{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T18:50:14Z","timestamp":1760986214730,"version":"3.41.2"},"reference-count":37,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2023,10,5]],"date-time":"2023-10-05T00:00:00Z","timestamp":1696464000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Oncol."],"abstract":"<jats:sec><jats:title>Introduction<\/jats:title><jats:p>Although surgery is the preferred treatment for sarcomatoid hepatocellular carcinoma (SHC), the prognosis remains considerably poor due to early postoperative recurrence and metastasis. Reports on surgery after combined treatment with a tyrosine kinase inhibitor and anti-programmed cell death (PD)-1 antibody are unavailable.<\/jats:p><\/jats:sec><jats:sec><jats:title>Case presentation<\/jats:title><jats:p>A 69-year-old male patient with SHC was admitted to our hospital for treatment of a liver tumor that was detected on ultrasonography. Abdominal computed tomography with triple-phase enhancement revealed a lesion in the right hepatic lobe that measured 86.0 mm \u00d7 75.0 mm \u00d7 71.0 mm. Biopsy revealed a pathological diagnosis of liver sarcoma or sarcomatoid carcinoma. The patient subsequently received transcatheter arterial chemo-embolization, as he did not consent to surgery. More than two months later, he received a combination of lenvatinib with camrelizumab, as computed tomography showed an increase in the lesion size (to 123.0 mm \u00d7 90.0 mm \u00d7 80.0 mm) and lateral growth posterior to the upper pole of the right kidney. Liver resection was performed after 6 months of systemic therapy; pathological examination confirmed a diagnosis of SHC and showed extensive necrosis of tumor cells. Combined treatment with lenvatinib and camrelizumab was continued for 6 months after surgery. The patient has survived for over 24 months after initial diagnosis and is currently tumor-free.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Combined systemic therapy with a tyrosine kinase inhibitor and anti-PD-1 antibody may represent a feasible treatment strategy for improving resectability in cases of unresectable SHC. The outcomes with this combination may also be explored in cases of resectable SHC that have a high-risk of recurrence; this may improve the therapeutic effect.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fonc.2023.1212013","type":"journal-article","created":{"date-parts":[[2023,10,5]],"date-time":"2023-10-05T13:21:50Z","timestamp":1696512110000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":2,"title":["Surgery after combination therapy with a tyrosine kinase inhibitor and anti-PD-1 antibody in sarcomatoid hepatocellular carcinoma: case report and literature review"],"prefix":"10.3389","volume":"13","author":[{"given":"Bin","family":"Liang","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tao","family":"Huang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shao-Lei","family":"Kuang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guang-Yuan","family":"Xie","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Tian-Qi","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuan-Yuan","family":"Chen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2023,10,5]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.32396","article-title":"Management and outcomes among patients with sarcomatoid hepatocellular carcinoma: A population-based analysis","volume":"125","author":"Wu","year":"2019","journal-title":"Cancer"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2022.864106","article-title":"Epidemiological and clinical characteristics of five rare pathological subtypes of hepatocellular carcinoma","volume":"12","author":"Chen","year":"2022","journal-title":"Front Oncol"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1002\/cam4.4162","article-title":"Sarcomatoid hepatocellular carcinoma: From clinical features to cancer genome","volume":"10","author":"Zhang","year":"2021","journal-title":"Cancer Med"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1002\/hep.30162","article-title":"Clinical manifestations and outcomes of patients with sarcomatoid hepatocellular carcinoma","volume":"69","author":"Liao","year":"2019","journal-title":"Hepatology"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1002\/ijc.33545","article-title":"Sarcomatoid hepatocellular carcinoma is distinct from ordinary hepatocellular carcinoma: Clinicopathologic, transcriptomic and immunologic analyses","volume":"149","author":"Morisue","year":"2021","journal-title":"Int J Cancer"},{"key":"B6","doi-asserted-by":"publisher","first-page":"219","DOI":"10.1186\/s12957-017-1286-1","article-title":"Sarcomatoid hepatocellular carcinoma (SHC): a case report","volume":"15","author":"Yu","year":"2017","journal-title":"World J Surg