Survival outcome of patients with spontaneously ruptured hepatocellular carcinoma treated surgically or by transarterial embolization

查看全文 作　　者：Young-Joo [1]Jin;Jin-Woo [1]Lee;Seoung-Wook [1]Park;Jung Il [2]Lee;Don Haeng [1,3]Lee;Young Soo [1]Kim;Soon Gu [4]Cho;Yong Sun [4]Jeon;Kun Young [5]Lee;Seung-Ik [5]Ahn

机构地区：[1]Department of Internal Medicine, Inha University Hospital, Inha University School of Medicine, Incheon 400-711, South Korea;[2]Department of Internal Medicine, Yonsei University College of Medicine, Seoul 120-752, South Korea;[3]Department of Internal Medicine and Center for Advanced Medical Education by Brain Korea 21 Project, Inha University School of Medicine, and Utah-Inha DDS and Advanced Therapeutics Research Center, Incheon 400-711, South Korea;[4]Department of Radiology, Inha University Hospital, Inha University School of Medicine, Incheon 400-711, South Korea;[5]Department of Surgery, Inha University Hospital, Inha University School of Medicine, Incheon 400-711, South Korea

出　　处：《World Journal of Gastroenterology》索引2013年第19卷第28期,共8页

基　　金：Supported by Inha University Research Grant 摘　　要：AIM: To evaluate clinical outcomes of patients that underwent surgery, transarterial embolization (TAE), or supportive care for spontaneously ruptured hepatocellular carcinoma (HCC). METHODS: A consecutive 54 patients who diagnosed as spontaneously ruptured HCC at our institution between 2003 and 2012 were retrospectively enrolled. HCC was diagnosed based on the diagnostic guidelines issued by the 2005 American Association for the Study of Liver Diseases. HCC rupture was defined as disruption of the peritumoral liver capsule with enhanced fluid collection in the perihepatic area adjacent to the HCC by dynamic liver computed tomography, and when abdominal paracentesis showed an ascitic red blood cell count of > 50000 mm 3 /mL in bloody fluid. RESULTS: Of the 54 patients, 6 (11.1%) underwent surgery, 25 (46.3%) TAE, and 23 (42.6%) supportive care. The 2-, 4and 6-mo cumulative survival rates at 2, 4 and 6 mo were significantly higher in the surgery (60%, 60% and 60%) or TAE (36%, 20% and 20%) groups than in the supportive care group (8.7%, 0% and 0%), respectively (each, P < 0.01), and tended to be higher in the surgical group than in the TAE group. Multivariate analysis showed that serum bilirubin (HR = 1.09, P < 0.01), creatinine (HR = 1.46, P = 0.04), and vasopressor requirement (HR = 2.37, P = 0.02) were significantly associated with post-treatment mortality, whereas surgery (HR = 0.41, P < 0.01), and TAE (HR = 0.13, P = 0.01) were inversely associated with posttreatment mortality. CONCLUSION: Post-treatment survival after surgery or TAE was found to be better than after supportive care, and surgery tended to provide better survival benefit than TAE. 关键词：RUPTURED HEPATOCELLULAR CARCINOMA Surgery Transarterial EMBOLIZATION

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Survival outcome of patients with spontaneously ruptured hepatocellular carcinoma treated surgically or by transarterial embolization

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