title: An Analysis of Surgical Treatment for the Spontaneous Rupture of Hepatocellular Carcinoma.
abstract: OBJECTIVE
  The prognosis of spontaneous rupture of hepatocellular carcinoma (HCC) remains unclear. We investigated the prognosis of patients with ruptured HCC based on the treatments and prognostic factors associated with long-term survival.
  
  
  METHODS
  The prognoses of 64 consecutive patients treated for ruptured HCC from 1986 to 2013 were analyzed according to their methods of treatment. The prognostic factors of 16 surgical patients were identified, and their overall survival (OS) and recurrence rates were compared to 1,157 surgical patients who underwent surgery for non-ruptured HCC. The surgical outcomes were also compared using a propensity score matching method.
  
  
  RESULTS
  Surgery was associated with a better OS. Curative resection was the only independent prognostic factor in surgical patients with ruptured HCC (p = 0.040). Although the OS of surgical patients with non-ruptured HCC was found to be significantly better than that of the patients with ruptured HCC, no significant difference in OS was observed after propensity score matching.
  
  
  CONCLUSIONS
  A curative resection should be the objective of treatment, assuming the suitability of the patient's clinical condition. When the liver function reserve and tumor extension of patients with ruptured and non-ruptured HCC are similar, then their surgical outcomes may not be significantly different.
authors.affiliation: Department of Gastroenterological and Transplant Surgery, Applied Life Sciences, Institute of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan.
authors.forename: Haruki
authors.initials: H
authors.lastname: Sada
authors.forename: Masahiro
authors.initials: M
authors.lastname: Ohira
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Kobayashi
authors.forename: Hirotaka
authors.initials: H
authors.lastname: Tashiro
authors.forename: Kazuaki
authors.initials: K
authors.lastname: Chayama
authors.forename: Hideki
authors.initials: H
authors.lastname: Ohdan
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000401:mortality / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D011379:Prognosis; D057216:Propensity Score; D012189:Retrospective Studies; D012422:Rupture, Spontaneous / Q000401:mortality / Q000601:surgery; D016019:Survival Analysis; D016896:Treatment Outcome