Risk factor analysis of perioperative mortality after ruptured bleeding in hepatocellular carcinoma

• Published in: World journal of gastroenterology : WJG Vol. 20; no. 40; pp. 14921 - 14926
• Main Authors: Lin, Hao-Ming, Lei, Li-Ming, Zhu, Jie, Li, Guo-Lin, Min, Jun
• Format: Journal Article
• Language: English
• Published: United States Baishideng Publishing Group Inc 28.10.2014
• Subjects: Adult; Aged; Blood Transfusion - mortality; carcinoma; Carcinoma, Hepatocellular - complications; Carcinoma, Hepatocellular - mortality; Carcinoma, Hepatocellular - pathology; Carcinoma, Hepatocellular - surgery; Chi-Square Distribution; China - epidemiology; Embolization, Therapeutic - mortality; Emergencies; Female; Hemorrhage - etiology; Hemorrhage - mortality; Hemorrhage - surgery; Hepatectomy - mortality; Hepatocellular; Humans; Kaplan-Meier Estimate; Liver; Liver Neoplasms - complications; Liver Neoplasms - mortality; Liver Neoplasms - pathology; Liver Neoplasms - surgery; Logistic Models; Male; Middle Aged; Multivariate Analysis; Retrospective Studies; Retrospective Study; Risk Assessment; Risk Factors; rupture; Rupture, Spontaneous; Shock - etiology; Shock - mortality; Spontaneous; Time Factors; Treatment Outcome; Tumor Burden; China; Hepatocellular carcinoma; Liver resection; Spontaneous rupture
• ISSN: 1007-9327; 2219-2840
• DOI: 10.3748/wjg.v20.i40.14921

AIM:To discuss strategies and prognosis for the emergency treatment of ruptured bleeding in primary hepatocellular carcinoma.METHODS:The retrospective analysis was performed by examining the emergency treatment experiences of60 cases of ruptured bleeding in primary hepatocellular carcinoma.The treatment methods included surgical tumour resection,transcatheter arterial embolization(TAE)and non-surgical treatment.Univariate and multivariate analyses were performed to identify the risk factors that impacted 30-d mortality in the research groups.RESULTS:The 30-d mortality of all patients was 28.3%(n=17).The univariate analysis showed that ChildPugh C level liver function,shock,massive blood transfusion and large tumour volume were risk factors thatinfluenced 30-d mortality.The multivariate analysis showed that shock and massive blood transfusion were independent risk factors that impacted the 30-d mortality of surgical resection.As for the TAE patients,larger tumour volume was a risk factor towards prognosis.CONCLUSION:Radical resection and TAE therapy would achieve better results in carefully selected ruptured hepatocellular tumours.