Risk factors of spontaneous rupture of hepatocellular carcinoma
10.3760/cma.j.issn.1007-631X.2011.02.025
- VernacularTitle:原发性肝细胞癌自发破裂的风险因素分析
- Author:
Wei XU
;
Jingdong LI
;
Gang SHI
;
Quanlin LI
;
Qiang LI
- Publication Type:Journal Article
- Keywords:
Carcinoma,hepatocellular;
Rupture;
Hemoperitoneum;
Risk factors
- From:
Chinese Journal of General Surgery
2011;26(2):149-153
- CountryChina
- Language:Chinese
-
Abstract:
Objective To explore risk factors relating to occurrence of spontaneous rupture (SR)of hepatocellular carcinoma (HCC). Methods We retrospectively reviewed medical records of 409 HCC patients treated in our department from Jan. 1st 2005 to Aug. 31st 2009. Clinicopathologic factors were explored for their possible association with occurrence of SR by univariate and multivariate analysis using Logistic regression model. Results Among 409 patients, SR occurred in 40 patients (9. 8% , 40/409).Type of SR was defined according to presentation of acute abdominal emergency, especially unstable hemodynamic status. Nineteen cases (4. 7%, 19/409) were grouped as type of HCC-SR Ⅰ and 21 cases (5. 1% ,21/409) as HCC-SR Ⅱ. Patients in the two groups possessed similar hepatitis infection status,severity of background liver disease and tumoral factors except for tumoral location, while HCC-SR Ⅰ group often needed emergency treatment demonstrating elevated values of aspartate aminotransferase (AST) and WBC, decreased PLT counts and worse Child-Pugh classification. Patients in the HCC-SR Ⅱ group had more opportunities of receiving curative hepatectomy and had longer overall survival. The 1,2 and 3 year survival rates were 26. 3 % (5/19), 5. 3% ( 1/19 ) and 0% (0/19)in the HCC-SR Ⅰ group and 66. 7% ( 14/21 ),42.9% (9/21)and 19. 5% (5/21) in the HCC-SR Ⅱ group, respectively. Differences reached statistical significance( P = 0. 011,0. 009,0. 049). Multivariate analysis identified that severity of concomitant liver cirrhosis , WBC ＞ 10 × 109/L and AST level more than twice normal (2N) as independent risk factors associating with occurrence of HCC-SR Ⅰ , while elevated values of AFP and presence of tumor thrombi in portal vein branch related to HCC-SR Ⅱ. Conclusions HCC-SR includes two different types, since different risk factors predict occurrence of each HCC-SR type.
