Spontaneous rupture of hepatocelluar carcinoma: surgical resection and long-term survival

Vergara, Valentín Fabián; Muratore, Andrea; Bouzari, Hedayat; Polastri, Roberto; Ferrero, A.; Galatola, G.; Capussotti, Lorenzo

doi:10.1053/ejso.2000.1001

Cited by 104 publications

(107 citation statements)

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“…The procedures are generally divided based on whether or not 49 TAE was performed before the operation. Some surgeons recommend emergency hepatic resection in the acute phase as the definitive treatment (when permitted by the patient's condition) [16,17] . However, this procedure is associated with a high mortality rate of between 16 and 100% due to inadequate knowledge on the liver function reserve [2] .…”

Section: Discussionmentioning

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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Section: Discussionmentioning

confidence: 99%

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

et al. 2015

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“…Open surgical method was the mainstay of treatment during 1960s-1980s. It was reported that various surgical procedures, including perihepatic packing, suture plication of bleeding tumors, injection of alcohol, hepatic artery ligation (HAL), and liver resection, are effective against hemostasis [10,[22][23][24][25][26] . Besides transarterial embolization (TAE) and transarterial chemoembolization (TACE) for palliative treatment in patients with unresectable HCC, TAE is also gradually used for hemostasis in spontaneous rupture of HCC.…”

Section: Discussionmentioning

confidence: 99%

Intraperitoneal metastasis of hepatocellular carcinoma after spontaneous rupture: A case report

Hung

Wu²,

Lee³

et al. 2008

WJG

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INTRODUCTIONHepatocellular carcinoma (HCC) is one of the most common malignancies worldwide. It is usually manifested in the 6th and 7th decades of life. Extrahepatic metastases are seen in 64% of patients with HCC. The most frequent sites of extrahepatic metastases are lung, abdominal lymph node and bone, but peritoneal dissemination is unusual [1,2] . The incidence of spontaneous rupture of HCC is about 8%-26% in Asia [3][4][5] and the mortality rate of HCC patients is 10% [6] . However, peritoneal metastasis of HCC after spontaneous rupture is seldom noted. Here, we report a case of intraperitoneal metastasis of HCC after spontaneous rupture 10 mo ago, which was treated with transarterial embolization. CASE REPORTA previously asymptomatic 72-year-old man had a history of chronic hepatitis C-related liver cirrhosis without regular follow-up. Sudden nausea and vomiting with watery diarrhea were noted on January 2006. Then he was sent to Yun-Lin Branch of National Taiwan University Hospital for help. Abdominal computer tomography (CT) scan showed a huge HCC that was suspicious of rupture. Under the request of his family, he was transferred to our hospital and transarterial embolization was performed on January 31, 2006. After discharge, he was regularly followed up at our Gastrointestinal (GI) Outpatient Department (OPD). Dull abdominal pain over the right upper quadrant area, accompanied with fullness sensation, was noted in November 2006. Besides, he also had body weight loss of about ten kilograms in one year. So he visited our hospital again. Abdominal CT scan revealed a peritoneal mass in the right upper quadrant peritoneal area and hepatoma recurrence was considered ( Figure 1). Transarterial embolization was arranged again, but failed. After consultation with the surgeon, he was admitted for surgical resection.Surgical intervention was arranged on January 24, 2007. Operative methods were segmental hepatectomy (S6 and partial S5), excision of extrahepatic tumor, and cholecystectomy. The operation showed a huge tumor (12 cm × 8 cm × 6 cm) over the right upper quadrant area just below liver parenchyma (Figure 2) with its blood supplied from the omentum. Besides, two small mass lesions (3 cm × 2 cm and 2 cm × 1 cm) were found over AbstractRupture of hepatocellular carcinoma (HCC) is a lifethreatening complication. Peritoneal metastasis of HCC after spontaneous rupture was seldom noted. We report a case of intraperitoneal metastasis of HCC after spontaneous rupture. A previously asymptomatic 72-yearold man was admitted due to dull abdominal pain with abdominal fullness. He had a history of HCC rupture 10 mo ago and transarterial embolization was performed at that time. Abdominal computer tomography (CT) scan showed a huge peritoneal mass over the right upper quadrant area. Surgical resection was arranged and subsequent microscopic examination confirmed a diagnosis of moderately-differentiated HCC.

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“…La quimioembolización intraarterial asociada a la resección tumoral en los casos de función hepática normal puede constituir una técnica relativamente segura, capaz de mejorar a corto plazo la supervivencia de estos pacientes (5 …”

Section: Discussionunclassified

Hepatocarcinoma primario no conocido como causa de hemoperitoneo espontáneo

Rodríguez

Martínez

Artacho

et al. 2009

Rev. esp. enferm. dig.

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El hemoperitoneo ocasionado por ruptura de hepatocarcinoma no traumático constituye una forma de presentación infrecuente en los países occidentales, menos de un 5%. Presentamos un caso atendido en nuestro centro, de hemoperitoneo agudo secundario a la rotura no traumática de un hepatocarcinoma, que supuso la primera manifestación del proceso neoplásico. Caso clínicoVarón de 66 años, de origen vietnamita y actualmente con residencia en EE. UU., acude a Urgencias de nuestro centro tras presentar dolor súbito en epigastrio, brusco y que asocia a comida copiosa. El dolor se irradia al hombro izquierdo. En la exploración aparece sudoración y palidez mucocutánea con pulsos distales conservados.El paciente se encuentra hipotenso y taquicárdico, su ECG es normal y ante la urgencia del cuadro se solicita ecografía abdominal que nos informa de masa en segmento hepático VI suFigs. 1 y 2. Imágenes del TAC con contraste en el que aparece la lesión sugestiva de hepatocarcinoma en segmento VI con signos de sangrado activo.

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Spontaneous rupture of hepatocelluar carcinoma: surgical resection and long-term survival

Cited by 104 publications

References 8 publications

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

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

Intraperitoneal metastasis of hepatocellular carcinoma after spontaneous rupture: A case report

Hepatocarcinoma primario no conocido como causa de hemoperitoneo espontáneo

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