Are the results of surgical treatment of hepatocellular carcinoma poor if the tumor has spontaneously ruptured?

Background: The aim of this study was to clarify whether the results of surgical treatment of ruptured hepatocellular carcinoma ( HCC) are poorer than the results of surgical treatment of non- ruptured HCC. Methods: Out of a total of 224 HCC patients, the 6 patients with ruptured HCC were compared with 15 patients with non- ruptured HCC based on TNM stage IVA and having a Cancer of the Liver Italian Program ( CLIP) score of 1 or 2. Results: There were no significant differences in clinical and pathological features between the two groups. The 1- year and 3- year overall survival rates were 69.3% and 21.2%, respectively, in the ruptured HCC group and 51.3% and 20.5%, respectively, in the non-ruptured HCC group. The 1- year and 3- year disease- free survival rates were 33.0% and 0%, respectively, in the ruptured HCC group and 38.9% and 15.6%, respectively, in the non- ruptured HCC group. The differences in survival rates between these two groups did not reach statistical significance. Conclusion: Hepatic resection as definitive treatment after recovery from the initial insult of the rupture of HCC yields results similar to those obtained by surgical treatment of non- ruptured HCC at the same tumor stage and with the same degree of liver damage.