DELAYED HEPATIC RESECTION FOR RUPTURED HEPATOCELLULAR-CARCINOMA

Background. Although transcatheter arterial embolization is advocated as initial therapy for ruptured hepatocellular carcinoma (HCC) hepatic resection is necessary for cure. The effectiveness of delayed hepatic resection for ruptured HCC was determined. Methods. The records of 10 patients who underwent delayed hepatic resection for ruptured HCC wer e reviewed. Results. All patients were men, and the mean age was 63 ye ars. For hemostasis, transcatheter arterial embolization was performed in three patients, whereas in the other patients bleeding stopped wit hout special procedures. Mean interval from rupture to hepatic resecti on was 74 days. Liver function test results before hepatic resection w ere almost normal. Trisegmentectomy in one and bisegmentectomy in four patients were performed, whereas minor hepatic resection was performe d for four extrahepatic HCCs. There were no operative or hospital deat hs. Four patients had cirrhosis. The mean tumor diameter was 7.5 cm. O f seven patients with recurrence, two with dissemination had tumors th at ruptured on the inferior aspect of the liver The 1- and 3-year surv ival rates were 77% and 48%, respectively. Conclusions. Because delaye d hepatic resection for ruptured HCC was safe and compared similarly w ith that for other patients who underwent resection for HCC, it should be used. However when, HCC ruptures in an inferior location, recurren ce of tumor as dissemination is likely.