Management of spontaneously ruptured hepatocellular carcinomas in the radiofrequency ablation era.

<h4>Background and aim</h4>Spontaneous rupture of hepatocellular carcinoma (HCC) carries a high mortality. The use of radiofrequency ablation (RFA) in recent years has enriched the armamentarium for hemostasis of spontaneously ruptured HCCs but its results have not been documented. This...

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Autores principales:	Tan To Cheung, Ronnie T P Poon, Kenneth S H Chok, Albert C Y Chan, Simon H Y Tsang, Wing Chiu Dai, Thomas C C Yau, See Ching Chan, Sheung Tat Fan, Chung Mau Lo
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2014
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/34267574a94d4c5386e85725f46312a4
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spelling	oai:doaj.org-article:34267574a94d4c5386e85725f46312a42021-11-18T08:24:14ZManagement of spontaneously ruptured hepatocellular carcinomas in the radiofrequency ablation era.1932-620310.1371/journal.pone.0094453https://doaj.org/article/34267574a94d4c5386e85725f46312a42014-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/24718254/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background and aim</h4>Spontaneous rupture of hepatocellular carcinoma (HCC) carries a high mortality. The use of radiofrequency ablation (RFA) in recent years has enriched the armamentarium for hemostasis of spontaneously ruptured HCCs but its results have not been documented. This study investigated the prognosis and outcome of spontaneous rupture of HCC as well as the results of using RFA for hemostasis.<h4>Patients and method</h4>From January 1991 to December 2010, 5283 patients were diagnosed with HCC at our hospital, and 189 of them had spontaneous rupture of HCCs. They were grouped under two periods: period 1, 1991-2000, n = 70; period 2, 2001-2010, n = 119. RFA was available in period 2 only.<h4>Results</h4>Hepatitis B virus infection was predominant in both periods. Surgical hemostasis was mainly achieved by hepatic artery ligation in period 1 and by RFA in period 2. The 30-day hospital mortality after surgical treatment was 55.6% (n = 18) in period 1 and 19.2% (n = 26) in period 2 (p = 0.012). Multivariate analysis identified 4 independent factors for better overall survival, namely, hemostasis by transarterial embolization [corrected] (hazard ratio 0.516, 95% confidence interval 0.354-0.751), hemostasis by RFA (hazard ratio 0.431, 95% confidence interval 0.236-0.790), having surgery as a subsequent treatment (hazard ratio 0.305, 95% confidence interval 0.186-0.498), and a serum total bilirubin level <19 umol/L (hazard ratio 1.596, 95% confidence interval 1.137-2.241).<h4>Conclusion</h4>The use of RFA for hemostasis during laparotomy greatly reduced the hospital mortality rate when compared with conventional hepatic artery ligation.Tan To CheungRonnie T P PoonKenneth S H ChokAlbert C Y ChanSimon H Y TsangWing Chiu DaiThomas C C YauSee Ching ChanSheung Tat FanChung Mau LoPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 9, Iss 4, p e94453 (2014)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Tan To Cheung Ronnie T P Poon Kenneth S H Chok Albert C Y Chan Simon H Y Tsang Wing Chiu Dai Thomas C C Yau See Ching Chan Sheung Tat Fan Chung Mau Lo Management of spontaneously ruptured hepatocellular carcinomas in the radiofrequency ablation era.
description	<h4>Background and aim</h4>Spontaneous rupture of hepatocellular carcinoma (HCC) carries a high mortality. The use of radiofrequency ablation (RFA) in recent years has enriched the armamentarium for hemostasis of spontaneously ruptured HCCs but its results have not been documented. This study investigated the prognosis and outcome of spontaneous rupture of HCC as well as the results of using RFA for hemostasis.<h4>Patients and method</h4>From January 1991 to December 2010, 5283 patients were diagnosed with HCC at our hospital, and 189 of them had spontaneous rupture of HCCs. They were grouped under two periods: period 1, 1991-2000, n = 70; period 2, 2001-2010, n = 119. RFA was available in period 2 only.<h4>Results</h4>Hepatitis B virus infection was predominant in both periods. Surgical hemostasis was mainly achieved by hepatic artery ligation in period 1 and by RFA in period 2. The 30-day hospital mortality after surgical treatment was 55.6% (n = 18) in period 1 and 19.2% (n = 26) in period 2 (p = 0.012). Multivariate analysis identified 4 independent factors for better overall survival, namely, hemostasis by transarterial embolization [corrected] (hazard ratio 0.516, 95% confidence interval 0.354-0.751), hemostasis by RFA (hazard ratio 0.431, 95% confidence interval 0.236-0.790), having surgery as a subsequent treatment (hazard ratio 0.305, 95% confidence interval 0.186-0.498), and a serum total bilirubin level <19 umol/L (hazard ratio 1.596, 95% confidence interval 1.137-2.241).<h4>Conclusion</h4>The use of RFA for hemostasis during laparotomy greatly reduced the hospital mortality rate when compared with conventional hepatic artery ligation.
format	article
author	Tan To Cheung Ronnie T P Poon Kenneth S H Chok Albert C Y Chan Simon H Y Tsang Wing Chiu Dai Thomas C C Yau See Ching Chan Sheung Tat Fan Chung Mau Lo
author_facet	Tan To Cheung Ronnie T P Poon Kenneth S H Chok Albert C Y Chan Simon H Y Tsang Wing Chiu Dai Thomas C C Yau See Ching Chan Sheung Tat Fan Chung Mau Lo
author_sort	Tan To Cheung
title	Management of spontaneously ruptured hepatocellular carcinomas in the radiofrequency ablation era.
title_short	Management of spontaneously ruptured hepatocellular carcinomas in the radiofrequency ablation era.
title_full	Management of spontaneously ruptured hepatocellular carcinomas in the radiofrequency ablation era.
title_fullStr	Management of spontaneously ruptured hepatocellular carcinomas in the radiofrequency ablation era.
title_full_unstemmed	Management of spontaneously ruptured hepatocellular carcinomas in the radiofrequency ablation era.
title_sort	management of spontaneously ruptured hepatocellular carcinomas in the radiofrequency ablation era.
publisher	Public Library of Science (PLoS)
publishDate	2014
url	https://doaj.org/article/34267574a94d4c5386e85725f46312a4
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Management of spontaneously ruptured hepatocellular carcinomas in the radiofrequency ablation era.

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