Risk Factors and Treatment Strategy of Ruptured Hepatocellular Carcinoma

Abstract

Backgrounds/Aims : The incidence of the spontaneous rupture of hepatocellular

carcinoma (HCC), which is a life-threatening condition, is reported to be 2.2-17.9% in

Korea. This study was conducted to analyze the risk factors of HCC rupture and to

make a treatment strategy.

Methods : We reviewed 370 patients with HCC in terms of the clinicopathologic

features, the prognosis according to the type of treatment.

Results : The incidence of HCC rupture was 13% (48/370). The suspected risk factors

of tumor rupture, except protrusion of tumor, showed no significant difference in this

series. Among the 48 patients with ruptured HCC, 15 underwent hepatic resection and

the remaining 33 received hepatic artery ligation, transarterial embolization or

conservative management. The median survival time of patients with resection and

non-resection were 9.0±2.4 months and 0.6±0.2 months, respectively (p<0.05). In stage

VIA HCC, the median survival time of patients with resection and non-resection were

6.0±1.5 months and 0.6±0.2 months, respectively (p<0.05).

Conclusions : The protrusion of tumor beyond the liver surface is the only significant

risk factor of HCC rupture. Partial hepatectomy seems to be an effective modality for

lifesaving as well as long-term survival for patients with ruptured HCC.