[The clinical study on spontaneously ruptured hepatocellular carcinoma].
OBJECTIVE
Spontaneous rupture of hepatocellular carcinoma (HCC) is known as a rare but life- threatening condition because of massive blood loss into the peritoneal cavity. In the countries with high prevalence, the reported incidence of spontaneous rupture and hemorrhage ranged from 10.2% to 14.5% of patients with HCC. This study was aimed to analyze the risk factors for spontaneous rupture and prognosis in the patients with ruptured HCC.


METHODS
Among 642 consecutive patients with HCC who had admitted to Gyeongsang National University Hospital from January 1998 to September 2003, spontaneous rupture of HCC occurred in 83 patients (12.9%). The medical records of the 83 patients were reviewed retrospectively, and the clinico-laboratory parameters and radiologic findings were analyzed.


RESULTS
Sixty-nine out of the 83 patients were male, the mean age was 57.7 +/- 13.2 years (male, 56.8 +/- 12.9 years; female, 62.3 +/- 13.5 years). Location of tumor, Child-Pugh class and Okuda stage were the risk factors influencing spontaneous rupture of HCC, whereas the TNM stage, presence of portal vein thrombosis, and size of the tumor were not. Among the 83 patients with ruptured HCC, 51 were treated by transarterial embolization (TAE), 31 by supportive measures, and 1 by operation. The median survival time was 3.4 +/- 4.5 months in all patients with ruptured HCC, 4.9 +/- 5.1 in successful TAE, and 2.1 +/- 3.4 in supportive measure groups.


CONCLUSIONS
Advanced Child-Pugh class, advanced Okuda stage, and peripheral location were the risk factors for spontaneous rupture of HCC. The prolonged survival could be achieved in patients eligible for successful transarterial embolization rather than supportive measures.
Min
Hyun Ju
HJ
Department of Internal Medicine, Gyeongsang Institute of Health Science, Gyeongsang National University College of Medicine, Jinju, Gyeongnam, Korea.
Lee
Ok Jae
OJ
Kang
Do Youn
DY
Lee
Eun Jung
EJ
Lee
Ji Hun
JH
Kim
Hyun Jin
HJ
Kim
Tae Hyo
TH
Jung
Woon Tae
WT
Cho
Joong Hyun
JH
D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000150:complications* / Q000473:pathology; D005260:Female; D006465:Hemoperitoneum / Q000209:etiology; D006801:Humans; D008113:Liver Neoplasms / Q000150:complications* / Q000473:pathology; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012307:Risk Factors; D012422:Rupture, Spontaneous