{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,29]],"date-time":"2026-10-29T10:59:57Z","timestamp":1793271597736,"version":"4.5.0"},"reference-count":47,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2024,2,23]],"date-time":"2024-02-23T00:00:00Z","timestamp":1708646400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>Undifferentiated embryonal sarcoma of the liver is a rare mesenchymal tumor with a highly malignant potential. It occurs almost exclusively in the pediatric population and typically has a poor outcome. Although previous studies have reported dismal prognoses, recent advances in combined treatment modalities, e.g., surgery and chemotherapy, have given cause for optimism. Even in those diseases not amenable to complete surgical resection or refractory diseases, other treatment modalities, such as liver transplant, have yielded promising results. This paper provides a review of the current treatment modalities for hepatic undifferentiated embryonal sarcoma in children.<\/jats:p>","DOI":"10.3390\/cancers16050897","type":"journal-article","created":{"date-parts":[[2024,2,23]],"date-time":"2024-02-23T07:33:56Z","timestamp":1708673636000},"page":"897","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Treatment of Undifferentiated Embryonal Sarcoma of the Liver in Children"],"prefix":"10.3390","volume":"16","author":[{"given":"Wen-Ya","family":"Lin","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Taichung Veterans General Hospital, Taichung 407219, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4855-8671","authenticated-orcid":false,"given":"Kang-Hsi","family":"Wu","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Chung Shan Medical University Hospital, Taichung 408, Taiwan"},{"name":"School of Medicine, Chung Shan Medical University, Taichung 408, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chun-Yu","family":"Chen","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Tungs\u2019 Taichung Metro Harbor Hospital, Taichung 43503, Taiwan"},{"name":"Department of Nursing, Jen-Teh Junior College of Medicine, Nursing and Management, Miaoli 356006, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1391-6264","authenticated-orcid":false,"given":"Bei-Cyuan","family":"Guo","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70142, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1433-6002","authenticated-orcid":false,"given":"Yu-Jun","family":"Chang","sequence":"additional","affiliation":[{"name":"Laboratory of Epidemiology and Biostastics, Changhua Christian Hospital, Changhua 500, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mao-Jen","family":"Lin","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Medicine, Taichung Tzu Chi Hospital, The Buddhist Tzu Chi Medical Foundation, Taichung 427213, Taiwan"},{"name":"Department of Medicine, College of Medicine, Tzu Chi University, Hualien 97004, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0069-4183","authenticated-orcid":false,"given":"Han-Ping","family":"Wu","sequence":"additional","affiliation":[{"name":"College of Medicine, Chang Gung University, Taoyuan 333, Taiwan"},{"name":"Department of Pediatrics, Chiayi Chang Gung Memorial Hospital, Chiayi 613, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,2,23]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"472","DOI":"10.1038\/modpathol.2013.80","article-title":"Towards an international pediatric liver tumor consensus classification: Proceedings of the Los Angeles COG liver tumors symposium","volume":"27","author":"Alaggio","year":"2014","journal-title":"Mod. Pathol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1016\/j.soc.2020.11.006","article-title":"Liver Tumors in Pediatric Patients","volume":"30","author":"Meyers","year":"2021","journal-title":"Surg. Oncol. Clin. N. Am."