Abstract 43P
Background
Alongside the scarcity of treatment options and the aggressive biology of liver sarcoma (LS), patients with this type of tumor often present with giant tumor size after months of unsuccessful diagnostic and treatment workup in low-volume centers. Awareness about LS among health care professionals of general hospitals could be raised with recognition and making emphasis on factors leading to delay in referral of patients with LS to tertiary care center
Methods
Data on diagnostic and treatment work-up before and after referral to the specialized center of 11 adult patients with primary hepatic and metastatic LS were analyzed.
Results
The median time interval between the first hospital visit and referral to the specialized center was 2.8 months (1.5-5 months). In 4 cases, the diagnosis before referral was liver abscess, in 4 cases – unknown type of tumor, in 1 case – liver hemangioma, in 1 case – liver pleomorphic sarcoma, in 1 case – liver tuberculoma. In almost half of the cases, invasive procedures were performed before referral, including percutaneous draining (n=4), surgical exploration complicated with tumor rupture (n=1), and tumor cytology (n=1), and in the remaining cases (n=5) only imaging before referral was performed. The median tumor size in the greatest dimension was 16 cm. All patients underwent surgical treatment at our center indicated by complications of the giant tumor size with or without tumor rupture. According to the histologic report, there were 4 cases of undifferentiated embryonal liver sarcoma, 2 cases of liver metastases of uterine leiomyosarcoma, 2 cases of liver angiosarcoma, 1 case of primary liver leiomyosarcoma, 1 case of liver metastases of gastrointestinal stromal tumor of small intestine and 1 case of liver PEComa.
Conclusions
Lack of awareness about liver sarcoma among general healthcare professionals is an established issue. However, another concern on the performance of invasive diagnostic and treatment procedures in non-specialized centers should be raised. The latter imposes patients to a tremendous pathway before true diagnosis will be established, substantially worsening oncological, as well as, surgical prognosis.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
M. Bilych.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.