title: Treatment of spontaneous ruptured hepatocellular carcinoma.
abstract: OBJECTIVE
  Spontaneous rupture with bleeding is a potentially life-threatening complication of hepatocellular carcinoma (HCC). We review our experience with treatments of ruptured HCC.
  
  
  METHODS
  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.
authors.affiliation: First Department of Surgery, Nippon Medical School, Tokyo, Japan.
authors.forename: H
authors.initials: H
authors.lastname: Yoshida
authors.forename: M
authors.initials: M
authors.lastname: Onda
authors.forename: T
authors.initials: T
authors.lastname: Tajiri
authors.forename: M
authors.initials: M
authors.lastname: Umehara
authors.forename: Y
authors.initials: Y
authors.lastname: Mamada
authors.forename: S
authors.initials: S
authors.lastname: Matsumoto
authors.forename: K
authors.initials: K
authors.lastname: Yamamoto
authors.forename: M
authors.initials: M
authors.lastname: Kaneko
authors.forename: T
authors.initials: T
authors.lastname: Kumazaki
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000150:complications* / Q000401:mortality / Q000601:surgery; D004621:Embolization, Therapeutic; D005260:Female; D006470:Hemorrhage / Q000209:etiology / Q000628:therapy*; D006498:Hepatectomy; D006801:Humans; D008107:Liver Diseases / Q000628:therapy; D008113:Liver Neoplasms / Q000150:complications* / Q000401:mortality / Q000601:surgery; D008297:Male; D008875:Middle Aged; D012421:Rupture; D015996:Survival Rate