Skip to main content

Advertisement

SpringerLink
Log in

Sarcomatoid hepatocellular carcinoma versus conventional hepatocellular carcinoma: a systematic review and meta-analysis

  • Review – Clinical Oncology
  • Published:
Journal of Cancer Research and Clinical Oncology Aims and scope Submit manuscript

Abstract

Background

Sarcomatoid hepatocellular carcinoma (SHCC) is a rare subtype of primary liver malignancies and is still ill-defined and poorly understood. Therefore, our study was performed to have a comprehensive evaluation SHCC versus conventional hepatocellular carcinoma (HCC).

Methods

A thorough database searching was performed in PubMed, EMBASE and the Cochrane Library. RevMan5.3 and Stata 13.0 software were used for statistical analyses. The primary endpoint of our analysis is the long-term survival and the secondary endpoint is clinical and pathological features.

Results

Four studies with a relative large cohort were finally identified. Compared with patients with pure HCC, patients with SHCC had a significantly worse overall survival (P < 0.00001) and disease-free survival (P < 0.0001). Moreover, a larger tumor size (P = 0.003), a higher incidence of node metastasis (P < 0.00001) and a higher proportion of advanced lesions (P = 0.04) were more frequently detected in patients with SHCC. Higher levels of serum ALT (P = 0.02) and TB (P = 0.005) were detected in patients with HCC rather than SHCC, while serum ALB (P = 0.02) level was relatively higher in patients with SHCC. For other measured outcomes, including concurrent viral hepatitis, liver cirrhosis, liver storage (Child A/B), multifocal tumors, vascular invasion and preoperative AFP level, the results showed no significant difference (P > 0.05).

Conclusion

SHCC has a worse prognosis and exhibits more aggressively than conventional HCC. Future large well-designed studies are demanded for further validation.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

Data availability statement

All data generated or analyzed during this study is included in the published article.

References

  • Chin S, Kim Z (2014) Sarcomatoid combined hepatocellular-cholangiocarcinoma: a case report and review of literature. Int J Clin Exp Pathol 7:8290–8294

    PubMed  PubMed Central  Google Scholar 

  • Choi D, Kum H, Park S et al (2019) Hepatocellular carcinoma screening is associated with increased survival of patients with cirrhosis. Clin Gastroenterol Hepatol off Clin Pract J Am Gastroenterol Assoc 17:976-987.e974

    Google Scholar 

  • Egger M, Davey Smith G, Schneider M, Minder C (1997) Bias in meta-analysis detected by a simple, graphical test. BMJ (clin Res Ed.) 315:629–634

    Article  CAS  Google Scholar 

  • Eriguchi N, Aoyagi S, Okuda K et al (2001) Unusual liver carcinomas with sarcomatous features: analysis of four cases. Surg Today 31:530–533

    Article  CAS  PubMed  Google Scholar 

  • Giunchi F, Vasuri F, Baldin P, Rosini F, Corti B, D’Errico-Grigioni A (2013) Primary liver sarcomatous carcinoma: report of two cases and review of the literature. Pathol Res Pract 209:249–254

    Article  PubMed  Google Scholar 

  • Heimbach J, Kulik L, Finn R et al (2018) AASLD guidelines for the treatment of hepatocellular carcinoma. Hepatology (Baltimore, MD) 67:358–380

    Article  Google Scholar 

  • Higgins JP, Thompson SG (2002) Quantifying heterogeneity in a meta-analysis. Stat Med 21:1539–1558

    Article  PubMed  Google Scholar 

  • Honda H, Hayashi T, Yoshida K et al (1996) Hepatocellular carcinoma with sarcomatous change: characteristic findings of two-phased incremental CT. Abdom Imaging 21:37–40

    Article  CAS  PubMed  Google Scholar 

  • Hwang S, Lee S, Lee Y et al (2008) Prognostic impact of sarcomatous change of hepatocellular carcinoma in patients undergoing liver resection and liver transplantation. J Gastrointest Surg off J Soc Surg Aliment Tract 12:718–724

