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Article: Management of spontaneous rupture of hepatocellular carcinoma: Single-center experience

TitleManagement of spontaneous rupture of hepatocellular carcinoma: Single-center experience
Authors
Issue Date2001
PublisherAmerican Society of Clinical Oncology. The Journal's web site is located at http://www.jco.org/
Citation
Journal Of Clinical Oncology, 2001, v. 19 n. 17, p. 3725-3732 How to Cite?
AbstractPurpose: To report the management of patients with spontaneous rupture of hepatocellular carcinoma (HCC) in a single center over a 10-year period and to evaluate a two-stage therapeutic approach. Patients and Methods: A retrospective study was performed on all 1,716 patients with HCC who presented from 1989 to 1998. The two-stage therapeutic approach to manage ruptured HCC consisted of initial management by conservative method, hemostasis by transarterial embolization (TAE) or surgical means, followed by second-stage hepatic resection or transarterial oily chemoembolization (TOCE). Results of definitive treatment were compared with patients with no history of rupture during the same study period. Results: During the study period, 154 patients (9%) had spontaneous HCC rupture. Initial intervention to control bleeding included TAE in 42 patients, surgical hemostasis in 35 patients, and conservative management only in 53 patients. The 30-day mortality rate was 38%. Independent factors on presentation affecting 30-day mortality were shock on admission, hemoglobin, serum total bilirubin, and known diagnosis of inoperable tumor. After initial stabilization and clinical evaluation, 33 patients underwent hepatic resection and 30 patients received TOCE. Median survival of the hepatectomy patients was 25.7 months; that of the TOCE patients was 9.7 months. Compared with patients with no rupture, survival after hepatectomy (25.7 months v 49.2 months, P = .003) was inferior but still substantially long, whereas survival after TOCE was comparable (9.7 months v 8.7 months, P = .904). Conclusion: Early mortality of spontaneous rupture of HCC was dependent on prerupture disease state, liver function, and severity of bleeding. Although it was a catastrophic presentation, prolonged survival could be achieved in selected patients with second-stage hepatic resection or TOCE. © 2001 by American Society of Clinical Oncology.
Persistent Identifierhttp://hdl.handle.net/10722/84373
ISSN
2015 Impact Factor: 20.982
2015 SCImago Journal Rankings: 9.204
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorLiu, CLen_HK
dc.contributor.authorFan, STen_HK
dc.contributor.authorLo, CMen_HK
dc.contributor.authorTso, WKen_HK
dc.contributor.authorTungPing Poon, Ren_HK
dc.contributor.authorLam, CMen_HK
dc.contributor.authorWong, Jen_HK
dc.date.accessioned2010-09-06T08:52:11Z-
dc.date.available2010-09-06T08:52:11Z-
dc.date.issued2001en_HK
dc.identifier.citationJournal Of Clinical Oncology, 2001, v. 19 n. 17, p. 3725-3732en_HK
dc.identifier.issn0732-183Xen_HK
dc.identifier.urihttp://hdl.handle.net/10722/84373-
dc.description.abstractPurpose: To report the management of patients with spontaneous rupture of hepatocellular carcinoma (HCC) in a single center over a 10-year period and to evaluate a two-stage therapeutic approach. Patients and Methods: A retrospective study was performed on all 1,716 patients with HCC who presented from 1989 to 1998. The two-stage therapeutic approach to manage ruptured HCC consisted of initial management by conservative method, hemostasis by transarterial embolization (TAE) or surgical means, followed by second-stage hepatic resection or transarterial oily chemoembolization (TOCE). Results of definitive treatment were compared with patients with no history of rupture during the same study period. Results: During the study period, 154 patients (9%) had spontaneous HCC rupture. Initial intervention to control bleeding included TAE in 42 patients, surgical hemostasis in 35 patients, and conservative management only in 53 patients. The 30-day mortality rate was 38%. Independent factors on presentation affecting 30-day mortality were shock on admission, hemoglobin, serum total bilirubin, and known diagnosis of inoperable tumor. After initial stabilization and clinical evaluation, 33 patients underwent hepatic resection and 30 patients received TOCE. Median survival of the hepatectomy patients was 25.7 months; that of the TOCE patients was 9.7 months. Compared with patients with no rupture, survival after hepatectomy (25.7 months v 49.2 months, P = .003) was inferior but still substantially long, whereas survival after TOCE was comparable (9.7 months v 8.7 months, P = .904). Conclusion: Early mortality of spontaneous rupture of HCC was dependent on prerupture disease state, liver function, and severity of bleeding. Although it was a catastrophic presentation, prolonged survival could be achieved in selected patients with second-stage hepatic resection or TOCE. © 2001 by American Society of Clinical Oncology.en_HK
dc.languageengen_HK
dc.publisherAmerican Society of Clinical Oncology. The Journal's web site is located at http://www.jco.org/en_HK
dc.relation.ispartofJournal of Clinical Oncologyen_HK
dc.titleManagement of spontaneous rupture of hepatocellular carcinoma: Single-center experienceen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0732-183X&volume=19&spage=3725&epage=3732&date=2001&atitle=Management+of+spontaneous+rupture+of+hepatocellular+carcinoma:+single-center+experienceen_HK
dc.identifier.emailFan, ST: stfan@hku.hken_HK
dc.identifier.emailLo, CM: chungmlo@hkucc.hku.hken_HK
dc.identifier.emailTungPing Poon, R: poontp@hku.hken_HK
dc.identifier.emailWong, J: jwong@hkucc.hku.hken_HK
dc.identifier.authorityFan, ST=rp00355en_HK
dc.identifier.authorityLo, CM=rp00412en_HK
dc.identifier.authorityTungPing Poon, R=rp00446en_HK
dc.identifier.authorityWong, J=rp00322en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.pmid11533094-
dc.identifier.scopuseid_2-s2.0-0035449931en_HK
dc.identifier.hkuros69772en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-0035449931&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume19en_HK
dc.identifier.issue17en_HK
dc.identifier.spage3725en_HK
dc.identifier.epage3732en_HK
dc.identifier.isiWOS:000170727600004-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridLiu, CL=7409789712en_HK
dc.identifier.scopusauthoridFan, ST=7402678224en_HK
dc.identifier.scopusauthoridLo, CM=7401771672en_HK
dc.identifier.scopusauthoridTso, WK=7006905486en_HK
dc.identifier.scopusauthoridTungPing Poon, R=7103097223en_HK
dc.identifier.scopusauthoridLam, CM=36799183200en_HK
dc.identifier.scopusauthoridWong, J=8049324500en_HK

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