کد مقاله کد نشریه سال انتشار مقاله انگلیسی نسخه تمام متن
6087945 1207680 2016 6 صفحه PDF دانلود رایگان
عنوان انگلیسی مقاله ISI
OncologyComparison of the prognostic influence of emergency hepatectomy and staged hepatectomy in patients with ruptured hepatocellular carcinoma
موضوعات مرتبط
علوم پزشکی و سلامت پزشکی و دندانپزشکی غدد درون ریز، دیابت و متابولیسم
پیش نمایش صفحه اول مقاله
OncologyComparison of the prognostic influence of emergency hepatectomy and staged hepatectomy in patients with ruptured hepatocellular carcinoma
چکیده انگلیسی

BackgroundSpontaneous hepatocellular carcinoma (HCC) rupture is a fatal complication of primary liver cancer and is associated with poor surgical outcomes. Whether emergency hepatectomy or staged hepatectomy should be performed in the situations of a spontaneous rupture for resectable HCC need to be investigated.MethodsBetween January 2005 and December 2014, 131 patients with HCC ruptures received emergency or staged hepatectomy in our hospital and were included in this study. We retrospectively compared the postoperative morbidity and mortality, overall survival (OS), and disease-free survival (DFS) of patients who received emergency or staged hepatectomies. Independent prognostic predictors were identified using the Cox multivariate regression analysis.ResultsEmergency hepatectomy could be performed for successful surgical hemostasis and radical tumor resection. However, the in-hospital mortality rate was 11.0%, which correlated with INR, liver function, shock, blood transfusion, and aggressive treatment by emergency hepatectomy (P < 0.05). Conversely, the 1-, 3-, and 5-year overall survival rates of ruptured HCC patients with staged hepatectomy were 82.8%, 55.2%, and 41.4%; and the disease-free survival rates were 70.7%, 44.8%, and 27.6%, respectively. The overall survival and disease-free survival of staged hepatectomy group were longer than that of emergency hepatectomy group (P = 0.034, P = 0.019). Multivariable analyses of HCC ruptures patients indicated that tumor sizes more than 10 cm and multiple-nodule tumors were independent predictors of poor long-term survival.ConclusionsThough they carry some risk, emergency hepatectomy is still an important means of treatment for spontaneous HCC ruptures. For resectable HCC ruptures, emergency hepatectomy or staged hepatectomy are life-saving procedures, and efficient therapeutic methods. After the initial hemostasis, staged liver resection can often help patients achieve better long-term survival than emergency hepatectomy.

ناشر
Database: Elsevier - ScienceDirect (ساینس دایرکت)
Journal: Digestive and Liver Disease - Volume 48, Issue 8, August 2016, Pages 934-939
نویسندگان
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