    Article  Google Scholar 

  • Kakizoe S, Kojiro M, Nakashima T (1987) Hepatocellular carcinoma with sarcomatous change. Clinicopathologic and immunohistochemical studies of 14 autopsy cases. Cancer 59:310–316

    Article  CAS  PubMed  Google Scholar 

  • Kim H, Kim H, Park Y (2015) Sarcomatoid cholangiocarcinoma with osteoclast-like giant cells associated with hepatolithiasis: a case report. Clin Mol Hepatol 21:309–313

    Article  PubMed  PubMed Central  Google Scholar 

  • Kim D, Kim B, Jeong J, Baek Y (2019) Analysis of intrahepatic sarcomatoid cholangiocarcinoma: experience from 11 cases within 17 years. World J Gastroenterol 25:608–621

    Article  PubMed  PubMed Central  Google Scholar 

  • Kojiro M, Sugihara S, Kakizoe S, Nakashima O, Kiyomatsu K (1989) Hepatocellular carcinoma with sarcomatous change: a special reference to the relationship with anticancer therapy. Cancer Chemother Pharmacol 23:S4-8

    Article  PubMed  Google Scholar 

  • Lao X, Chen D, Zhang Y et al (2007) Primary carcinosarcoma of the liver: clinicopathologic features of 5 cases and a review of the literature. Am J Surg Pathol 31:817–826

    Article  PubMed  Google Scholar 

  • Lee K (2014) Sarcomatoid hepatocellular carcinoma with mixed osteoclast-like giant cells and chondroid differentiation. Clin Mol Hepatol 20:313–316

    Article  PubMed  PubMed Central  Google Scholar 

  • Lee JW, Kim MW, Choi NK, Cho IJ, Hong R (2014) Double primary hepatic cancer (sarcomatoid carcinoma and hepatocellular carcinoma): a case report. Mol Clin Oncol 2:949–952

    Article  PubMed  PubMed Central  Google Scholar 

  • Lester T, Hunt K, Nayeemuddin K et al (2012) Metaplastic sarcomatoid carcinoma of the breast appears more aggressive than other triple receptor-negative breast cancers. Breast Cancer Res Treat 131:41–48

    Article  CAS  PubMed  Google Scholar 

  • Li Z, Wu X, Bi X et al (2018) Clinicopathological features and surgical outcomes of four rare subtypes of primary liver carcinoma. Chin J Cancer Res Chung-Kuo Yen Cheng Yen Chiu 30:364–372

    Article  PubMed  Google Scholar 

  • Liao S, Su T, Jeng Y et al (2019) Clinical Manifestations and outcomes of patients with sarcomatoid hepatocellular carcinoma. Hepatology (Baltimore, MD) 69:209–221

    Article  Google Scholar 

  • Liberati A, Altman DG, Tetzlaff J et al (2009) The PRISMA statement for reporting systematic reviews and meta-analyses of studies that evaluate health care interventions: explanation and elaboration. PLoS Med 6:e1000100

    Article  PubMed  PubMed Central  Google Scholar 

  • Lu J, Xiong X, Li F et al (2015) Prognostic significance of sarcomatous change in patients with hepatocellular carcinoma after surgical resection. Ann Surg Oncol 22:S1048-1056

    Article  PubMed  Google Scholar 

  • Maeda T, Adachi E, Kajiyama K, Takenaka K, Sugimachi K, Tsuneyoshi M (1996) Spindle cell hepatocellular carcinoma. A clinicopathologic and immunohistochemical analysis of 15 cases. Cancer 77:51–57

    Article  CAS  PubMed  Google Scholar 

  • McCluggage W (2002) Malignant biphasic uterine tumours: carcinosarcomas or metaplastic carcinomas? J Clin Pathol 55:321–325

