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Surgical Outcomes for the Ruptured Hepatocellular Carcinoma: Multicenter Analysis with a Case-Controlled Study

  • Original Article
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Journal of Gastrointestinal Surgery Aims and scope

Abstract

Background

While spontaneously ruptured hepatocellular carcinoma (HCC) has a poor prognosis, the true impact of a rupture on survival after hepatic resection is unclear.

Methods

Fifty-eight patients with ruptured HCC and 1922 with non-ruptured HCC underwent hepatic resection between 2000 and 2013. To correct the difference in the clinicopathological factors between the two groups, propensity score matching (PSM) was used at a 1:1 ratio, resulting in a comparison of 42 patients/group. We investigated outcomes in all patients with ruptured HCC and compared outcomes between the two matched groups.

Results

Of the 58 patients with ruptured HCC, 7 patients (13 %) died postoperatively. Overall survival (OS) rate at 5 years after hepatic resection was 37 %. Emergency hepatic resection was an independent risk factor for in-hospital death and Child-Pugh class B for unfavorable OS in multivariate analysis. Clinicopathological variables were well-balanced between the two groups after PSM. No significant differences were noted in incidence of in-hospital death (ruptured HCC 12 % vs non-ruptured HCC 2 %, p = 0.202) or OS rate (5/10-year; 42 %/38 % vs 67 %/30 %, p = 0.115).

Conclusion

Emergency hepatic resection should be avoided for ruptured HCC in Child-Pugh class B patients. Rupture itself was not a risk for unfavorable surgical outcomes.

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Contribution of Authors

Design of work: S Tanaka, S Kubo

Acquisition, analysis, and interpretation of data: S Tanaka, M Ueno, H Wada, F Hirokawa, T Nakai, H Iida, H Eguchi

Drafting and revising: S Tanaka, M Kaibori, M Ueno, M Hayashi, S Kubo

Final approval: S Tanaka, M Ueno, S Kubo

Agreement to be accountable for all aspects of the work: S Tanaka, M Kaibori, M Ueno, H Wada, F Hirokawa, T Nakai, H Iida, H Eguchi, M Hayashi, S Kubo

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Authors and Affiliations

  1. Department of Hepato-Biliary-Pancreatic Surgery, Osaka City University Graduate School of Medicine, 1-4-3 Asahimachi, Abenoku, Osaka, 545-8585, Japan

    Shogo Tanaka & Shoji Kubo

  2. Department of Surgery, Hirakata Hospital, Kansai Medical University, Hirakata, Osaka, Japan

    Masaki Kaibori & Hiroya Iida

  3. Second Department of Surgery, Wakayama Medical University, Wakayama, Japan

    Masaki Ueno

  4. Department of Gastroenterological Surgery, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan

    Hiroshi Wada & Hidetoshi Eguchi

  5. Department of General and Gastroenterological Surgery, Osaka Medical College, Takatsuki, Osaka, Japan

    Fumitoshi Hirokawa & Michihiro Hayashi

  6. Department of Surgery, Faculty of Medicine, Kinki University, Osaka-Sayama, Osaka, Japan

    Takuya Nakai

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  1. Shogo Tanaka
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  2. Masaki Kaibori
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Correspondence to Shogo Tanaka.

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Tanaka, S., Kaibori, M., Ueno, M. et al. Surgical Outcomes for the Ruptured Hepatocellular Carcinoma: Multicenter Analysis with a Case-Controlled Study. J Gastrointest Surg 20, 2021–2034 (2016). https://doi.org/10.1007/s11605-016-3280-2

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  • DOI: https://doi.org/10.1007/s11605-016-3280-2

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