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"e26272","DOI":"10.1002\/pbc.26272","article-title":"Characteristics and outcomes in children with undifferentiated embryonal sarcoma of the liver: A report from the National Cancer Database","volume":"64","author":"Shi","year":"2017","journal-title":"Pediatr. Blood Cancer"},{"key":"ref_4","doi-asserted-by":"crossref","unstructured":"Lucas, B., Ravishankar, S., and Pateva, I. (2021). Pediatric Primary Hepatic Tumors: Diagnostic Considerations. Diagnostics, 11.","DOI":"10.3390\/diagnostics11020333"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"Hep19","DOI":"10.2217\/hep-2020-0002","article-title":"Hepatic mesenchymal hamartoma and undifferentiated embryonal sarcoma of the liver: A pathologic review","volume":"7","author":"Putra","year":"2020","journal-title":"Hepatic Oncol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"2274","DOI":"10.1002\/cncr.23431","article-title":"Undifferentiated embryonal sarcoma of the liver in adults","volume":"112","author":"Lenze","year":"2008","journal-title":"Cancer"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"2202","DOI":"10.1016\/j.jpedsurg.2013.05.020","article-title":"Treatment of undifferentiated embryonal sarcoma of the liver in children--single center experience","volume":"48","author":"Ismail","year":"2013","journal-title":"J. Pediatr. Surg."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"1419","DOI":"10.1053\/jpsu.2002.35404","article-title":"Undifferentiated (embryonal) sarcoma of the liver: Combination treatment by surgery and chemotherapy","volume":"37","author":"Kim","year":"2002","journal-title":"J. Pediatr. Surg."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"252","DOI":"10.1002\/cncr.10191","article-title":"Undifferentiated sarcoma of the liver in childhood: A curable disease","volume":"94","author":"Bisogno","year":"2002","journal-title":"Cancer"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1912","DOI":"10.1016\/j.jpedsurg.2008.06.016","article-title":"Childhood undifferentiated embryonal liver sarcoma: Clinical features and immunohistochemistry analysis","volume":"43","author":"Wei","year":"2008","journal-title":"J. Pediatr. Surg."},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"269","DOI":"10.5858\/arpa.2013-0463-RS","article-title":"Undifferentiated embryonal sarcoma of the liver: A concise review","volume":"139","author":"Putra","year":"2015","journal-title":"Arch. Pathol. Lab. Med."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"1615","DOI":"10.1111\/ans.15684","article-title":"Long-term survival outcomes of undifferentiated embryonal sarcoma of the liver: A pooled analysis of 308 patients","volume":"90","author":"Wu","year":"2020","journal-title":"ANZ J. Surg."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1095","DOI":"10.1016\/j.radcr.2020.05.015","article-title":"Undifferentiated embryonal sarcoma of liver: Paradoxical imaging appearance","volume":"15","author":"Thombare","year":"2020","journal-title":"Radiol. Case Rep."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"646","DOI":"10.1016\/j.radcr.2020.12.017","article-title":"Undifferentiated embryonal sarcoma of the liver: A rare hepatic tumor and its related characteristic radiological features","volume":"16","author":"Gomes","year":"2021","journal-title":"Radiol. Case Rep."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1016\/j.radcr.2021.10.017","article-title":"Subgaleal and epidural metastases of the undifferentiated embryonal sarcoma of the liver","volume":"17","author":"Dogan","year":"2022","journal-title":"Radiol. Case Rep."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"498","DOI":"10.1053\/j.sult.2020.05.014","article-title":"Pearls and Pitfalls in the Imaging of Soft-Tissue Masses in Children","volume":"41","author":"Navarro","year":"2020","journal-title":"Semin. Ultrasound CT MR"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"493","DOI":"10.1148\/radiol.2020200751","article-title":"Pediatric Hepatoblastoma, Hepatocellular Carcinoma, and Other Hepatic Neoplasms: Consensus Imaging Recommendations from American College of Radiology Pediatric Liver Reporting and Data System (LI-RADS) Working Group","volume":"296","author":"Schooler","year":"2020","journal-title":"Radiology"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"4763","DOI":"10.12998\/wjcc.v8.i20.4763","article-title":"Undifferentiated embryonal sarcoma of the liver: Clinical characteristics and outcomes","volume":"8","author":"Zhang","year":"2020","journal-title":"World J. Clin. Cases"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"461","DOI":"10.1007\/s00256-022-04182-7","article-title":"Molecular imaging of sarcomas with FDG PET","volume":"52","author":"Mendoza","year":"2023","journal-title":"Skeletal Radiol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1097\/MPH.0b013e3182282825","article-title":"Is there a need for dedicated bone imaging in addition to 18F-FDG PET\/CT imaging in pediatric sarcoma