Skip to main content

Hepatic Metastases from Sarcomas

  • Chapter
  • First Online:
  • 906 Accesses

Abstract

Soft-tissue sarcomas (STSs) are rare malignant tumors with an incidence of approximately 1 % of all malignancies. Their treatment is complex, requiring a multidisciplinary approach that includes surgeons, radiologists, pathologists, and medical oncologists. The liver is one of the target organs for sarcoma metastases. Liver metastases from sarcomas can be diagnosed using imaging modalities such as computed tomography, ultrasound, and magnetic resonance imaging. The most effective treatment for liver metastases is surgery, either alone or in combination with imatinib. Many alternative methods can be used to treat recurrences.

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

Buying options

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   159.00
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD   109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

References

  1. Rehders A, Peiper M, Stoecklein NH, Alexander A, Boelke E, Knoefel WT, Rogiers X (2009) Hepatic metastasectomy for soft-tissue sarcomas: is it justified? World J Surg 33:111–117

    Article  CAS  PubMed  Google Scholar 

  2. Schmitt T, Keller E, Dietrich S, Wuchter P, Ho AD, Egerer G (2010) Trabectedin for metastatic soft tissue sarcoma: a retrospective single center analysis. Mar Drugs 8:2647–2658

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  3. Chua TC, Chu F, Morris DL (2011) Outcomes of single-centre experience of hepatic resection and cryoablation of sarcoma liver metastases. Am J Clin Oncol 34:317–320

    Article  PubMed  Google Scholar 

  4. Deneve JL, Choi J, Gonzalez RJ, Conley AP, Stewart S, Han D, Werner P, Chaudhry TA, Zager JS (2012) Chemosaturation with percutaneous hepatic perfusion for unresectable isolated hepatic metastases from sarcoma. Cardiovasc Intervent Radiol 35:1480–1487

    Article  PubMed  Google Scholar 

  5. DeMatteo RP, Lewis JJ, Leung D, Mudan SS, Woodruff JM, Brennan MF (2000) Two hundred gastrointestinal stromal tumors: recurrence patterns and prognostic factors for survival. Ann Surg 231:51–58

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  6. Mudan SS, Conlon KC, Woodruff JM, Lewis JJ, Brennan MF (2000) Salvage surgery for patients with recurrent gastrointestinal sarcoma: prognostic factors to guide patient selection. Cancer 88:66–74

    Article  CAS  PubMed  Google Scholar 

  7. Miettinen M, Kopczynski J, Makhlouf HR, Sarlomo-Rikala M, Gyorffy H, Burke A, Sobin LH, Lasota J (2003) Gastrointestinal stromal tumors, intramural leiomyomas, and leiomyosarcomas in the duodenum: a clinicopathologic, immunohistochemical, and molecular genetic study of 167 cases. Am J Surg Pathol 27:625–641

    Article  PubMed  Google Scholar 

  8. Goettsch WG, Bos SD, Breekveldt-Postma N, Casparie M, Herings RM, Hogendoorn PC (2005) Incidence of gastrointestinal stromal tumours is underestimated: results of a nation-wide study. Eur J Cancer 41:2868–2872

    Article  PubMed  Google Scholar 

  9. Burkill GJ, Badran M, Al-Muderis O, Meirion Thomas J, Judson IR, Fisher C, Moskovic EC (2003) Malignant gastrointestinal stromal tumor: distribution, imaging features, and pattern of metastatic spread. Radiology 226:527–532

    Article  PubMed  Google Scholar 

  10. Giuly JA, Picand R, Giuly D, Monges B, Nguyen-Cat R (2003) Von Recklinghausen disease and gastrointestinal stromal tumors. Am J Surg 185:86–87

    Article  PubMed  Google Scholar 

  11. Miettinen M, Lasota J (2006) Gastrointestinal stromal tumors: review on morphology, molecular pathology, prognosis, and differential diagnosis. Arch Pathol Lab Med 130:1466–1478

    CAS  PubMed  Google Scholar 

  12. Miettinen M, Lasota J (2006) Gastrointestinal stromal tumors: pathology and prognosis at different sites. Semin Diagn Pathol 23:70–83

    Article  PubMed  Google Scholar 

  13. Fletcher CD, Berman JJ, Corless C, Gorstein F, Lasota J, Longley BJ, Miettinen M, O’Leary TJ, Remotti H, Rubin BP, Shmookler B, Sobin LH, Weiss SW (2002) Diagnosis of gastrointestinal stromal tumors: a consensus approach. Hum Pathol 33:459–465