Oncol"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.4251\/wjgo.v12.i10.1209","article-title":"Achievement of complete response to nivolumab in a patient with advanced sarcomatoid hepatocellular carcinoma: A case report","volume":"12","author":"Zhu","year":"2020","journal-title":"World J Gastrointest Oncol"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1007\/BF00647229","article-title":"Hepatocellular carcinoma with sarcomatous change: a special reference to the relationship with anticancer therapy","volume":"23","author":"Kojiro","year":"1989","journal-title":"Cancer Chemother Pharmacol"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1111\/j.1872-034X.2012.01017.x","article-title":"Combined hepatocellular carcinoma and neuroendocrine carcinoma with sarcomatous change of the liver after transarterial chemoembolization","volume":"42","author":"Nakanishi","year":"2012","journal-title":"Hepatol Res"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1007\/s12072-007-9040-3","article-title":"Insufficient radiofrequency ablation therapy may induce further Malignant transformation of hepatocellular carcinoma","volume":"2","author":"Obara","year":"2008","journal-title":"Hepatol Int"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.1159\/000111710","article-title":"Severe complications of radiofrequency ablation therapy for hepatocellular carcinoma: an analysis of 3,891 ablations in 2,614 patients","volume":"72","author":"Kasugai","year":"2007","journal-title":"Oncology"},{"key":"B12","doi-asserted-by":"publisher","DOI":"10.1016\/s1386-6346(03)00207-9","article-title":"Hepatocellular carcinoma with sarcomatous change arising after radiofrequency ablation for well-differentiated hepatocellular carcinoma","volume":"27","author":"Koda","year":"2003","journal-title":"Hepatol Res"},{"key":"B13","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v26.i29.4327","article-title":"Clinicopathological characteristics and surgical outcomes of sarcomatoid hepatocellular carcinoma","volume":"26","author":"Wang","year":"2020","journal-title":"World J Gastroenterol"},{"key":"B14","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v25.i5.608","article-title":"Analysis of intrahepatic sarcomatoid cholangiocarcinoma: Experience from 11 cases within 17 years","volume":"25","author":"Kim","year":"2019","journal-title":"World J Gastroenterol"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.2147\/JHC.S325182","article-title":"Primary liver sarcomatoid carcinoma: A case series and literature review","volume":"8","author":"Ji","year":"2021","journal-title":"J Hepatocell Carcinoma"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1007\/s00432-014-1641-3","article-title":"Primary hepatic sarcomatoid carcinoma: clinical features and prognosis of 28 resected cases","volume":"140","author":"Lu","year":"2014","journal-title":"J Cancer Res Clin Oncol"},{"key":"B17","doi-asserted-by":"publisher","DOI":"10.1097\/MD.0000000000030005","article-title":"A retrospective study on the clinical and pathological features of hepatic sarcomatoid carcinoma: Fourteen cases of a rare tumor","volume":"101","author":"Ma","year":"2022","journal-title":"Med (Baltimore)"},{"key":"B18","doi-asserted-by":"publisher","first-page":"977","DOI":"10.1186\/s12885-020-07475-z","article-title":"Clinical and imaging characteristics of primary hepatic sarcomatoid carcinoma and sarcoma: a comparative study","volume":"20","author":"Shi","year":"2020","journal-title":"BMC Cancer"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1097\/RCT.0b013e3181591ccd","article-title":"Radiological and clinical features of sarcomatoid hepatocellular carcinoma in 11 cases","volume":"32","author":"Koo","year":"2008","journal-title":"J Comput Assist Tomogr"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2021.611738","article-title":"MRI features of hepatic sarcomatoid carcinoma different from hepatocellular carcinoma and intrahepatic cholangiocarcinoma","volume":"11","author":"Zhang","year":"2021","journal-title":"Front Oncol"},{"key":"B21","doi-asserted-by":"publisher","DOI":"10.3969\/j.issn.1001-5256.2020.10.022","article-title":"Sarcomatoid carcinomas of the liver, gallbladder, and pancreas: A clinicopathological portrait and literature review","volume":"36","author":"Chen Jieyao","year":"2022","journal-title":"J Clin Hepatol"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.4103\/ijpm.Ijpm_751_20","article-title":"An update on subtypes of hepatocellular carcinoma: From morphology to molecular","volume":"64","author":"Vyas","year":"2021","journal-title":"Indian J Pathol Microbiol"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.1007\/s00432-022-03949-8","article-title":"Sarcomatoid hepatocellular carcinoma versus conventional hepatocellular carcinoma: a