Adult versus paediatric undifferentiated embryonal sarcoma of the liver: a SEER database analysis
Lu Pan1, Lu Yin2, Xin-Chun Liu3
1Department of Intensive Care Unit, Affiliated Hangzhou First People's Hospital, Zhejiang University School of Medicine, Hangzhou, China.
Insights
Undifferentiated embryonal sarcoma of the liver (UESL) affects adults and children differently. Adult UESL has a male predominance and a significantly worse prognosis, highlighting the need for tailored treatment strategies.
Area of Science:
- Hepatobiliary Oncology
- Pediatric Oncology
- Surgical Oncology
Background:
- Undifferentiated embryonal sarcoma of the liver (UESL) is a rare hepatic tumor predominantly seen in pediatric populations.
- Limited data exists comparing clinical characteristics and survival outcomes between adult and pediatric UESL cases.
Purpose of the Study:
- To investigate and delineate the differences in clinical presentation, management, and survival between adult and pediatric patients diagnosed with UESL.
- To identify prognostic factors influencing overall survival in UESL patients across different age groups.
Main Methods:
- A retrospective analysis of 113 UESL patients from the Surveillance, Epidemiology, and End Results (SEER) database (1975-2015).
- Patients were stratified into pediatric (<18 years) and adult (≥18 years) cohorts for comparative analysis.
- Clinical characteristics, treatment modalities (chemotherapy, surgery), and overall survival (OS) were evaluated using univariate and multivariate analyses.
Main Results:
- UESL demonstrated a significant male predominance in adult patients compared to pediatric patients (71.9% vs. 48.2%, P=0.022).
- Pediatric patients received chemotherapy more frequently than adults (93.8% vs. 65.6%, P<0.001).
- Adults exhibited significantly poorer 5-year overall survival rates (30.0%) compared to pediatric patients (81.2%, P<0.001). Adult age, SEER summary stage, and surgical therapy were independent prognostic factors for OS.
Conclusions:
- UESL presents with a male predilection in adults and carries a poorer prognosis in this demographic compared to children.
- The findings underscore the importance of considering both surgical intervention and chemotherapy in the comprehensive management of UESL.
- Age is a critical factor in UESL prognosis, necessitating age-specific treatment considerations.
Background:
Undifferentiated embryonal sarcoma of the liver (UESL) is a rare liver tumour that occurs mainly in children. Herein, we aimed to identify any differences in clinical characteristics and survival between adult and paediatric patients with UESL.
Methods:
From 1975 to 2015 in the Surveillance, Epidemiology and End Results (SEER) database, patients diagnosed with UESL were identified and divided into paediatric (<18 years) and adult (≥18 years) groups. We then compared the clinical characteristics, management, and overall survival (OS) of adults and children diagnosed with UESL.
Results:
We analysed 113 patients with UESL (81 children and 32 adults). UESL was significantly more common in adult male than paediatric male patients (71.9% vs. 48.2%; P = 0.022). When compared to adult patients, paediatric patients were more likely to receive chemotherapy (93.8% vs. 65.6%; P < 0.001). Adults had a significantly worse OS than paediatric patients (5-year OS, 30.0% vs. 81.2%; P < 0.001). Univariate analysis found that adult age, surgical therapy and chemotherapy were associated with OS. Multivariate analysis revealed that adult age, SEER summary stage and surgical therapy were independent prognostic factors for OS.
Conclusions:
UESL had a male predominance among adult patients. Moreover, the prognosis of adult patients with UESL was significantly worse than that of paediatric patients. Surgery and chemotherapy should be considered in the treatment of patients with UESL.
