scholarly journals Factors Predicting Survival in Ruptured Hepatocellular Carcinoma Treated with Surgical Resection

2022 ◽  
Vol 74 (1) ◽  
pp. 40-47
Author(s):  
Charnwit Assawasirisin ◽  
Pholasith Sangserestid ◽  
Yongyut Sirivatanauksorn ◽  
Somchai Limsrichamrern ◽  
Prawat Kositamongkol ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Surgical Resection ◽  
Cancer Surveillance ◽  
Postoperative Liver Failure ◽  
High Risk Population ◽  
Term Survival ◽  
Factors Affecting ◽  
Screening Programs ◽  
Number Of Patients ◽  
Ruptured Hepatocellular Carcinoma

Background: Today, ruptured hepatocellular carcinoma (HCC) is a less frequently encountered problem globally due to availability of cancer surveillance protocols for the high-risk population. However, in Thailand, a number of patients do not enroll in screening programs, leading to high rates of ruptured complications. In fit-for-surgery and clinically stable patients, hepatectomy means long-term survival. This study aimed to identify predictive factors of survival in resected patients. Methods: A retrospective review of patients with ruptured HCC who underwent liver resection between January 2013 and December 2019 at Siriraj Hospital was performed. The clinical data and outcomes of patients were analyzed. Results: A total of forty-five patients with ruptured HCC underwent resection or 9.8% (45/460) of all operable HCC cases. There were 6 patients (14.3%) who suffered from postoperative liver failure and one patient (2.4%) died within 30 days. Overall survival (OS) and recurrence-free survival were 90%, 64%, 52% and 42.5%, 24%, 16% at 1, 3, and 5 years, respectively. The factors affecting OS were tumor size > 10 cm, vascular invasion, and positive resection margin. Conclusion: Ruptured HCC is treatable disease and surgical resection plays a major role in good outcomes in patients.

Outcomes of Surgical Resection for Ruptured Hepatocellular Carcinoma

2017 ◽  
Vol 17 (1) ◽  
pp. 54-59
Author(s):  
Hae Won Lee ◽  
Chang-Sup Lim ◽  
Hyo-Sin Kim
Keyword(s):  
Hepatocellular Carcinoma ◽  
Surgical Resection ◽  
Ruptured Hepatocellular Carcinoma

scholarly journals Management of hepatocellular carcinoma: international guidelines

2013 ◽  
pp. 136-147
Author(s):  
Luigi Fenoglio ◽  
Elisabetta Castagna ◽  
Cristina Serraino ◽  
Adele Cardellicchio ◽  
Fulvio Pomero ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Screening Test ◽  
Early Stage ◽  
The United States ◽  
High Rate ◽  
Disease Stage ◽  
Percutaneous Ablation ◽  
Major Health Problem ◽  
Screening Programs ◽  
Number Of Patients

Hepatocellular carcinoma (HCC) is a major health problem worldwide. The incidence of HCC is increasing in Europe and in the United States. HCC is currently the leading cause of death among cirrhotic patients. Cirrhosis is the strongest and the most common risk factor for HCC. Surveillance for HCC is widely practiced and can be recommended for certain at-risk groups. Among serological screening test, alpha-fetoprotein (AFP) is the best known (cut-off 20 ng/mL, sensitivity 60%, specificity 91%). The radiological screening test most widely used is ultrasonography (sensitivity 65—80%, specificity >90%). The tests used to diagnose HCC include radiology, biopsy and AFP. Detection of hepatic mass within a cirrhotic liver is highly suspicious of HCC. If AFP is greater than 200 ng/mL and the radiological appearance of the mass is suggestive for HCC, the likelihood that the lesion is HCC is high. The Barcelona-Clinic-Liver-Cancer staging system identifies patients with early HCC who may benefit from curative therapies, those at intermediate or advanced disease stage who may benefit from palliative treatments, as well as those at end-stage with a very poor life expectancy. Today many patients are diagnosed at an early stage. The therapies that offer a high rate of complete responses and potential cure are surgical resection, transplantation and percutaneous ablation. Among non-curative therapies the only one that has been shown to positively impact survival is transarterial chemoembolization. Several steps have to be taken to improve effectiveness of HCC therapy. These include patient education on risk factors for HCC and implementation of screening programs, increasing the number of patients diagnosed in early stage.

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