    Article  PubMed  Google Scholar 

  14. Rossi S, Miceli R, Messerini L, Bearzi I, Mazzoleni G, Capella C, Arrigoni G, Sonzogni A, Sidoni A, Toffolatti L, Laurino L, Mariani L, Vinaccia V, Gnocchi C, Gronchi A, Casali PG, Dei Tos AP (2011) Natural history of imatinib-naive GISTs: a retrospective analysis of 929 cases with long-term follow-up and development of a survival nomogram based on mitotic index and size as continuous variables. Am J Surg Pathol 35:1646–1656

    Article  PubMed  Google Scholar 

  15. Joensuu H, Vehtari A, Riihimäki J, Nishida T, Steigen SE, Brabec P, Plank L, Nilsson B, Cirilli C, Braconi C, Bordoni A, Magnusson MK, Linke Z, Sufliarsky J, Federico M, Jonasson JG, Dei Tos AP, Rutkowski P (2012) Risk of recurrence of gastrointestinal stromal tumour after surgery: an analysis of pooled population-based cohorts. Lancet Oncol 13:265–274

    Article  PubMed  Google Scholar 

  16. Hartman DS, Hayes WS, Choyke PL, Tibbetts GP (1992) From the archives of the AFIP. Leiomyosarcoma of the retroperitoneum and inferior vena cava: radiologic-pathologic correlation. Radiographics 12:1203–1220

    Article  CAS  PubMed  Google Scholar 

  17. O’Sullivan PJ, Harris AC, Munk PL (2008) Radiological imaging features of non-uterine leiomyosarcoma. Br J Radiol 81:73–81

    Article  PubMed  Google Scholar 

  18. Rogatsch H, Bonatti H, Menet A, Larcher C, Feichtinger H, Dirnhofer S (2000) Epstein-Barr virus-associated multicentric leiomyosarcoma in an adult patient after heart transplantation: case report and review of the literature. Am J Surg Pathol 24:614–621

    Article  CAS  PubMed  Google Scholar 

  19. Barbetakis N, Paliouras D, Asteriou C, Samanidis G, Kleontas A, Anestakis D, Kaplanis K, Tsilikas C (2009) Cutaneous skull metastasis from uterine leiomyosarcoma: a case report. World J Surg Oncol 7:45

    Article  PubMed Central  PubMed  Google Scholar 

  20. Miettinen M, Sobin LH, Lasota J (2009) True smooth muscle tumors of the small intestine: a clinicopathologic, immunhistochemical, and molecular genetic study of 25 cases. Am J Surg Pathol 33:430–436

    Article  PubMed  Google Scholar 

  21. Ceballos KM, Nielsen GP, Selig MK, O’Connell JX (2000) Is anti-h-caldesmon useful for distinguishing smooth muscle and myofibroblastic tumors? An immunohistochemical study. Am J Clin Pathol 114:746–753

    Article  CAS  PubMed  Google Scholar 

  22. Levy AD, Remotti HE, Thompson WM, Sobin LH, Miettinen M (2003) Gastrointestinal stromal tumors: radiologic features with pathologic correlation. Radiographics 23:283–304

    Article  PubMed  Google Scholar 

  23. Miettinen M, Sarlomo-Rikala M, Lasota J (1998) Gastrointestinal stromal tumours. Ann Chir Gynaecol 87(4):278–281

    CAS  PubMed  Google Scholar 

  24. O’Sullivan PJ, Harris AC, Ho SG, Munk PL (2006) The imaging features of gastrointestinal stromal tumours. Eur J Radiol 60:431–438

    Article  PubMed  Google Scholar 

  25. Levy AD, Remotti HE, Thompson WM, Sobin LH, Miettinen M (2003) Anorectal gastrointestinal stromal tumors: CT and MR imaging features with clinical and pathologic correlation. AJR Am J Roentgenol 180:1607–1612

    Article  PubMed  Google Scholar 

  26. Kim SJ, Choi JA, Lee SH, Choi JY, Hong SH, Chung HW, Kang HS (2004) Imaging findings of extrapulmonary metastases of osteosarcoma. Clin Imaging 28:291–300

    Article  PubMed  Google Scholar 

  27. Prasad SR, Wang H, Rosas H, Menias CO, Narra VR, Middleton WD, Heiken JP (2005) Fat-containing lesions of the liver: radiologic-pathologic correlation. Radiographics 25:321–331

