World Journal of Surgery

, Volume 38, Issue 8, pp 2070–2078 | Cite as

Impact of Spontaneous Hepatocellular Carcinoma Rupture on Recurrence Pattern and Long-term Surgical Outcomes after Partial Hepatectomy

  • Hyung Soon Lee
  • Gi Hong Choi
  • Dae Ryong Kang
  • Kwang-Hyub Han
  • Sang Hoon Ahn
  • Do Young Kim
  • Jun Yong Park
  • Seung Up Kim
  • Jin Sub ChoiEmail author



The clinical significance of spontaneous hepatocellular carcinoma (HCC) rupture association with recurrence pattern and long-term surgical outcomes remains under debate. We investigated the impact of spontaneous HCC rupture on recurrence pattern and long-term surgical outcomes after partial hepatectomy.


From 2000 to 2012, 119 patients with diagnosed ruptured HCC were reviewed. To compare outcomes between staged hepatectomy in spontaneously ruptured HCC and hepatectomy in non-ruptured HCC, we performed propensity score-matching to adjust for significant differences in patient characteristics. Overall survival, disease-free survival, and recurrence pattern were compared between the matched groups.


Forty-four patients with newly diagnosed ruptured HCC and Child A class were initially treated with transcatheter arterial embolization for hemostasis. Three patients underwent emergency laparotomy, 18 underwent staged hepatectomy, and 23 received transarterial chemoembolization (TACE) alone after transcatheter arterial embolization. Among the 23 patients treated with TACE alone, 10 had resectable tumors. The staged hepatectomy group shows significantly higher overall survival with TACE alone than the resectable tumor group (P < 0.001). After propensity score-matching, overall survival, disease-free survival, and recurrence pattern were not significantly different between the ruptured HCC with staged hepatectomy group and the non-ruptured HCC with hepatectomy group. Peritoneal recurrence rates were similar at 14.3 % versus 10.0 %, respectively (P = 0.632).


Patients with spontaneously ruptured HCC with staged hepatectomy show comparable long-term survival and recurrence pattern as patients with non-ruptured HCC having similar tumor characteristics and liver functional status. Thus, spontaneous HCC rupture may not increase peritoneal recurrence and decrease long-term survival after partial hepatectomy.


Overall Survival Tace Recurrence Pattern Liver Functional Reserve Resectable Tumor Group 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Conflict of interest

No author has any conflict of interest to declare, financial or otherwise.




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Copyright information

© Société Internationale de Chirurgie 2014

Authors and Affiliations

  • Hyung Soon Lee
    • 1
  • Gi Hong Choi
    • 1
  • Dae Ryong Kang
    • 2
  • Kwang-Hyub Han
    • 3
  • Sang Hoon Ahn
    • 3
  • Do Young Kim
    • 3
  • Jun Yong Park
    • 3
  • Seung Up Kim
    • 3
  • Jin Sub Choi
    • 1
    Email author
  1. 1.Department of SurgeryYonsei University College of MedicineSeoulRepublic of Korea
  2. 2.Biostatistics Collaboration UnitYonsei University College of MedicineSeoulRepublic of Korea
  3. 3.Department of Internal MedicineYonsei University College of MedicineSeoulRepublic of Korea

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