Treatment of spontaneous ruptured hepatocellular carcinoma

BACKGROUND/AIMS: Spontaneous rupture with bleeding is a potentially life-th reatening complication of hepatocellular carcinoma (HCC). We review our exp erience with treatments of ruptured HCC. METHODOLOGY: Between January 1988 and December 1997, 18 patients with ruptu red HCC were admitted. The patients were divided into 4 groups according to the treatment type of ruptured HCC. Group 1 consisted of 10 patients treat ed by transarterial embolization (TAE) followed by elective hepatectomy. Gr oup 2 consisted of 2 patients treated by only TAE. Group 3 consisted of 3 p atients treated by emergency operation. Group 4 consisted of 3 patients who could not be treated by TAE or surgery. RESULTS: In Group 1, 4 of the 10 patients died; 3 from recurrent HCC and 1 from cerebral hemorrhage, and hospital mortality was absent. The 1-year sur vival rate was 87.5%. In Group 2, both patients recovered sufficiently well to be discharged. The 1-year survival rate was 50%. In Groups 3 and 4, hos pital mortality rate was 100%. CONCLUSIONS: TAE followed by elective hepatectomy was an effective treatmen t in patients with ruptured HCC.