title: Patients with spontaneously ruptured hepatocellular carcinoma benefit from staged surgical resection after successful transarterial embolization.
abstract: BACKGROUND
  Surgical resection of spontaneously ruptured hepatocellular carcinoma (HCC) after successful transarterial embolization (TAE) remains controversial. The aim of this study was to investigate its efficacy in a series of cases.
  
  
  METHODS
  We retrospectively examined ruptured HCC cases from Jan 2000 to Dec 2008; all of these 126 cases received TAE as the initial therapy. Subsequently, 74 cases received staged surgical resection, and the remaining 52 cases underwent repeated TACE. The baseline demographic data, tumor characteristics, and long term survival were recorded and compared.
  
  
  RESULTS
  The demographic and baseline characteristics were comparable between the hepatic resection and TACE groups; furthermore, no significant difference in the tumor characteristics was detected between the two groups. The differences in in-hospital, 30- day and 90-day mortality between the two groups were not significant (P>0.05). However, the 1-, 3-, and 5-year overall survival rates were 85.1%, 63.5%, and 37.8%, respectively, in the hepatic resection group, which were significantly higher than those in the TACE group (69.2%, 46.2%, and 17.3%, respectively, P=0.004). Univariate and multivariate analyses indicated that these patients benefitted from hepatic resection compared with TACE with respect to long-term outcomes.
  
  
  CONCLUSIONS
  Staged hepatic resection after TAE is an effective treatment that results in superior long-term survival to repeated TACE.
authors: Emergency Department, Gansu Provincial Hospital, Lanzhou, China E-mail : wxpgsdoctor@163.com.
authors: Dong-Zhi
authors: DZ
authors: Zhang
authors: Ke
authors: K
authors: Zhang
authors: Xiao-Peng
authors: XP
authors: Wang
authors: Hui
authors: H
authors: Cai
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D004621:Embolization, Therapeutic / Q000009:adverse effects*; D005260:Female; D006801:Humans; D008099:Liver / Q000473:pathology / Q000601:surgery*; D008113:Liver Neoplasms / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011859:Radiography; D012189:Retrospective Studies; D012422:Rupture, Spontaneous / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000601:surgery*; D015996:Survival Rate; D016896:Treatment Outcome