underwent both surgery and radiation had the best survival, with a median overall survival of 97 months.
- However, only 31.9 percent of patients underwent surgery, and the great majority – 92.8 percent – did not receive radiation.
- Patients who received radiation alone had a median overall survival of only five months, and those who received no treatment at all survived only two months.
- Patients with the stromal type of primary liver sarcoma had the best outcome, with a median overall survival of 175 months, while patients with the blood vessel type had the worst survival, with a median of only two months.
- More than 50 percent of the patients in the study had blood vessel tumors; only 14.5 percent had mixed stromal type.
Guye identified several factors that independently predicted poor outcomes, including older age, being male, tumor size, advanced stage of disease, tumor type and not undergoing surgery.
“We also need further studies to evaluate the impact of chemotherapy on survival outcomes,” she said. “Our dataset did not have chemotherapy information available as a data point.”
Although she sees the need for further study, Guye said that, for now, patients diagnosed with primary liver sarcoma, should strongly consider surgery if it's an available option.