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  • Midia M, Odedra D, Shuster A, Midia R, Muir J (2019) Predictors of bleeding complications following percutaneous image-guided liver biopsy: a scoping review. Diagn Interv Radiol (Ankara, Turkey) 25:71–80

    Article  Google Scholar 

  • Murata M, Miyoshi Y, Iwao K et al (2001) Combined hepatocellular/cholangiocellular carcinoma with sarcomatoid features: genetic analysis for histogenesis. Hepatol Res off J Jpn Soc Hepatol 21:220–227

    Article  Google Scholar 

  • Numbere N, Zhang D, Agostini-Vulaj D (2020) A rare histologic subtype of hepatocellular carcinoma, sarcomatoid hepatocellular carcinoma: report of a case. Hepat Oncol 8:HEP33

    Article  PubMed  PubMed Central  Google Scholar 

  • Seo N, Kim M, Rhee H (2019) Hepatic sarcomatoid carcinoma: magnetic resonance imaging evaluation by using the liver imaging reporting and data system. Eur Radiol 29:3761–3771

    Article  PubMed  Google Scholar 

  • Shin P, Ohmi S, Sakurai M (1981) Hepatocellular carcinoma combined with hepatic sarcoma. Acta Pathol Jpn 31:815–824

    CAS  PubMed  Google Scholar 

  • Stang A, Stang A (2010) (2010) Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in meta-analyses. Eur J Epidemiol 259:603–605

    Article  Google Scholar 

  • Sung C, Choi H, Lee K, Kim S (2013) Sarcomatoid carcinoma represents a complete phenotype with various pathways of epithelial mesenchymal transition. J Clin Pathol 66:601–606

    Article  CAS  PubMed  Google Scholar 

  • Tierney JF, Stewart LA, Ghersi D, Burdett S, Sydes MR (2007) Practical methods for incorporating summary time-to-event data into meta-analysis. Trials 8:16

    Article  PubMed  PubMed Central  Google Scholar 

  • Wang Q, Cui B, Weng J, Wu Q, Qiu J, Lin X (2012) Clinicopathological characteristics and outcome of primary sarcomatoid carcinoma and carcinosarcoma of the liver. J Gastrointest Surg off J Soc Surg Aliment Tract 16:1715–1726

    Article  Google Scholar 

  • Wang J, Yao Z, Sun Y et al (2020) Clinicopathological characteristics and surgical outcomes of sarcomatoid hepatocellular carcinoma. World J Gastroenterol 26:4327–4342

    Article  PubMed  PubMed Central  Google Scholar 

  • Watanabe J, Nakashima O, Kojiro M (1994) Clinicopathologic study on lymph node metastasis of hepatocellular carcinoma: a retrospective study of 660 consecutive autopsy cases. Jpn J Clin Oncol 24:37–41

    CAS  PubMed  Google Scholar 

  • Wu L, Tsilimigras D, Farooq A et al (2019) Management and outcomes among patients with sarcomatoid hepatocellular carcinoma: a population-based analysis. Cancer 125:3767–3775

    Article  PubMed  Google Scholar 

  • Xue D, Zuo K, Li X et al (2013) Concomitant early gallbladder carcinoma with primary sarcomatoid hepatocellular carcinoma: a case report. Oncol Lett 5:1965–1967

    Article  PubMed  PubMed Central  Google Scholar 

  • Yamaguchi R, Nakashima O, Yano H, Kutami R, Kusaba A, Kojiro M (1997) Hepatocellular carcinoma with sarcomatous change. Oncol Rep 4:525–529

    CAS  PubMed  Google Scholar 

  • Yang Z, Lv K, Zhao Y, Pan M, Zhang C, Wei S (2020) Sarcomatoid hepatocellular carcinoma mimicking hepatic abscess: a case report. Medicine 99:e22489

