One-stage liver resection for spontaneous rupture of hepatocellular carcinoma.
The objective of this study was to evaluate the rationale of a policy of one-stage liver resection for selective cases of spontaneous rupture of hepatocellular carcinoma (HCC). Altogether, 36 patients with spontaneous rupture of an HCC admitted between November 1994 and September 2003 underwent a one-stage laparotomy with a view to curative liver resection; 33 cases underwent liver resection successfully, and 3 cases were found to have lesions unresectable at laparotomy and were treated with other hemostatic procedures. The prognostic value was calculated by Kaplan-Meier survival curve analysis. Effective surgical hemostasis was achieved in all patients, with a postoperative mortality rate of 5.8% (2/36). The estimated survivals at 1, 3, and 5 years for patients who underwent liver resection were 88%, 54%, and 51%, respectively. These results suggest that a one-stage surgical operation offers a feasible, effective treatment for patients with ruptured HCC in whom the tumor is judged likely to be resectable on the computed tomography scan and who have a liver function grade of A or B according to Child-Pugh criteria.
Hai
Liu
L
Department of Surgical Oncology, Hainan Provincial People's Hospital, Haikou, Hainan 570311, People's Republic of China. dr_liuhai@hotmail.com
Yong-Hong
Peng
P
Yong
Fu
F
Ren-Feng
Li
L
D000328:Adult; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000601:surgery*; D005260:Female; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D008113:Liver Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D012422:Rupture, Spontaneous; D016019:Survival Analysis; D016896:Treatment Outcome