Zhu Q, et al. - Researchers sought to investigate the independent predictive factors of spontaneous tumor rupture (STR) for curative resection of hepatocellular carcinoma (HCC) and to determine the impact of STR of HCC on long-term survival after resection. For patients undergoing hepatic resection after ruptured HCC, the presence of hypertension, liver cirrhosis, higher total bilirubin (TB) levels, tumor size >5 cm and ascites were the independent indicators of poorer prognosis. Tumor rupture itself seemed to have a negative impact on patient survival, however, when technically feasible, hepatic resection could be safe and appropriate in selected patients and could result in overall survival (OS) and recurrence-free survival (RFS) rates comparable to that of patients with non-ruptured HCC.

Methods

• Researchers investigated the clinicopathological parameters of 106 patients with ruptured HCC and 201 patients with non-ruptured HCC who underwent hepatic resection from 2007 to 2011.
• The groups were compared regarding clinical features and factors associated with the clinical outcomes.

Results

• Surgical resection was performed on 774 HCC patients.
• Out of them, 106 (13.7%) had tumor rupture.
• For patients with ruptured HCC, independent prognostic factors assessed with multivariate stepwise logistic regression analysis included hypertension, liver cirrhosis, total bilirubin (TB), tumor size and ascites to be.
• Significantly poorer overall survival (OS) of patients was evident in the ruptured HCC group compared with those in the non-ruptured HCC group.
• In the non-ruptured HCC group, the 1-, 3- and 5-year OS rates were 77.7%, 56.9% and 41.6%, respectively, and the corresponding values were 37.7%, 19.7%, 14.%, respectively, in the ruptured HCC group (P<0.001).
• Researchers observed similar OS rates in patients with non-ruptured and ruptured HCC; patients in the non-ruptured HCC group indicated a significantly better recurrence-free survival (RFS) rate compared with those in the ruptured group (P=0.016).