    Article  PubMed  PubMed Central  Google Scholar 

  • Yen C, Lai C, Liao C et al (2017) Characterization of a new murine cell line of sarcomatoid hepatocellular carcinoma and its application for biomarker/therapy development. Sci Rep 7:3052

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  • Yokomizo J, Cho A, Yamamoto H et al (2007) Sarcomatous hepatocellular carcinoma without previous anticancer therapy. J Hepatobiliary Pancreat Surg 14:324–327

    Article  PubMed  Google Scholar 

  • Yoshida N, Midorikawa Y, Kajiwara T et al (2013) Hepatocellular carcinoma with sarcomatoid change without anticancer therapies. Case Rep Gastroenterol 7:169–174

    Article  PubMed  PubMed Central  Google Scholar 

  • Yu Y, Zhong Y, Wang J, Wu D (2017) Sarcomatoid hepatocellular carcinoma (SHC): a case report. World J Surg Oncol 15:219

    Article  PubMed  PubMed Central  Google Scholar 

  • Zhu S, Li H, Yuan Z et al (2020) Achievement of complete response to nivolumab in a patient with advanced sarcomatoid hepatocellular carcinoma: a case report. World J Gastrointest Oncol 12:1209–1215

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Acknowledgements

We acknowledge the 1.3.5 project for disciplines of excellence, West China Hospital, Sichuan University (ZYJC21046); 1.3.5 project for disciplines of excellence-Clinical Research Incubation Project, West China Hospital, Sichuan University (2021HXFH001); Sichuan Science and Technology Program (2021YJ0132, 2021YFS0100); The fellowship of China Postdoctoral Science Foundation (2021M692277); Sichuan University-Zigong School-local Cooperation project (2021CDZG-23); Fundamental Research Funds for the Central Universities (2019SCUH0021), and Post-Doctor Research Project, West China Hospital, Sichuan University (2021HXBH127).

Funding

This study was Supported by 1.3.5 project for disciplines of excellence, West China Hospital, Sichuan University (ZYJC21046); 1.3.5 project for disciplines of excellence-Clinical Research Incubation Project, West China Hospital, Sichuan University (2021HXFH001); Sichuan Science and Technology Program (2021YJ0132, 2021YFS0100); The fellowship of China Postdoctoral Science Foundation (2021M692277); Sichuan University-Zigong School-local Cooperation project (2021CDZG-23); Fundamental Research Funds for the Central Universities (2019SCUH0021), and Post-Doctor Research Project, West China Hospital, Sichuan University (2021HXBH127).

Author information

Author notes

  1. Tian-Run Lv and Hai-Jie Hu contributed equally to the study and were the co-first authors.

Authors and Affiliations

  1. Department of Biliary Surgery, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China

    Tian-Run Lv, Hai-Jie Hu, Parbatraj Regmi, Fei Liu & Fu-Yu Li

Authors
  1. Tian-Run Lv
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Hai-Jie Hu
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Parbatraj Regmi
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Fei Liu
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Fu-Yu Li
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

T-RL and H-JH contributed equally to the study. T-RL contributed to data acquisition and drafted the manuscript. H-JH contributed to the literature review, manuscript editing and subsequent minor revision. PR, FL were involved editing the manuscript. F-YL contributed to the study design and revision of the manuscript.

Corresponding author

Correspondence to Fu-Yu Li.

Ethics declarations

Role of the funding source

Funding Source has no role in design and preparation of the manuscript.

Conflict of interest

All authors declare that they have no conflict of interest to disclose.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Supplementary Information

Below is the link to the electronic supplementary material.

Supplementary file1 (DOCX 18 KB)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Lv, TR., Hu, HJ., Regmi, P. et al. Sarcomatoid hepatocellular carcinoma versus conventional hepatocellular carcinoma: a systematic review and meta-analysis. J Cancer Res Clin Oncol 148, 1685–1696 (2022). https://doi.org/10.1007/s00432-022-03949-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00432-022-03949-8

Keywords

Search

Navigation