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- Title
Partial hepatectomy for ruptured hepatocellular carcinoma.
- Authors
Yang, T.; Sun, Y. F.; Zhang, J.; Lau, W. Y.; Lai, E. C. H.; Lu, J. H.; Shen, F.; Wu, M. C.
- Abstract
Background Improvements in surgical technique and perioperative care have made partial hepatectomy a safe and effective treatment for hepatocellular carcinoma ( HCC), even in the event of spontaneous HCC rupture. Methods A consecutive cohort of patients who underwent partial hepatectomy for HCC between 2000 and 2009 was divided into a ruptured group and a non-ruptured group. Patients with ruptured HCC were further divided into emergency and staged hepatectomy subgroups. Mortality and morbidity, overall survival and recurrence-free survival ( RFS) were compared. Prognostic factors for overall survival and RFS were identified by univariable and multivariable analyses. Results A total of 1233 patients underwent partial hepatectomy for HCC, of whom 143 had a ruptured tumour. The morbidity and mortality rates were similar in the ruptured and non-ruptured groups, as well as in the emergency and staged subgroups. In univariable analyses, overall survival and RFS were lower in the ruptured group than in the non-ruptured group (both P < 0·001), and also in the emergency subgroup compared with the staged subgroup ( P = 0·016 and P = 0·025 respectively). In multivariable analysis, spontaneous rupture independently predicted poor overall survival after hepatectomy (hazard ratio 1·54, 95 per cent confidence interval 1·24 to 1·93) and RFS ( HR 1·75, 1·39 to 2·22). Overall survival and RFS after hepatectomy for ruptured HCC in the emergency and staged subgroups were not significantly different in multivariable analyses. Conclusion Spontaneous rupture predicted poor long-term survival after hepatectomy for HCC, but surgical treatment seems possible, safe and appropriate in selected patients.
- Subjects
LIVER cancer; HEPATECTOMY; CANCER-related mortality; PERIOPERATIVE care; CANCER relapse; MULTIVARIATE analysis
- Publication
British Journal of Surgery, 2013, Vol 100, Issue 8, p1071
- ISSN
0007-1323
- Publication type
Article
- DOI
10.1002/bjs.9167