Prognosis and therapy for ruptured hepatocellular carcinoma: Problems with staging and treatment strategy

Hiraoka, Atsushi; Kawamura, Tomoe; Aibiki, Toshihiko; Okudaira, Taeko; Toshimori, Akiko; Yamago, Hiroka; Nakahara, Hiromasa; Suga, Yasuhiro; Azemoto, Nobuaki; Miyata, Hideki; Miyamoto, Yoshinori; Nakamura, Tomoyuki; Murakami, Tadashi; Ishimaru, Yuki; Kawasaki, Hideki; Hirooka, Masashi; Abe, Masanori; Matsuura, Bunzo; Hiasa, Yoichi; Michitaka, Kojiro

doi:10.1016/j.ejrad.2014.11.038

Cited by 30 publications

(26 citation statements)

References 11 publications

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“…These researchers suggested it would be more appropriate to give additional stages to the baseline TNM staging in cases of ruptured HCC 3. Another study also supports the proposal that T4 classification should not include all types of ruptured HCC 11.…”

Section: Discussionmentioning

confidence: 73%

Impact of spontaneous tumor rupture on prognosis of patients with T4 hepatocellular carcinoma

Chan

Hung

Pan

et al. 2016

Journal of Surgical Oncology

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Background and objectivesCompare the outcomes of three groups of patients with T4 hepatocellular carcinoma (HCC): tumor rupture with shock (RS group), tumor rupture without shock (R group), and no tumor rupture (NR group).Materials and MethodsWe retrospectively reviewed 221 patients with T4 HCC from 2010 to 2012. The clinical background and prognosis were analyzed.ResultsOverall in‐hospital mortality rate was 18.1%; overall median survival time was 4 months. The NR group were more likely to have multiple and infiltrative tumors (P < 0.001). Relative to the NR group, the R + RS group had better survival rates at 6 months (49.2% vs. 32.2%), 1 year (35.3% vs. 21.0%), 3 years (22.5% vs. 11.0%), and 5 years (17.7% vs. 5.5%) (P = 0.010). Patients in the RS group had a higher in‐hospital mortality rate, but significantly better long‐term survival than the NR and R group (P < 0.001). Multivariate analysis indicated that Child‐Pugh class B or C, presence of portal venous thrombosis, and absence of shock were significantly associated with poor survival.ConclusionPatients with tumor rupture and shock had worse in‐hospital survival. However, patients without decompensated liver cirrhosis and portal venous thrombosis, and eligible for curative treatment had favorable long‐term outcome. J. Surg. Oncol. 2016;113:789–795. © 2016 The Authors. Journal of Surgical Oncology Published by Wiley Periodicals, Inc.

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Section: Discussionmentioning

confidence: 73%

Impact of spontaneous tumor rupture on prognosis of patients with T4 hepatocellular carcinoma

Chan

Hung

Pan

et al. 2016

Journal of Surgical Oncology

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“…The surgical procedures thus remain controversial at this time. Additionally, there has been insufficient knowledge on surgical prognostic factors [11] . Although the surgical outcomes of patients with ruptured HCC were reported to be poorer than those of patients without ruptured HCC [9,12] , the former group had worse liver reserve function, more severe tumor factors and a lower rate of curative resection [12] .…”

Section: Introductionmentioning

confidence: 99%

“…Surgical procedures have provided better outcomes than any other treatments for patients with ruptured HCC [5][6][7][8] . Moreover, transcatheter arterial embolization (TAE) followed by elective hepatic resection has been considered an effective treatment [2,[9][10][11] ; on the other hand, one-stage resection could be recommended [12] . The surgical procedures thus remain controversial at this time.…”

