title: Outcomes and Prognostic Factors in Patients with Spontaneously Ruptured Hepatocellular Carcinoma.
abstract: OBJECTIVE
  Spontaneous rupture is a life-threatening complication of hepatocellular carcinoma (HCC). Although hemostasis can be achieved by transarterial embolization (TAE), the prognosis remains poor. The aims of this study were to evaluate the effectiveness of emergent TAE for ruptured HCC and to clarify the prognostic factors.
  
  
  METHODS
  Thirty-six patients with spontaneously ruptured HCC were retrospectively analyzed. Prognostic factors of short-term (57 days) and long-term (>7 days) survival after HCC rupture were investigated by univariate and multivariate analyses.
  
  
  RESULTS
  Emergent TAE was performed in 22 patients and conservative treatment was applied in 14. The hemostasis rate of TAE was 86.4%, and median survival time in patients with TAE was significantly longer than that in patients with conservative treatment (142 days vs. 5 days, p = 0.0006). In multivariate analysis, high serum creatinine (p = 0.036) was a significant independent predictor of poor 7-day survival, and low serum albumin (p = 0.050) and absence of emergent TAE (p = 0.061) tended to be associated with poor 7-day survival. HCC treatment within the past 12 months (p = 0.048) and, high serum total bilirubin (p = 0.016) were predictors of poor long-term survival. Conclusions: We identified some survival predictors after HCC rupture. Emergent TAE appears to be effective for improving short-term oroLnosis after HCC ruoture.
authors.forename: Tomonori
authors.initials: T
authors.lastname: Matsumoto
authors.forename: Hobyung
authors.initials: H
authors.lastname: Chung
authors.forename: Yoshiki
authors.initials: Y
authors.lastname: Suginoshita
authors.forename: Kyo
authors.initials: K
authors.lastname: Ito
authors.forename: Tetsuro
authors.initials: T
authors.lastname: Inokuma
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001663:Bilirubin / Q000097:blood; D006528:Carcinoma, Hepatocellular / Q000097:blood / Q000473:pathology / Q000628:therapy*; D015331:Cohort Studies; D003404:Creatinine / Q000097:blood; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000097:blood / Q000473:pathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D012422:Rupture, Spontaneous / Q000097:blood / Q000401:mortality / Q000628:therapy; D016896:Treatment Outcome; D047368:Tumor Burden
chemical_list: D003404:Creatinine; D001663:Bilirubin