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Efficacy and prognostic factors of transarterial embolization as initial treatment for spontaneously ruptured hepatocellular carcinoma: a single-center retrospective analysis in 57 patients

  • Chun Zhou
  • Qing-Quan Zu
  • Bin Wang
  • Chun-Gao Zhou
  • Hai-Bin Shi
  • Sheng Liu
Original Article
  • 16 Downloads

Abstract

Purpose

To evaluate the efficacy and prognostic factors following transarterial embolization (TAE) as initial treatment for spontaneously ruptured hepatocellular carcinoma (HCC).

Methods

From June 2012 to June 2016, a total of 57 spontaneously ruptured HCC patients who received TAE as initial therapy were retrospectively studied at our institution. Patients were followed until October 2016. Survival rates were estimated using the Kaplan–Meier method, and prognostic factors related to survival were evaluated using Cox regression analysis.

Results

Among them, 8 (14.0%) patients died within 30 days after initial TAE. The median overall survival time was 208 days. The 6-month, 1-year, and 2-year cumulative overall survival rates were 50.3%, 35.9%, and 14.7%, respectively. Multivariate analysis indicated that tumor size [HR (hazard ratio) 1.12; 95% CI (confidence interval) 1.02–1.23, P = 0.022] Child–Pugh class (HR 1.78; 95% CI 1.13–2.80; P = 0.013), absence of shock on admission (HR 0.40; 95% CI 0.17–0.95; P = 0.039), and embolization with lipiodol and gelatin sponge particles (HR 0.33; 95% CI 0.16–0.70; P = 0.004) were independent prognostic factors for survival.

Conclusion

TAE appeared to be an effective initial treatment for spontaneously ruptured HCC. The results indicated that large tumors, poor Child–Pugh class, and shock on admission were associated with poor prognosis. For these patients, embolization with lipiodol and gelatin sponge particles could achieve better survival than PVA particles used.

Keywords

Hepatocellular carcinoma Prognostic factors Spontaneous rupture Transarterial embolization 

Notes

Acknowledgements

We would like to thank Jin LIU from the First Affiliated Hospital of Nanjing Medical University for his Statistical Work.

Funding

None.

Compliance with ethical standards

Conflict of interest

No conflict of interest to declare.

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Copyright information

© Japan Radiological Society 2018

Authors and Affiliations

  • Chun Zhou
    • 1
  • Qing-Quan Zu
    • 1
  • Bin Wang
    • 1
  • Chun-Gao Zhou
    • 1
  • Hai-Bin Shi
    • 1
  • Sheng Liu
    • 1
  1. 1.Department of Interventional Radiologythe First Affiliated Hospital of Nanjing Medical UniversityNanjingChina

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