title: Transarterial embolization for ruptured hepatocellular carcinoma: survival predictors.
abstract: OBJECTIVE
  Survival predictors in patients with ruptured hepatocellular carcinoma (HCC) treated by transarterial embolization (TAE), have not been fully investigated.
  
  
  METHODS
  Predictors of short-term (< or = 30 days) and long-term (>30 days) survival were evaluated by using the logistic regression model and the Cox proportional hazard model, respectively.
  
  
  RESULTS
  Forty-eight patients treated by emergency TAE were enrolled. The median survival time was 231 days. Although hemostasis was attained by TAE in 44 patients (91.7%), 15 patients (31.3%) died within 30 days. In a multivariate analysis, low serum creatinine level (p=0.018) was the only significant predictor of increased short-term survival. Of the 33 patients who survived more than 30 days after TAE, he patic resection was performed in 8, transarterial chemoembolization or chemotherapy in 8, and conservative treatment in 17. In a multivariate analysis, among the 33 who survived, unilateral location of tumors (p=0.041) and low a-fetoprotein level (p=0.004) were significant predictors of increased long-term survival.
  
  
  CONCLUSIONS
  Short-term survival of patients with ruptured HCC who were treated by TAE depended on serum creatinine level on arrival. Long-term survival of patients who survived more than 30 days after TAE, was influenced by tumor location and a-fetoprotein level.
authors.affiliation: Department of Gastroenterology and Hepatology, Kurashiki Central Hospital, Kurashiki, Japan. n.toshikuni@gmail.com
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Toshikuni
authors.forename: Yoshitaka
authors.initials: Y
authors.lastname: Takuma
authors.forename: Youichi
authors.initials: Y
authors.lastname: Morimoto
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Shimomura
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Yamamoto
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000628:therapy*; D004621:Embolization, Therapeutic; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D016896:Treatment Outcome