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Treatment of spontaneous ruptured hepatocellular carcinoma
Insights
Transarterial embolization (TAE) followed by surgery effectively treated ruptured hepatocellular carcinoma (HCC), significantly improving survival rates compared to other methods. This approach demonstrated a high 1-year survival rate for bleeding HCC patients.
Area of Science:
- Hepatobiliary Surgery
- Interventional Radiology
- Oncology
Background:
- Spontaneous rupture with bleeding is a critical complication of hepatocellular carcinoma (HCC).
- Effective management strategies for ruptured HCC are crucial for patient survival.
- This study reviews treatment outcomes for ruptured HCC patients.
Purpose of the Study:
- To evaluate the effectiveness of different treatment modalities for ruptured hepatocellular carcinoma (HCC).
- To compare the outcomes of transarterial embolization (TAE) combined with hepatectomy versus other treatments for ruptured HCC.
Main Methods:
- Retrospective review of 18 patients with ruptured HCC admitted between January 1988 and December 1997.
- Patients were categorized into four groups based on treatment: TAE followed by elective hepatectomy (Group 1), TAE alone (Group 2), emergency surgery (Group 3), and non-interventional (Group 4).
Main Results:
- Group 1 (TAE + hepatectomy) showed no hospital mortality and an 87.5% 1-year survival rate, with late deaths due to HCC recurrence or cerebral hemorrhage.
- Group 2 (TAE alone) had a 50% 1-year survival rate.
- Groups 3 and 4 (emergency surgery or no intervention) experienced 100% hospital mortality.
Conclusions:
- Transarterial embolization (TAE) followed by elective hepatectomy is an effective treatment strategy for ruptured HCC.
- This combined approach significantly improves survival outcomes in patients with bleeding HCC.
- Prompt and appropriate intervention is vital for managing this life-threatening complication.
Background/Aims:
Spontaneous rupture with bleeding is a potentially life-threatening complication of hepatocellular carcinoma (HCC). We review our experience with treatments of ruptured HCC.
Methodology:
Between January 1988 and December 1997, 18 patients with ruptured HCC were admitted. The patients were divided into 4 groups according to the treatment type of ruptured HCC. Group 1 consisted of 10 patients treated by transarterial embolization (TAE) followed by elective hepatectomy. Group 2 consisted of 2 patients treated by only TAE. Group 3 consisted of 3 patients treated by emergency operation. Group 4 consisted of 3 patients who could not be treated by TAE or surgery.
Results:
In Group 1, 4 of the 10 patients died; 3 from recurrent HCC and 1 from cerebral hemorrhage, and hospital mortality was absent. The 1-year survival rate was 87.5%. In Group 2, both patients recovered sufficiently well to be discharged. The 1-year survival rate was 50%. In Groups 3 and 4, hospital mortality rate was 100%.
Conclusions:
TAE followed by elective hepatectomy was an effective treatment in patients with ruptured HCC.