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Titolo:
Management of spontaneous rupture of hepatocellular carcinoma: Single-center experience
Autore:
Liu, CL; Fan, ST; Lo, CM; Tso, WK; Poon, RTP; Lam, CM; Wong, J;
Indirizzi:
Univ Hong Kong, Queen Mary Hosp, Dept Surg, Med Ctr, Hong Kong, Hong Kong,Peoples R China Univ Hong Kong Hong Kong Hong Kong Peoples R China Kong,Peoples R China Univ Hong Kong, Queen Mary Hosp, Dept Diagnost Radiol, Med Ctr, Hong Kong,Hong Kong, Peoples R China Univ Hong Kong Hong Kong Hong Kong Peoples R China Kong, Peoples R China Univ Hong Kong, Queen Mary Hosp, Ctr Study Liver Dis, Med Ctr, Hong Kong, Hong Kong, Peoples R China Univ Hong Kong Hong Kong Hong Kong Peoples R China Kong, Peoples R China
Titolo Testata:
JOURNAL OF CLINICAL ONCOLOGY
fascicolo: 17, volume: 19, anno: 2001,
pagine: 3725 - 3732
SICI:
0732-183X(20010901)19:17<3725:MOSROH>2.0.ZU;2-D
Fonte:
ISI
Lingua:
ENG
Soggetto:
TRANSCATHETER ARTERIAL EMBOLIZATION; TRANSARTERIAL OILY CHEMOEMBOLIZATION; EMERGENCY LIVER RESECTION; MULTIVARIATE-ANALYSIS; COMPLICATING CIRRHOSIS; HEPATIC RESECTION; HEMOPERITONEUM; HEPATECTOMY; DIAGNOSIS; FEATURES;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Life Sciences
Citazioni:
36
Recensione:
Indirizzi per estratti:
Indirizzo: Liu, CL Univ Hong Kong, Queen Mary Hosp, Dept Surg, Med Ctr, 102 Pokfulam Rd, HongKong, Hong Kong, Peoples R China Univ Hong Kong 102 Pokfulam Rd Hong Kong Hong Kong Peoples R China
Citazione:
C.L. Liu et al., "Management of spontaneous rupture of hepatocellular carcinoma: Single-center experience", J CL ONCOL, 19(17), 2001, pp. 3725-3732

Abstract

Purpose: To report the management of patients with spontaneous rupture of hepatocellular carcinoma (HCC) in a single center over a 10-year period andto evaluate a two-stage therapeutic approach. Patients and Methods. A retrospective study was performed on all 1,716 patients with HCC who presented from 1989 to 1998. The two-stage therapeutic approach to manage ruptured HCC consisted of initial management by conservative method, hemostasis by transarterial embolization (TAE) or surgical means, followed by second-stage hepatic resection or transarterial oily chemoembolization (TOCE). Results of definitive treatment were compared with patients with no history of rupture during the same study period. Results: During the study period, 154 patients (9%) had spontaneous HCC rupture. Initial intervention to control bleeding included TAE in 42 patients, surgical hemostasis in 35 patients, and conservative management only in 53 patients. The 30-day mortality rate was 38%. Independent factors on presentation affecting 30-day mortality were shock on admission, hemoglobin, serum total bilirubin, and known diagnosis of inoperable tumor. After initial stabilization and clinical evaluation, 33 patients underwent hepatic resection and 30 patients received TOCE. Median survival of the hepatectomy patients was 25.7 months; that of the TOCE patients was 9.7 months. Compared with patients with no rupture, survival after hepatectomy (25.7 months v 49.2 months, P = .003) was inferior but still substantially long, whereas survival after TOCE was comparable (9.7 months v 8.7 months, P = .904). Conclusion: Early mortality of spontaneous rupture of-HCC was dependent onprerupture disease state, liver function, and severity of bleeding. Although it was a catastrophic presentation, prolonged survival could be achievedin selected patients with second-stage hepatic resection or TOCE. (C) 2001by American Society of Clinical Oncology.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 01/12/20 alle ore 07:44:55