    Article  PubMed  Google Scholar 

  28. Chan HH, Chan JK, Ng WM, Shek TW, Chan FL (2001) Lace-like enhancement pattern of osteosarcoma of rib and liver metastasis in CT scans. Australas Radiol 45:305–308

    Article  CAS  PubMed  Google Scholar 

  29. Sheah K, Ouellette HA, Torriani M, Nielsen GP, Kattapuram S, Bredella MA (2008) Metastatic myxoid liposarcomas: imaging and histopathologic findings. Skelet Radiol 37:251–258

    Article  Google Scholar 

  30. Mahfouz AE, Hamm B, Mathieu D (1996) Imaging of metastases to the liver. Eur Radiol 6:607–614

    Article  CAS  PubMed  Google Scholar 

  31. Mahfouz AE, Hamm B, Wolf KJ (1994) Peripheral washout: a sign of malignancy on dynamic gadolinium-enhanced MR images of focal liver lesions. Radiology 190:49–52

    Article  CAS  PubMed  Google Scholar 

  32. Lafaro KJ, Roumanis P, Demirjian AN, Lall C, Imagawa DK (2013) Gd-EOB-DTPA-Enhanced MRI for detection of liver metastases from colorectal cancer: a surgeon’s perspective! Int J Hepatol 2013:572307

    PubMed Central  PubMed  Google Scholar 

  33. Chua SC, Groves AM, Kayani I, Menezes L, Gacinovic S, Du Y, Bomanji JB, Ell PJ (2007) The impact of 18F-FDG PET/CT in patients with liver metastases. Eur J Nucl Med Mol Imaging 34:1906–1914

    Article  PubMed  Google Scholar 

  34. Le Cesne A, Judson I, Crowther D, Rodenhuis S, Keizer HJ, Van Hoesel Q, Blay JY, Frisch J, Van Glabbeke M, Hermans C, Van Oosterom A, Tursz T, Verweij J (2000) Randomized phase III study comparing conventional-dose doxorubicin plus ifosfamide versus high-dose doxorubicin plus ifosfamide plus recombinant human granulocyte-macrophage colony-stimulating factor in advanced soft tissue sarcomas: a trial of the european organization for research and treatment of cancer/soft tissue and bone sarcoma group. J Clin Oncol 18:2676–2684

    PubMed  Google Scholar 

  35. DeMatteo RP, Shah A, Fong Y, Jarnagin WR, Blumgart LH, Brennan MF (2001) Results of hepatic resection for sarcoma metastatic to liver. Ann Surg 234:540–547

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  36. Hirota S, Isozaki K, Moriyama Y, Hashimoto K, Nishida T, Ishiguro S, Kawano K, Hanada M, Kurata A, Takeda M, Muhammad Tunio G, Matsuzawa Y, Kanakura Y, Shinomura Y, Kitamura Y (1998) Gain-of-function mutations of c-kit in human gastrointestinal stromal tumors. Science 279:577–580

    Article  CAS  PubMed  Google Scholar 

  37. Demetri GD, von Mehren M, Blanke CD, Van den Abbeele AD, Eisenberg B, Roberts PJ, Heinrich MC, Tuveson DA, Singer S, Janicek M, Fletcher JA, Silverman SG, Silberman SL, Capdeville R, Kiese B, Peng B, Dimitrijevic S, Druker BJ, Corless C, Fletcher CD, Joensuu H (2002) Efficacy and safety of imatinib mesylate in advanced gastrointestinal stromal tumors. N Engl J Med 347:472–480

    Article  CAS  PubMed  Google Scholar 

  38. van Oosterom AT, Judson I, Verweij J, Stroobants S, di Donato PE, Dimitrijevic S, Martens M, Webb A, Sciot R, Van Glabbeke M, Silberman S, Nielsen OS, European Organisation for Research and Treatment of Cancer Soft Tissue and Bone Sarcoma Group (2001) Safety and efficacy of imatinib (STI571) in metastatic gastrointestinal stromal tumours: a phase I study. Lancet 358:1421–1423

    Article  PubMed  Google Scholar 

  39. Rubin BP, Fletcher JA, Fletcher CD (2000) Molecular insights into the histogenesis and pathogenesis of gastrointestinal stromal tumors. Int J Surg Pathol 8:5–10