systematic review and meta-analysis","volume":"148","author":"Lv","year":"2022","journal-title":"J Cancer Res Clin Oncol"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.21873\/invivo.12270","article-title":"The epidemiology, staging and outcomes of sarcomatoid hepatocellular carcinoma: A SEER population analysis","volume":"35","author":"Giannis","year":"2021","journal-title":"In Vivo"},{"key":"B25","doi-asserted-by":"publisher","first-page":"394","DOI":"10.21037\/atm-21-4322","article-title":"Long-term outcomes and prognosis for patients with sarcomatoid hepatocellular carcinoma","volume":"10","author":"Zhou","year":"2022","journal-title":"Ann Transl Med"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijsu.2018.05.736","article-title":"The prognosis of subsequent surgical treatment in patients with sarcomatoid carcinoma in the liver: A retrospective study","volume":"55","author":"Kan","year":"2018","journal-title":"Int J Surg"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-015-4818-3","article-title":"Prognostic significance of sarcomatous change in patients with hepatocellular carcinoma after surgical resection","author":"Lu","year":"2015","journal-title":"Ann Surg Oncol"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1007\/s11605-007-0393-7","article-title":"Prognostic impact of sarcomatous change of hepatocellular carcinoma in patients undergoing liver resection and liver transplantation","volume":"12","author":"Hwang","year":"2008","journal-title":"J Gastrointest Surg"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.7150\/ijms.53602","article-title":"Development and validation of a comprehensive radiomics nomogram for prognostic prediction of primary hepatic sarcomatoid carcinoma after surgical resection","volume":"18","author":"Tang","year":"2021","journal-title":"Int J Med Sci"},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.3390\/cancers15061680","article-title":"Systemic therapy for advanced hepatocellular carcinoma: current stand and perspectives","volume":"15","author":"Girardi","year":"2023","journal-title":"Cancers (Basel)"},{"key":"B31","doi-asserted-by":"publisher","first-page":"65","DOI":"10.1007\/s10238-021-00727-7","article-title":"Second-line treatments for advanced hepatocellular carcinoma: A systematic review and bayesian network meta-analysis","volume":"22","author":"Solimando","year":"2022","journal-title":"Clin Exp Med"},{"key":"B32","doi-asserted-by":"publisher","DOI":"10.18632\/oncotarget.25989","article-title":"Apatinib-based targeted therapy against pulmonary sarcomatoid carcinoma: a case report and literature review","volume":"9","author":"Li","year":"2018","journal-title":"Oncotarget"},{"key":"B33","doi-asserted-by":"publisher","DOI":"10.1016\/j.jtho.2020.01.014","article-title":"Efficacy of immune checkpoint inhibitors in lung sarcomatoid carcinoma","volume":"15","author":"Domblides","year":"2020","journal-title":"J Thorac Oncol"},{"key":"B34","doi-asserted-by":"publisher","DOI":"10.3389\/fonc.2022.1086908","article-title":"Genetic testing and prognosis of sarcomatoid hepatocellular carcinoma patients","volume":"12","author":"Jia","year":"2022","journal-title":"Front Oncol"},{"key":"B35","doi-asserted-by":"publisher","DOI":"10.1016\/j.modpat.2022.100042","article-title":"Hepatic sarcomatoid carcinoma is an aggressive hepatic neoplasm sharing common molecular features with its conventional carcinomatous counterparts","volume":"36","author":"Yoshuantari","year":"2023","journal-title":"Mod Pathol"},{"key":"B36","doi-asserted-by":"publisher","DOI":"10.1007\/s12328-023-01758-1","article-title":"A ruptured sarcomatoid hepatocellular carcinoma treated with combined immunotherapy","volume":"16","author":"Goto","year":"2023","journal-title":"Clin J Gastroenterol"},{"key":"B37","doi-asserted-by":"publisher","DOI":"10.1177\/23247096221129470","article-title":"Disease control achieved using atezolizumab + Bevacizumab in a patient with sarcomatoid hepatocellular carcinoma (SHCC), a rare variant excluded from the IMbrave150 trial","volume":"10","author":"Fencer","year":"2022","journal-title":"J Investig Med High Impact Case Rep"}],"container-title":["Frontiers in Oncology"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2023.1212013\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,5]],"date-time":"2023-10-05T13:21:55Z","timestamp":1696512115000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fonc.2023.1212013\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,10,5]]},"references-count":37,"alternative-id":["10.3389\/fonc.2023.1212013"],"URL":"https:\/\/doi.org\/10.3389\/fonc.2023.1212013","relation":{},"ISSN":["2234-943X"],"issn-type":[{"type":"electronic","value":"2234-943X"}],"subject":[],"published":{"date-parts":[[2023,10,5]]},"article-number":"1212013"}}