patients?","volume":"34","author":"Walter","year":"2012","journal-title":"J. Pediatr. Hematol. Oncol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"451","DOI":"10.1097\/MPH.0b013e318271c948","article-title":"A single-institution retrospective cases series of childhood undifferentiated embryonal liver sarcoma (UELS): Success of combined therapy and the use of orthotopic liver transplant","volume":"35","author":"Plant","year":"2013","journal-title":"J. Pediatr. Hematol. Oncol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"1004108","DOI":"10.3389\/fonc.2022.1004108","article-title":"Case report: Multimodal neoadjuvant and adjuvant chemotherapy for hepatic undifferentiated embryonal sarcoma in a young adult","volume":"12","author":"Vergara","year":"2022","journal-title":"Front. Oncol."},{"key":"ref_23","first-page":"7840865","article-title":"Pulmonary Metastases from an Undifferentiated Embryonal Sarcoma of the Liver: A Case Report and Review","volume":"2018","author":"Shi","year":"2018","journal-title":"Case Rep. Oncol. Med."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"336","DOI":"10.1002\/1097-0142(197807)42:1<336::AID-CNCR2820420151>3.0.CO;2-V","article-title":"Undifferentiated (embryonal) sarcoma of the liver: Report of 31 cases","volume":"42","author":"Stocker","year":"1978","journal-title":"Cancer"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1641","DOI":"10.1016\/S0022-3468(99)90634-6","article-title":"Undifferentiated embryonal sarcoma of the liver: Results of clinical management in one center","volume":"34","author":"Webber","year":"1999","journal-title":"J. Pediatr. Surg."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"e28598","DOI":"10.1002\/pbc.28598","article-title":"Undifferentiated sarcoma of the liver: Multicenter international experience of the Cooperative Soft-Tissue Sarcoma Group and Polish Paediatric Solid Tumor Group","volume":"67","author":"Murawski","year":"2020","journal-title":"Pediatr. Blood Cancer"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1097\/MPH.0000000000000529","article-title":"Undifferentiated Embryonal Sarcoma of the Liver (UESL): A Single-Center Experience and Review of the Literature","volume":"38","author":"Techavichit","year":"2016","journal-title":"J. Pediatr. Hematol. Oncol."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"2124","DOI":"10.1016\/j.jpedsurg.2010.07.016","article-title":"Primary hepatic sarcomas in children--a single-center experience over 19 years","volume":"45","author":"Upadhyaya","year":"2010","journal-title":"J. Pediatr. Surg."},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1002\/lt.23773","article-title":"Multimodal therapy including liver transplantation for hepatic undifferentiated embryonal sarcoma","volume":"20","author":"Walther","year":"2014","journal-title":"Liver Transpl."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"6437","DOI":"10.12998\/wjcc.v10.i19.6437","article-title":"Neoadjuvant transcatheter arterial chemoembolization and systemic chemotherapy for the treatment of undifferentiated embryonal sarcoma of the liver in children","volume":"10","author":"He","year":"2022","journal-title":"World J. Clin. Cases"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"e30374","DOI":"10.1002\/pbc.30374","article-title":"Outcome of patients with undifferentiated embryonal sarcoma of the liver treated according to European soft tissue sarcoma protocols","volume":"70","author":"Martelli","year":"2023","journal-title":"Pediatr. Blood Cancer"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"132","DOI":"10.1055\/s-0034-1387937","article-title":"Pitfalls in the surgical management of undifferentiated sarcoma of the liver and benefits of preoperative chemotherapy","volume":"25","author":"Merli","year":"2015","journal-title":"Eur. J. Pediatr. Surg."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1590\/S1679-45082015RW3164","article-title":"Liver transplantation: History, outcomes and perspectives","volume":"13","author":"Salvalaggio","year":"2015","journal-title":"Einstein"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"e14645","DOI":"10.1111\/petr.14645","article-title":"Modern-era successful liver transplantation outcomes in children with hepatic undifferentiated embryonal sarcoma","volume":"28","author":"Rolfes","year":"2023","journal-title":"Pediatr. Transplant."