Multidisciplinary management of ruptured hepatocellular carcinoma

被引:54
作者
Buczkowski, AK
Kim, PTW
Ho, SG
Schaeffer, DF
Lee, SI
Owen, DA
Weiss, AH
Chung, SW
Scudamore, CH
机构
[1] Vancouver Hosp & Hlth Sci Ctr, Div Gen Surg, Vancouver, BC V5Z 1M9, Canada
[2] Vancouver Hosp & Hlth Sci Ctr, Div Gastroenterol, Vancouver, BC V5Z 1M9, Canada
[3] Vancouver Hosp & Hlth Sci Ctr, Dept Surg, Vancouver, BC V5Z 1M9, Canada
[4] Vancouver Hosp & Hlth Sci Ctr, Dept Radiol, Vancouver, BC V5Z 1M9, Canada
[5] Vancouver Hosp & Hlth Sci Ctr, Dept Pathol, Vancouver, BC V5Z 1M9, Canada
关键词
hepatocellular carcinoma; rupture; transcatheter arterial embolization;
D O I
10.1016/j.gassur.2005.10.012
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Spontaneous rupture of hepatocellular carcinoma (HCC) is a dramatic presentation of the disease. Most published studies are from Asian centers, and North American experience is limited. This study was undertaken to review the experience of ruptured HCC at a North American multidisciplinary unit. Thirty patients presenting with ruptured HCC at a tertiary care center from 1985 to 2004 were studied retrospectively and analyzed according to the demographics, clinical presentation, tumor characteristics, treatment, and outcome in four treatment groups: emergency resection, delayed resection (resection after angiographic embolization), transcatheter arterial embolization (TAE), and conservative management. Ten, 10, 7, and 3 patients underwent emergency resection, delayed resection, TAE, and conservative treatment, respectively. The mean age of all patients was 57 years, and the mean Child-Turcotte-Pugh score was 7 +/- 2. Cirrhosis was present in 57% of the patients. Seventy percent of tumors were greater than 5 cm in diameter, and 68% of patients had multiple tumors. There was a trend toward higher 30-day mortality in the emergency resection group than in the delayed resection group. One-year survival was significantly better in the delayed resection group. In selected patients, the multidisciplinary approach of angiographic embolization and delayed resection affords better short-term survival than emergency resection.
引用
收藏
页码:379 / 386
页数:8
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