Peritoneal Carcinomatosis Risk and Long-Term Survival Following Hepatectomy for Spontaneous Hepatocellular Carcinoma Rupture: Results of a Multicenter French Study (FRENCH—AFC)

Abstract

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Development and Validation of Artificial Neural Networks for Survival Prediction Model for Patients with Spontaneous Hepatocellular Carcinoma Rupture After Transcatheter Arterial Embolization

“…The incidence of spontaneous HCC rupture in Asia-Pacific region is higher than in Western countries. [9][10][11] Spontaneous HCC rupture might be related to the rapid growth of the tumor leading to intratumor necrosis and tumor vascular hyperplasia, with vascular dysfunction caused by the degeneration of the vessel structure composition (elastin, collagen IV). 12,13 The current treatment strategy for patients with spontaneous HCC rupture remains controversial.…”

Imaging features and outcomes in patients with ruptured hepatocellular carcinoma following transcatheter arterial chemoembolization: a retrospective clinical study

“…However, hepatic resection might have the advantage of achieving hemostasis and thereby offer a potentially curative resection in selected patients. 8,9 A vascular lake was also associated with an increased risk of rupture. A vascular lake has been suggested to reflect a blood space secondary to destroyed arterial vessels and tumor necrosis, demonstrated by contrast pooling on preoperative angiography.…”

Treatment of spontaneously ruptured hepatocellular carcinoma: use of laparoscopic microwave ablation and washout

“…19,37 The washout component of the procedure addresses the concern of increased risk of peritoneal recurrence after rupture with a reported rate that varies, with studies reporting rates up to 33%. 12,44,45 Studies suggest improvement in distant disease recurrence after immediate emergency resection when compared to staged resection, suggesting washout benefit. 12,45 There was only one documented recurrence out of the six patients who had follow-up scans available for review.…”

“…12,44,45 Studies suggest improvement in distant disease recurrence after immediate emergency resection when compared to staged resection, suggesting washout benefit. 12,45 There was only one documented recurrence out of the six patients who had follow-up scans available for review.…”

“…11 Previous studies report decreased incidence of peritoneal disease after emergency resection compared to staged hepatectomy, suggesting immediate washout may reduce the occurrence of distant tumor dissemination. 12 Microwave ablation (MWA) is considered a safe and effective mainstay ablative modality for treating patients diagnosed with HCC. 13 The uniform, predictable coagulative necrosis achieved using MWA effects both hemorrhage control and oncologic benefit with consistently low incomplete ablation and local recurrence rates.…”