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"e654","DOI":"10.1097\/TXD.0000000000001106","article-title":"Liver Transplantation in Locally Unresectable, Undifferentiated Embryonal Cell Sarcoma","volume":"7","author":"Babu","year":"2021","journal-title":"Transplant. Direct"},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"403","DOI":"10.1007\/s00595-016-1337-1","article-title":"Liver transplantation for hepatobiliary malignancies: A new era of \u201cTransplant Oncology\u201d has begun","volume":"47","author":"Hibi","year":"2017","journal-title":"Surg. Today"},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"495","DOI":"10.1097\/MPH.0000000000000623","article-title":"The Role of Liver Transplantation in Undifferentiated Embryonal Sarcoma of the Liver in Children","volume":"38","author":"Schluckebier","year":"2016","journal-title":"J. Pediatr. Hematol. Oncol."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"728","DOI":"10.7196\/SAMJ.6058","article-title":"Management of undifferentiated embryonal sarcoma of the liver in children: A case series and management review","volume":"103","author":"Geel","year":"2013","journal-title":"S. Afr. Med. J."},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"12395","DOI":"10.18632\/aging.202944","article-title":"Expression and prognosis analyses of BUB1, BUB1B and BUB3 in human sarcoma","volume":"13","author":"Long","year":"2021","journal-title":"Aging"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"5895","DOI":"10.18632\/aging.204191","article-title":"Combined analysis of expression, prognosis and immune infiltration of GINS family genes in human sarcoma","volume":"14","author":"Zhang","year":"2022","journal-title":"Aging"},{"key":"ref_41","first-page":"1891","article-title":"Hepatic mesenchymal hamartoma: An uncommon but important paediatric diagnosis","volume":"24","author":"Gray","year":"2020","journal-title":"SA J. Radiol."},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"482","DOI":"10.1007\/s10024001-0047-9","article-title":"Undifferentiated embryonal sarcoma with unusual features arising within mesenchymal hamartoma of the liver: Report of a case and review of the literature","volume":"4","author":"Swanson","year":"2001","journal-title":"Pediatr. Dev. Pathol."},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"1248","DOI":"10.1097\/00000478-199710000-00018","article-title":"Hepatic undifferentiated (embryonal) sarcoma arising in a mesenchymal hamartoma","volume":"21","author":"Lauwers","year":"1997","journal-title":"Am. J. Surg. Pathol."},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1016\/j.yexmp.2013.09.006","article-title":"Characterization of translocations in mesenchymal hamartoma and undifferentiated embryonal sarcoma of the liver","volume":"95","author":"Mathews","year":"2013","journal-title":"Exp. Mol. Pathol."},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"111","DOI":"10.2350\/09-07-0681-OA.1","article-title":"Undifferentiated embryonal sarcoma of the liver is associated with mesenchymal hamartoma and multiple chromosomal abnormalities: A review of eleven cases","volume":"14","author":"Shehata","year":"2011","journal-title":"Pediatr. Dev. Pathol."},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"52","DOI":"10.1002\/1097-0142(19920101)69:1<52::AID-CNCR2820690111>3.0.CO;2-L","article-title":"Undifferentiated (embryonal) sarcoma of the liver. Pathologic findings and long-term survival after complete surgical resection","volume":"69","author":"Walker","year":"1992","journal-title":"Cancer"},{"key":"ref_47","doi-asserted-by":"crossref","unstructured":"Ziogas, I.A., Zamora, I.J., Lovvorn Iii, H.N., Bailey, C.E., and Alexopoulos, S.P. (2021). Undifferentiated Embryonal Sarcoma of the Liver in Children Versus Adults: A National Cancer Database Analysis. Cancers, 13.","DOI":"10.3390\/cancers13122918"}],"container-title":["Cancers"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2072-6694\/16\/5\/897\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T14:03:39Z","timestamp":1760105019000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2072-6694\/16\/5\/897"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,2,23]]},"references-count":47,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2024,3]]}},"alternative-id":["cancers16050897"],"URL":"https:\/\/doi.org\/10.3390\/cancers16050897","relation":{},"ISSN":["2072-6694"],"issn-type":[{"value":"2072-6694","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,2,23]]}}}