    Article  CAS  PubMed  Google Scholar 

  40. Turley RS, Peng PD, Reddy SK, Barbas AS, Geller DA, Marsh JW, Tsung A, Pawlik TM, Clary BM (2012) Hepatic resection for metastatic gastrointestinal stromal tumors in the tyrosine kinase inhibitor era. Cancer 118:3571–3578

    Article  PubMed Central  PubMed  Google Scholar 

  41. Wu PC, Langerman A, Ryan CW, Hart J, Swiger S, Posner MC (2003) Surgical treatment of gastrointestinal stromal tumors in the imatinib (STI-571) era. Surgery 134:656–665

    Article  PubMed  Google Scholar 

  42. Jaques DP, Coit DG, Casper ES, Brennan MF (1995) Hepatic metastases from soft-tissue sarcoma. Ann Surg 221:392–397

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  43. Elias D, de Cavalcanti AA, Eggenspieler P, Plaud B, Ducreux M, Spielmann M, Theodore C, Bonvalot S, Lasser P (1998) Resection of liver metastases from a noncolorectal primary: indications and results based on 147 monocentric patients. J Am Coll Surg 187:487–493

    Article  CAS  PubMed  Google Scholar 

  44. Chen H, Pruitt A, Nicol TL, Gorgulu S, Choti MA (1998) Complete hepatic resection of metastases from leiomyosarcoma prolongs survival. J Gastrointest Surg 2:151–155

    Article  CAS  PubMed  Google Scholar 

  45. Lang H, Nussbaum KT, Kaudel P, Frühauf N, Flemming P, Raab R (2000) Hepatic metastases from leiomyosarcoma: a single-center experience with 34 liver resections during a 15-year period. Ann Surg 231:500–505

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  46. Shima Y, Horimi T, Ishikawa T, Ichikawa J, Okabayashi T, Nishioka Y, Hamada M, Shibuya Y, Ishii T, Ito M (2003) Aggressive surgery for liver metastases from gastrointestinal stromal tumors. J Hepato Pancreat Surg 10:77–80

    Google Scholar 

  47. Nunobe S, Sano T, Shimada K, Sakamoto Y, Kosuge T (2005) Surgery including liver resection for metastatic gastrointestinal stromal tumors or gastrointestinal leiomyosarcomas. Jpn J Clin Oncol 35:338–341

    Article  PubMed  Google Scholar 

  48. Ercolani G, Grazi GL, Ravaioli M, Ramacciato G, Cescon M, Varotti G, Del Gaudio M, Vetrone G, Pinna AD (2005) The role of liver resections for noncolorectal, nonneuroendocrine metastases: experience with 142 observed cases. Ann Surg Oncol 12:459–466

    Article  PubMed  Google Scholar 

  49. Adam R, Chiche L, Aloia T, Elias D, Salmon R, Rivoire M, Jaeck D, Saric J, Le Treut YP, Belghiti J, Mantion G, Mentha G, Association Française de Chirurgie (2006) Hepatic resection for noncolorectal nonendocrine liver metastases: analysis of 1,452 patients and development of a prognostic model. Ann Surg 244:524–535

    Article  PubMed Central  PubMed  Google Scholar 

  50. Teo MC, Tan YM, Chung AY, Chow PK, Cheow PC, Soo KC, Hee SW, Ooi LL (2006) Metastectomy for non-colorectal, non-neuroendocrine liver secondaries. ANZ J Surg 76:575–578

    Article  PubMed  Google Scholar 

  51. Lendoire J, Moro M, Andriani O, Grondona J, Gil O, Raffin G, Silva J, Bracco R, Podestá G, Valenzuela C, Imventarza O, Pekolj J, De Santibañes E (2007) Liver resection for non-colorectal, non-neuroendocrine metastases: analysis of a multicenter study from Argentina. HPB (Oxford) 9:435–439

    Article  CAS  Google Scholar 

  52. Zacherl M, Bernhardt GA, Zacherl J, Gruber G, Kornprat P, Bacher H, Mischinger HJ, Windhager R, Jakesz R, Grünberger T (2011) Surgery for liver metastases originating from sarcoma-case series. Langenbecks Arch Surg 396:1083–1091

    Article  PubMed  Google Scholar 

  53. Ng EH, Pollock RE, Romsdahl MM (1992) Prognostic implications of patterns of failure for gastrointestinal leiomyosarcomas. Cancer 69:1334–1341

    Article  CAS  PubMed  Google Scholar 

  54. Haller F, Detken S, Schulten HJ, Happel N, Gunawan B, Kuhlgatz J, Füzesi L (2007) Surgical management after neoadjuvant imatinib therapy in gastrointestinal stromal tumours (GISTs) with respect to imatinib resistance caused by secondary KIT mutations. Ann Surg Oncol 14:526–532

