Abstract
Abstract
Aim
To investigate predictors affecting survival in patients with spontaneously ruptured hepatocellular carcinoma (srHCC).
Methods
One-hundred-and-twenty-seven patients experiencing srHCC between January 2010 and December 2020 were enrolled. The clinical features, treatments, and outcomes were reviewed. Statistics included univariate analysis, Kaplan–Meier analysis, multivariate analysis using Cox proportional hazards model and logistic regression model, and receiver operating characteristic (ROC) curve analysis.
Results
Of the 127 srHCC patients, 24, 42, and 61 patients received conservative treatment, surgical treatment, and transarterial chemoembolization/embolization (TACE/TAE) treatment at HCC rupture, respectively. The largest tumor size [hazard ratio (HR) 1.127; p < 0.001], Barcelona-Clinic Liver Cancer (BCLC) stage (HR 2.184, p = 0.023), international normalized ratio (INR; HR 3.895; p = 0.012), total bilirubin level (TBil; HR 1.014; p = 0.014), TACE after rupture (compared with conservative treatment) (HR 0.549; p = 0.029), TACE/TAE and surgery at rupture, and albumin level (HR 0.949; p = 0.017) were independent predictors affecting overall survival. A survival predictive model for HCC rupture (SPHR) using these predictors was created. ROC analysis showed that the area under the curve (AUC) of the SPHR model for 30 day survival was 0.925, and the AUCs of the model for end-stage liver disease (MELD) score and Child–Pugh score for 30 day survival were 0.767 and 0.757, respectively.
Conclusion
The largest tumor size, advanced BCLC stage, higher INR and TBil, lower albumin, and conservative treatment were negative independent predictors for overall survival. The SPHR model may be more suitable than the MELD score and Child–Pugh score for predicting 30 day survival in srHCC.
Funder
National Natural Science Foundation of China
Publisher
Springer Science and Business Media LLC
Reference25 articles.
1. Chen W, Zheng R, Baade PD, et al. Cancer statistics in China 2015. CA. 2016;66(2):115–132
2. Chung W, Jo C, Chung WJ, et al. Liver cirrhosis and cancer: comparison of mortality. Hepatol Int. 2018;12(3):269–276
3. Hsueh K-C, Fan H-L, Chen T-W, et al. Management of spontaneously ruptured hepatocellular carcinoma and hemoperitoneum manifested as acute abdomen in the emergency room. World J Surg. 2012;36(11):2670–2676
4. Yoshida H, Mamada Y, Taniai N, et al. Spontaneous ruptured hepatocellular carcinoma. Hepatol Res. 2016;46(1):13–21
5. Al-Mashat FM, Sibiany AM, Kashgari RH, et al. Spontaneous rupture of hepatocellular carcinoma. Saudi Med J. 2002;23(7):866–870
Cited by
4 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献