Prognostic impact of adjuvant therapy following surgical resection in primary hepatic sarcomatoid carcinoma: a retrospective cohort study.

backgroundPrimary hepatic sarcomatoid carcinoma (PHSC) is a rare and aggressive hepatic malignancy characterized by high recurrence rates and poor prognosis. This study aims to evaluate the efficacy of postoperative adjuvant therapy in PHSC patients after surgical resection.

methodsThe retrospective study enrolled patients with postoperatively, pathologically confirmed PHSC at a major academic medical center between December 2018 and May 2023. Patients were divided into two groups based on the receipt of postoperative adjuvant therapy. Clinical and follow-up data were retrospectively collected. The primary endpoint was disease-free survival (DFS), and the secondary endpoint was overall survival (OS). Survival curves were generated using the Kaplan-Meier method and compared via the log-rank test. Univariate and multivariate Cox regression analyses were employed to identify prognostic factors.

resultsOf 2071 patients with hepatic malignancies, 52 cases (2.5%) were pathologically confirmed as PHSC. The final analysis included 36 PHSC patients, with 19 in the treatment group and 17 in the non-treatment group. The treatment group showed significantly longer DFS compared to the non-treatment group (10.5 vs. 3.0 months, P = 0.008), although the difference in OS was not statistically significant (30.4 vs. 24.1 months, P = 0.229). Multivariable analysis identified adjuvant therapy as an independent protective factor for DFS (HR 0.24, 95% CI 0.08-0.69, P = 0.008).

conclusionPostoperative adjuvant therapy significantly prolongs DFS in patients with PHSC, although a corresponding OS benefit was not statistically demonstrated. Further multicenter prospective studies are needed to determine the optimal adjuvant therapy regimen for PHSC.