    Article  PubMed  Google Scholar 

  55. Joensuu H (2006) Gastrointestinal stromal tumor (GIST). Ann Oncol 17(Suppl 10):x280–x286

    Article  PubMed  Google Scholar 

  56. Steeghs N, Nortier JW, Gelderblom H (2007) Small molecule tyrosine kinase inhibitors in the treatment of solid tumors: an update of recent developments. Ann Surg Oncol 14:942–953

    Article  PubMed  Google Scholar 

  57. Verweij J, Casali PG, Zalcberg J, LeCesne A, Reichardt P, Blay JY, Issels R, van Oosterom A, Hogendoorn PC, Van Glabbeke M, Bertulli R, Judson I (2004) Progression-free survival in gastrointestinal stromal tumours with high-dose imatinib: randomised trial. Lancet 364:1127–1134

    Article  CAS  PubMed  Google Scholar 

  58. Xia L, Zhang MM, Ji L, Li X, Wu XT (2010) Resection combined with imatinib therapy for liver metastases of gastrointestinal stromal tumors. Surg Today 40:936–942

    Article  CAS  PubMed  Google Scholar 

  59. Husted TL, Neff G, Thomas MJ, Gross TG, Woodle ES, Buell JF (2006) Liver transplantation for primary or metastatic sarcoma to the liver. Am J Transplant 6:392–397

    Article  CAS  PubMed  Google Scholar 

  60. Trevisani F, De Notariis S, Rossi C, Bernardi M (2001) Randomized control trials on chemoembolization for hepatocellular carcinoma: is there room for new studies? J Clin Gastroenterol 32:383–389

    Article  CAS  PubMed  Google Scholar 

  61. Mavligit GM, Zukwiski AA, Ellis LM, Chuang VP, Wallace S (1995) Gastrointestinal leiomyosarcoma metastatic to the liver. Durable tumor regression by hepatic chemoembolization infusion with cisplatin and vinblastine. Cancer 75:2083–2088

    Article  CAS  PubMed  Google Scholar 

  62. Bleicher RJ, Allegra DP, Nora DT, Wood TF, Foshag LJ, Bilchik AJ (2003) Radiofrequency ablation in 447 complex unresectable liver tumors: lessons learned. Ann Surg Oncol 10:52–58

    Article  PubMed  Google Scholar 

  63. Jones RL, McCall J, Adam A, O’Donnell D, Ashley S, Al-Muderis O, Thway K, Fisher C, Judson IR (2010) Radiofrequency ablation is a feasible therapeutic option in the multi modality management of sarcoma. Eur J Surg Oncol 36:477–482

    Article  CAS  PubMed  Google Scholar 

  64. Pawlik TM, Vauthey JN, Abdalla EK, Pollock RE, Ellis LM, Curley SA (2006) Results of a single-center experience with resection and ablation for sarcoma metastatic to the liver. Arch Surg 141:537–543

    Article  PubMed  Google Scholar 

  65. Uthappa MC, Ravikumar R, Gupta A (2011) Selective internal radiation therapy: 90Y (yttrium) labeled microspheres for liver malignancies (primary and metastatic). Indian J Cancer 48:18–23

    Article  CAS  PubMed  Google Scholar 

  66. Hong X, Choi H, Loyer EM, Benjamin RS, Trent JC, Charnsangavej C (2006) Gastrointestinal stromal tumor: role of CT in diagnosis and in response evaluation and surveillance after treatment with imatinib. Radiographics 26:481–495

    Article  PubMed  Google Scholar 

Download references

Acknowledgment 

The Authors are very grateful to doctor Ahmed Mafhouz from Weill Cornell Medical College-Q, New York, USA for his contribution for the part of diagnosis in the present chapter.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Isidoro Di Carlo .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2015 Springer International Publishing Switzerland

About this chapter

Cite this chapter

Toro, A., Di Carlo, I. (2015). Hepatic Metastases from Sarcomas. In: Di Carlo, I. (eds) Noncolorectal, Nonneuroendocrine Liver Metastases. Springer, Cham. https://doi.org/10.1007/978-3-319-09293-5_10

Download citation

  • DOI: https://doi.org/10.1007/978-3-319-09293-5_10

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-09292-8

  • Online ISBN: 978-3-319-09293-5

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics