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Article: Management of spontaneously ruptured hepatocellular carcinomas in the radiofrequency ablation era

TitleManagement of spontaneously ruptured hepatocellular carcinomas in the radiofrequency ablation era
Authors
Issue Date2014
Citation
PLoS ONE, 2014, v. 9, n. 4 How to Cite?
AbstractBackground and aim: Spontaneous rupture of hepatocellular carcinoma (HCC) carries a high mortality. The use of radiofrequency ablation (RFA) in recent years has enriched the armamentarium for hemostasis of spontaneously ruptured HCCs but its results have not been documented. This study investigated the prognosis and outcome of spontaneous rupture of HCC as well as the results of using RFA for hemostasis. Patients and method: From January 1991 to December 2010, 5283 patients were diagnosed with HCC at our hospital, and 189 of them had spontaneous rupture of HCCs. They were grouped under two periods: period 1, 1991-2000, n = 70; period 2, 2001-2010, n = 119. RFA was available in period 2 only. Results: Hepatitis B virus infection was predominant in both periods. Surgical hemostasis was mainly achieved by hepatic artery ligation in period 1 and by RFA in period 2. The 30-day hospital mortality after surgical treatment was 55.6% (n = 18) in period 1 and 19.2% (n = 26) in period 2 (p = 0.012). Multivariate analysis identified 4 independent factors for better overall survival, namely, hemostasis by transarterial chemoembolization (hazard ratio 0.516, 95% confidence interval 0.354-0.751), hemostasis by RFA (hazard ratio 0.431, 95% confidence interval 0.236-0.790), having surgery as a subsequent treatment (hazard ratio 0.305, 95% confidence interval 0.186-0.498), and a serum total bilirubin level <19 umol/L (hazard ratio 1.596, 95% confidence interval 1.137-2.241). Conclusion: The use of RFA for hemostasis during laparotomy greatly reduced the hospital mortality rate when compared with conventional hepatic artery ligation. © 2014 Cheung et al.
Persistent Identifierhttp://hdl.handle.net/10722/221359
PubMed Central ID

 

DC FieldValueLanguage
dc.contributor.authorCheung, TT-
dc.contributor.authorPoon, RTP-
dc.contributor.authorChok, KSH-
dc.contributor.authorChan, ACY-
dc.contributor.authorTsang, SHY-
dc.contributor.authorDai, WC-
dc.contributor.authorYau, TCC-
dc.contributor.authorChan, SC-
dc.contributor.authorFan, ST-
dc.contributor.authorLo, CM-
dc.date.accessioned2015-11-18T06:09:06Z-
dc.date.available2015-11-18T06:09:06Z-
dc.date.issued2014-
dc.identifier.citationPLoS ONE, 2014, v. 9, n. 4-
dc.identifier.urihttp://hdl.handle.net/10722/221359-
dc.description.abstractBackground and aim: Spontaneous rupture of hepatocellular carcinoma (HCC) carries a high mortality. The use of radiofrequency ablation (RFA) in recent years has enriched the armamentarium for hemostasis of spontaneously ruptured HCCs but its results have not been documented. This study investigated the prognosis and outcome of spontaneous rupture of HCC as well as the results of using RFA for hemostasis. Patients and method: From January 1991 to December 2010, 5283 patients were diagnosed with HCC at our hospital, and 189 of them had spontaneous rupture of HCCs. They were grouped under two periods: period 1, 1991-2000, n = 70; period 2, 2001-2010, n = 119. RFA was available in period 2 only. Results: Hepatitis B virus infection was predominant in both periods. Surgical hemostasis was mainly achieved by hepatic artery ligation in period 1 and by RFA in period 2. The 30-day hospital mortality after surgical treatment was 55.6% (n = 18) in period 1 and 19.2% (n = 26) in period 2 (p = 0.012). Multivariate analysis identified 4 independent factors for better overall survival, namely, hemostasis by transarterial chemoembolization (hazard ratio 0.516, 95% confidence interval 0.354-0.751), hemostasis by RFA (hazard ratio 0.431, 95% confidence interval 0.236-0.790), having surgery as a subsequent treatment (hazard ratio 0.305, 95% confidence interval 0.186-0.498), and a serum total bilirubin level <19 umol/L (hazard ratio 1.596, 95% confidence interval 1.137-2.241). Conclusion: The use of RFA for hemostasis during laparotomy greatly reduced the hospital mortality rate when compared with conventional hepatic artery ligation. © 2014 Cheung et al.-
dc.languageeng-
dc.relation.ispartofPLoS ONE-
dc.rightsCreative Commons: Attribution 3.0 Hong Kong License-
dc.titleManagement of spontaneously ruptured hepatocellular carcinomas in the radiofrequency ablation era-
dc.typeArticle-
dc.description.naturepublished_or_final_version-
dc.identifier.doi10.1371/journal.pone.0094453-
dc.identifier.pmid24718254-
dc.identifier.pmcidPMC3981783-
dc.identifier.scopuseid_2-s2.0-84899556253-
dc.identifier.hkuros233255-
dc.identifier.volume9-
dc.identifier.issue4-
dc.identifier.eissn1932-6203-

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