Section: Introductionmentioning

confidence: 99%

An Analysis of Surgical Treatment for the Spontaneous Rupture of Hepatocellular Carcinoma

et al. 2015

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Background/Aims: The prognosis of spontaneous rupture of hepatocellular carcinoma (HCC) remains unclear. We investigated the prognosis of patients with ruptured HCC based on the treatments and prognostic factors associated with long-term survival. Methods: The prognoses of 64 consecutive patients treated for ruptured HCC from 1986 to 2013 were analyzed according to their methods of treatment. The prognostic factors of 16 surgical patients were identified, and their overall survival (OS) and recurrence rates were compared to 1,157 surgical patients who underwent surgery for non-ruptured HCC. The surgical outcomes were also compared using a propensity score matching method. Results: Surgery was associated with a better OS. Curative resection was the only independent prognostic factor in surgical patients with ruptured HCC (p = 0.040). Although the OS of surgical patients with non-ruptured HCC was found to be significantly better than that of the patients with ruptured HCC, no significant difference in OS was observed after propensity score matching. Conclusion: A curative resection should be the objective of treatment, assuming the suitability of the patient's clinical condition. When the liver function reserve and tumor extension of patients with ruptured and non-ruptured HCC are similar, then their surgical outcomes may not be significantly different.

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“…Hepatitis B virus (HBV) was quantified by chemiluminescence using an Architect i2000SR immunoassay analyser (Abbott Diagnostics, Lake Forest, IL, USA). The tumours were staged according to the 7th edition of TNM system (38) issued by the American Joint Committee on Cancer/International Union Against Cancer, and graded following the Edmondson system (39).…”

Section: Methodsmentioning

confidence: 99%

Glasgow Prognostic Score predicts prognosis of intrahepatic cholangiocarcinoma

Qin

Zhang

et al. 2017

Molecular and Clinical Oncology

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Abstract. High Glasgow Prognostic Score (GPS) has been associated with poor prognosis in patients with lung, ovarian, colorectal and renal cancer, as well as hepatocellular carcinoma. The aim of this study was to investigate the prognostic value of GPS in patients with intrahepatic cholangiocarcinoma (ICC) undergoing partial hepatectomy. A total of 72 patients with pathologically confirmed ICC were classified according to their GPS scores assigned based on the preoperative levels of C-reactive protein (CRP) and albumin. Their clinicopathological data were retrospectively assessed using univariate and multivariate analysis to determine their association with overall survival and recurrence. High GPS scores in ICC patients were associated with preoperative levels of CRP (P<0.001) and albumin (P<0.001), frequency of ascites accumulation (P=0.035), lymph node metastasis (P=0.002) and tumour size (P=0.005). On univariate analysis, preoperative levels of CRP (P<0.001), albumin (P=0.016) and carbohydrate antigen 19-9 (P=0.038), hepatitis B virus (HBV) positivity (P=0.009), occurrence of lymph node metastasis (P=0.001), Child-Pugh class B (P=0.013) and high tumour-node-metastasis (TNM) stage (P=0.002) were found to be associated with the 1-and 3-year overall survival. Multivariate analysis suggested that GPS score (HR=2.037, 95% CI: 1.092-3.799, P=0.025), TNM classification (HR=2.000, 95% CI: 1.188-3.367, P=0.009) and HBV positivity (HR=0.559 95% CI: 0.328-0.953, P=0.032) were independently associated with patient survival. High GPS scores also predicted ICC recurrence. In conclusion, our results demonstrated that GPS may serve as an independent marker of prognosis in patients with ICC following partial hepatectomy.

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Prognosis and therapy for ruptured hepatocellular carcinoma: Problems with staging and treatment strategy

Cited by 30 publications

References 11 publications

Impact of spontaneous tumor rupture on prognosis of patients with T4 hepatocellular carcinoma

Impact of spontaneous tumor rupture on prognosis of patients with T4 hepatocellular carcinoma

An Analysis of Surgical Treatment for the Spontaneous Rupture of Hepatocellular Carcinoma

Glasgow Prognostic Score predicts prognosis of intrahepatic cholangiocarcinoma

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