Spontaneous tumor rupture and surgical prognosis of patients with hepatocellular carcinoma
Spontaneous tumor rupture and surgical prognosis of patients with hepatocellular carcinoma
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肝细胞癌患者肿瘤自发破裂与手术预后
DOI：
10.3109/00365521.2012.685753
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发表时间：
2012-09-01
影响因子：
1.9
通讯作者：
Lv, Yi
中科院分区：
文献类型：
--
作者：
Zhang, Xu-Feng;Wei, Tao;Lv, Yi
抽象背景。自发性破裂是肝细胞癌（HCC）的一种罕见但最致命的并发症，并被认为是肿瘤复发的危险因素。本研究旨在探讨肝癌破裂患者的近期和远期生存情况，并评估肿瘤破裂对患者肝切除术后生存的影响。患者和方法。回顾性分析2000 - 2010年101例肝癌破裂患者的临床资料。记录并评价肿瘤破裂的处理和影响患者30天死亡率的临床病理参数。41例接受肝切除术的患者的长期生存率与同期446例未破裂HCC患者的长期生存率进行比较。结果101例HCC破裂患者的30天死亡率为35.6%，中位生存期为79天。影响30天死亡率的独立危险因素是肿瘤大小和输血量。与446例非破裂HCC患者相比，41例破裂HCC患者行肝切除术的总体和无病生存率与446例无破裂HCC患者相似（对数秩检验，p分别为0.704和0.084）。多因素分析显示，年龄、性别和肿瘤大小是区分肿瘤破裂与非破裂的独立重要因素。结论肝癌自发性破裂的早期死亡率取决于术前肝功能、肿瘤状态和出血的严重程度。肝癌破裂患者行肝切除术后，生存期可延长至与无并发症者相同。
Abstract Background. Spontaneous rupture is an uncommon but the most fatal complication of hepatocellular carcinoma (HCC) and is recognized as a risk factor for tumor recurrence. The present study is to investigate the short- and long-term survival of the patients with HCC rupture and evaluate the influence of tumor rupture on patient's survival after hepatic resection. Patients and methods. The clinical data of 101 patients with HCC rupture from 2000 to 2010 were reviewed retrospectively. The management of tumor rupture and clinicopathological parameters affecting 30-day mortality of the patients were recorded and evaluated. Long-term survival of the 41 patients undergoing hepatic resection was compared with 446 patients with non-ruptured HCC at the same time period. Results. The 30-day mortality rate of the 101 patients with HCC rupture was 35.6% and median survival was 79 days. The independent risk factors affecting 30-day mortality were tumor size and blood transfusion quantity. Compared with 446 non-ruptured HCC patients, 41 patients with ruptured HCC undergoing hepatic resection had a similar overall and disease-free survival to 446 without rupture (Log-rank test, p = 0.704 and 0.084, respectively). Multivariate analysis revealed that age, gender, and tumor size were independently significant factors in differentiating tumor rupture from non-rupture. Conclusion. Early mortality of spontaneous rupture of HCC was dependent on preoperational liver function, tumor status, and severity of bleeding. Prolonged survival can be achieved in patients with ruptured HCC after hepatic resection as those without the complication.