Spontaneous ruptured hepatocellular carcinoma

Yoshida, Hiroshi; Mamada, Yasuhiro; Taniai, Nobuhiko; Uchida, Eiji

doi:10.1111/hepr.12498

Cited by 109 publications

(150 citation statements)

References 83 publications

(353 reference statements)

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“…The incidence of HCC rupture in our study was 5.3%, lower than in a 1995 study in Taiwan (26%) 13. Other studies reported that ruptured HCC is associated with high in‐hospital mortality, above 25% 4, 5. In the current study, 23% of the patients with tumor ruptures died during their hospital stays.…”

Section: Discussionsupporting

confidence: 48%

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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: Discussionsupporting

confidence: 48%

“…Transarterial embolization is an effective method for achieving prompt hemostasis and has a success rate of 53–100% 4, 5, 15, 16. After initial stabilization, the liver functional reserve and tumor stage should be investigated to determine the best treatment.…”

Section: Discussionmentioning

confidence: 99%

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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“…Spontaneous rupture of hepatocellular carcinoma has occurred occasionally 18,19 , but spontaneous rupture appears to be a rare complication of nonparasitic hepatic cysts 1 16 . Simple hepatic cysts occasionally disappear spontaneously without symptoms 20,21 .…”

Section: Discussionmentioning

confidence: 99%

Spontaneous Rupture of a Simple Hepatic Cyst: Report of a Case

et al. 2015

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We describe the spontaneous rupture of a simple hepatic cyst. A 62-year-old woman was admitted for right upper quadrant pain of sudden onset. The patient denied a history of abdominal trauma. Computed tomography of the abdomen showed a 13-cm-diameter solitary hepatic cyst in the right lobe. Part of the cyst surface was irregular, and the internal echo was heterogeneous. Retained fluid was detected under the liver capsule. Ten days after admission, computed tomography revealed that the volume of fluid retained under the liver capsule had decreased but that the hepatic cyst had enlarged again. The patient was referred to our hospital for further evaluation and treatment. Physical examination revealed mild right upper quadrant pain, but no signs or symptoms of peritonitis or abnormalities of the chest or heart. Percutaneous puncture was performed with a needle and an 8-French pigtail catheter under ultrasonographic guidance. Brown serous fluid was aspirated. After the removal of approximately 1,000 mL of fluid, contrast medium was injected to check for communications between the cyst and the biliary tree and to document the absence of leakage into the peritoneal cavity. After complete aspiration of the cyst fluid, 200 mg of minocycline hydrochloride dissolved in 10 mL of saline was injected into the cyst, and the catheter was flushed with 10 mL of saline (total volume of saline, 20 mL). The catheter was then clamped for 30 minutes. After percutaneous aspiration, the patient's symptoms resolved. Minocycline hydrochloride was injected daily for 7 days, and the catheter was removed. There has been no evidence of recurrence after 2 years. (J Nippon Med Sch 2015; 82: 113 116)

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“…[6] In the presence of haemodynamic stability, non-operative management with close monitoring is gold standard care. [7] However, when there is haemodynamic instability, several treatment options are available.…”

Section: Introductionmentioning

confidence: 99%

Outcomes of emergency and interval hepatectomy for ruptured resectable hepatocellular carcinoma: a single tertiary referral centre experience

Fung¹,

Chong²,

Lee³

et al. 2017

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How to cite this article: Fung AKY, Chong CCN, Lee KF, Wong J, Cheung YS, Fong AKW, Lai PBS. Outcomes of emergency and interval hepatectomy for ruptured resectable hepatocellular carcinoma: a single tertiary referral centre experience. Hepatoma Res 2017;3:196-204. Aim: The short and long term outcomes of patients who underwent emergency and interval hepatectomy for ruptured and resectable hepatocellular carcinoma (HCC) were analysed. Methods: The data of patients with ruptured HCC presenting between April 2004 and October 2015 were analysed. Emergency hepatectomy was defined as hepatectomy within 48 h of the clinico-radiological diagnosis of HCC rupture. Results: Thirty patients underwent hepatectomy for ruptured HCC. Nine (30%) patients underwent emergency hepatectomy. The median age was 56 and 54 years (P = 0.13) with a similar gender distribution. The mean HCC size (10.5 vs. 8.3 cm, P = 0.17), total blood loss (3,000 vs. 850 mL, P = 0.002) and total units of red blood cell transfusion (1.9 vs. 0.5 units, P = 0.27) were greater in the emergency hepatectomy group. The complication rate was 44% and 38% (P = 0.53), with median length of hospital stay of 10 and 12 days (P = 0.07) in the emergency and interval hepatectomy groups, respectively, and no 30-day mortality in both groups. The median overall survival was 29 and 15.7 months (P = 0.25), with survival rates of 78%, 45%, 0% and 85%, 43% and 5% at 1, 3 and 5 years in the emergency and interval hepatectomy groups, respectively. Conclusion: Hepatectomy should be considered for ruptured HCC provided the patient could tolerate curative resection. Key words:Hepatocellular carcinoma, rupture, hepatectomy ABSTRACTArticle history:

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Spontaneous ruptured hepatocellular carcinoma

Cited by 109 publications

References 83 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

Spontaneous Rupture of a Simple Hepatic Cyst: Report of a Case

Outcomes of emergency and interval hepatectomy for ruptured resectable hepatocellular carcinoma: a single tertiary referral centre experience

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