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Staged partial hepatectomy versus transarterial chemoembolization for the treatment of spontaneous hepatocellular carcinoma rupture: a multicenter analysis in Korea
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Type
Academic journal
Author
Hyung Soon Lee (National Health Insurance Service Ilsan Hospital) Gi Hong Choi (Yonsei University College of Medicine) Jin Sub Choi (Yonsei University College of Medicine) Kwang-Hyub Han (Yonsei University College of Medicine) Sang Hoon Ahn (Yonsei University College of Medicine) Do Young Kim (Yonsei University College of Medicine)
Journal
The Korean Surgical Society Annals of Surgical Treatment and Research Vol.96 No.6 KCI Accredited Journals SCIE
Published
2019.6
Pages
275 - 282 (8page)

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Staged partial hepatectomy versus transarterial chemoembolization for the treatment of spontaneous hepatocellular carcinoma rupture: a multicenter analysis in Korea
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Research history (2)

2019

Staged partial hepatectomy versus transarterial chemoembolization for the treatment of spontaneous hepatocellular carcinoma rupture: a multicenter analysis in Korea
Hyung Soon Lee ,  Gi Hong Choi ,  Jin Sub Choi and others 13 Annals of Surgical Treatment and Research 2019.06 Academic journal

2016

Staged partial hepatectomy versus transarterial chemoembolization for the treatment of spontaneous hepatocellular carcinoma rupture : A multicenter analysis in Korea
Hyung Soon Lee ,  Gi Hong Choi ,  Jin Sub Choi and others 13 The Korean Association of Hepato-Biliary-Pancreatic Surgery 2016.04 Proceeding
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Abstract· Keywords

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Purpose: The aim of this study was to identify the prognostic factors and compare the long-term outcomes of staged hepatectomy and transarterial chemoembolization (TACE) for patients with spontaneous rupture of hepatocellular carcinoma (HCC).
Methods: This study is a multicenter, retrospective analysis of patients with newly diagnosed ruptured HCC. To compare overall survival between staged hepatectomy group and TACE alone group, we performed propensity score-matching to adjust for significant differences in patient characteristics. To identify prognostic factors, the clinical characteristics at the time of diagnosis of tumor rupture were investigated using Cox-regression analysis.
Results: From 2000 to 2014, 172 consecutive patients with newly diagnosed ruptured HCC were treated in 6 Korean centers. One hundred seventeen patients with Child-Pugh class A disease were identified; of which 112 were initially treated with transcatheter arterial embolization (TAE) for hemostasis and five underwent emergency surgery for bleeder ligation. Of the 112 patients treated with TAE, 44 underwent staged hepatectomy, 61 received TACE alone, and 7 received conservative treatment after TAE. Those that underwent staged hepatectomy had significantly higher overall survival than those that underwent TACE alone before matching (P ＜ 0.001) and after propensity score-matching (P = 0.006). Multivariate analysis showed that type of treatment, presence of portal vein thrombosis, pretreatment transfusion ＞1,200 mL, and tumor size ＞5 ㎝ were associated with poor overall survival.
Conclusion: Staged hepatectomy may offer better long-term survival than TACE alone for spontaneous rupture of HCC. Staged hepatectomy should be considered in spontaneous rupture of HCC with resectable tumor and preserved liver function.
#Hepatocellular carcinoma #Spontaneous rupture #Hepatectomy #Therapeutic chemoembolization

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References (23)

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Lai EC / 2006 / Spontaneous rupture of hepatocellular carcinoma : a systematic review / Arch Surg 141:191~198 google schola Aoki T / 2014 / Prognostic impact of spontaneous tumor rupture in patients with hepatocellular carcinoma : an analysis of 1160 cases from a nationwide survey / Ann Surg 259:532~542 google schola Chan AC / 2016 / Prognostic influence of spontaneous tumor rupture on hepatocellular carcinoma after interval hepatectomy / Surgery 159:409~417 google schola Liu CL / 2001 / Management of spontaneous rupture of hepatocellular carcinoma : single-center experience / J Clin Oncol 19:3725~3732 google schola Amin MB / 2017 / AJCC cancer staging manual / Springer google schola

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