지원사업
학술연구/단체지원/교육 등 연구자 활동을 지속하도록 DBpia가 지원하고 있어요.
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연구자들이 자신의 연구와 전문성을 널리 알리고, 새로운 협력의 기회를 만들 수 있는 네트워킹 공간이에요.
논문 기본 정보
- 자료유형
- 학술저널
- 저자정보
- 저널정보
- 대한외과학회 Annals of Surgical Treatment and Research Annals of Surgical Treatment and Research Vol.96 No.6
- 발행연도
- 2019.6
- 수록면
- 275 - 282 (8page)
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Purpose: The aim of this study was to identify the prognostic factors and compare the long-term outcomes of staged hepatectomy and transarterial chemoembolization (TACE) for patients with spontaneous rupture of hepatocellular carcinoma (HCC).
Methods: This study is a multicenter, retrospective analysis of patients with newly diagnosed ruptured HCC. To compare overall survival between staged hepatectomy group and TACE alone group, we performed propensity score-matching to adjust for significant differences in patient characteristics. To identify prognostic factors, the clinical characteristics at the time of diagnosis of tumor rupture were investigated using Cox-regression analysis.
Results: From 2000 to 2014, 172 consecutive patients with newly diagnosed ruptured HCC were treated in 6 Korean centers. One hundred seventeen patients with Child-Pugh class A disease were identified; of which 112 were initially treated with transcatheter arterial embolization (TAE) for hemostasis and five underwent emergency surgery for bleeder ligation. Of the 112 patients treated with TAE, 44 underwent staged hepatectomy, 61 received TACE alone, and 7 received conservative treatment after TAE. Those that underwent staged hepatectomy had significantly higher overall survival than those that underwent TACE alone before matching (P ＜ 0.001) and after propensity score-matching (P = 0.006). Multivariate analysis showed that type of treatment, presence of portal vein thrombosis, pretreatment transfusion ＞1,200 mL, and tumor size ＞5 ㎝ were associated with poor overall survival.
Conclusion: Staged hepatectomy may offer better long-term survival than TACE alone for spontaneous rupture of HCC. Staged hepatectomy should be considered in spontaneous rupture of HCC with resectable tumor and preserved liver function.
Methods: This study is a multicenter, retrospective analysis of patients with newly diagnosed ruptured HCC. To compare overall survival between staged hepatectomy group and TACE alone group, we performed propensity score-matching to adjust for significant differences in patient characteristics. To identify prognostic factors, the clinical characteristics at the time of diagnosis of tumor rupture were investigated using Cox-regression analysis.
Results: From 2000 to 2014, 172 consecutive patients with newly diagnosed ruptured HCC were treated in 6 Korean centers. One hundred seventeen patients with Child-Pugh class A disease were identified; of which 112 were initially treated with transcatheter arterial embolization (TAE) for hemostasis and five underwent emergency surgery for bleeder ligation. Of the 112 patients treated with TAE, 44 underwent staged hepatectomy, 61 received TACE alone, and 7 received conservative treatment after TAE. Those that underwent staged hepatectomy had significantly higher overall survival than those that underwent TACE alone before matching (P ＜ 0.001) and after propensity score-matching (P = 0.006). Multivariate analysis showed that type of treatment, presence of portal vein thrombosis, pretreatment transfusion ＞1,200 mL, and tumor size ＞5 ㎝ were associated with poor overall survival.
Conclusion: Staged hepatectomy may offer better long-term survival than TACE alone for spontaneous rupture of HCC. Staged hepatectomy should be considered in spontaneous rupture of HCC with resectable tumor and preserved liver function.
목차
INTRODUCTION
METHODS
RESULTS
DISCUSSION
REFERENCES
참고문헌 (23)
참고문헌 신청
Lai EC / 2006 / Spontaneous rupture of hepatocellular carcinoma : a systematic review / Arch Surg 141:191~198
Aoki T / 2014 / Prognostic impact of spontaneous tumor rupture in patients with hepatocellular carcinoma : an analysis of 1160 cases from a nationwide survey / Ann Surg 259:532~542
Chan AC / 2016 / Prognostic influence of spontaneous tumor rupture on hepatocellular carcinoma after interval hepatectomy / Surgery 159:409~417
Liu CL / 2001 / Management of spontaneous rupture of hepatocellular carcinoma : single-center experience / J Clin Oncol 19:3725~3732
Amin MB / 2017 / AJCC cancer staging manual / Springer
Aoki T / 2014 / Prognostic impact of spontaneous tumor rupture in patients with hepatocellular carcinoma : an analysis of 1160 cases from a nationwide survey / Ann Surg 259:532~542
Chan AC / 2016 / Prognostic influence of spontaneous tumor rupture on hepatocellular carcinoma after interval hepatectomy / Surgery 159:409~417
Liu CL / 2001 / Management of spontaneous rupture of hepatocellular carcinoma : single-center experience / J Clin Oncol 19:3725~3732
Amin MB / 2017 / AJCC cancer staging manual / Springer
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