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Original Article
Outcomes of Surgical Resection for Ruptured Hepatocellular Carcinoma
Hae Won Lee, Chang-Sup Lim, Hyo-Sin Kim
J Liver Cancer. 2017;17(1):54-59.   Published online March 31, 2017
DOI: https://doi.org/10.17998/jlc.17.1.54
  • 2,458 Views
  • 33 Downloads
  • 1 Citation
AbstractAbstract PDF
Background/Aims
Many recent studies have shown excellent outcomes of surgical resection for ruptured hepatocellular carcinoma (HCC). In addition, there are several reports suggesting that a ruptured HCC did not increase the risk for peritoneal dissemination of a tumor after surgical resection. However, the impact of HCC rupture on recurrence and patient survival has not yet been clarified.
Methods
The medical data of patients who underwent surgical resection for ruptured HCC in our center between January 2011 and December 2015 were retrospectively reviewed. The outcomes of the patients were investigated.
Results
Among 128 patients who underwent surgical resection for HCC, 5 patients (3.9%) had a ruptured HCC. All patients underwent elective operation in a stable condition. Transarterial chemoembolization (TACE) was performed for achieving hemostasis in four patients except one who achieved spontaneous hemostasis. Two patients had tumor recurrence and one patient died due to HCC recurrence during the median follow-up duration of 28.3 months (range, 24.3–62.3 months). One patient who developed late intrahepatic recurrence at 40.0 months after resection was managed well by means of radiofrequency ablation and TACE and is now alive for 5 years without any evidence of viable tumor. However, the other patient who showed early peritoneal seeding at 1.9 months after resection finally died despite aggressive treatments.
Conclusions
Rupture of HCC might result in peritoneal seeding of the tumor in the early postoperative stage, which could lead to a poor result. Nonetheless, surgical resection may be the best treatment option yielding good survival, even for a ruptured HCC.

Citations

Citations to this article as recorded by  
  • Ruptured Massive Hepatocellular Carcinoma Cured by Transarterial Chemoembolization
    Ji Eun Lee, Joong-Won Park, In Joon Lee, Bo Hyun Kim, Seoung Hoon Kim, Hyun Beom Kim
    Journal of Liver Cancer.2020; 20(2): 154.     CrossRef
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Case Report
A Case of Rapidly Recurred Hepatocellular Carcinoma with Distant Metastasis after Surgical Resection
Mi Yeon Kim, Hye Won Lee, Kyu Sik Jung, Beom Kyung Kim, Seung Up Kim, Jun Yong Park, Sang Hoon Ahn, Kwang-Hyub Han, Do Young Kim
J Liver Cancer. 2015;15(2):136-139.   Published online September 30, 2015
DOI: https://doi.org/10.17998/jlc.15.2.139
  • 1,163 Views
  • 10 Downloads
AbstractAbstract PDF
Hepatocellular carcinoma (HCC) is one of the cancers with poor prognosis. However, surgical resection is the treatment of choice as curative aim for early HCC with preserved liver function. A 5 year survival rate after curative resection is over 50%. We experienced a case of rapidly recurred HCC with bone metastasis after surgical resection. In our case, microscopically microvessel invasion was present after resection. Microvascular invasion (MVI) is an important factor to influence survival and/or HCC recurrence. So we suggested the patients with MVI need to follow up intensively and adjuvant therapy may be considered.
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Review Article
2009 Treatment Guideline for Hepatocellular Carcinoma: Surgical Resection and Liver Transplantation
Sung Hoon Kim, Kyung Sik Kim
Journal of the Korean Liver Cancer Study Group. 2010;10(1):6-10.   Published online June 30, 2010
  • 626 Views
  • 4 Downloads
AbstractAbstract PDF
The effort we are trying to set up the treatment guideline for hepatocellular carcinoma has produced various guidelines after drawing a conclusion from Barcelona EASL meeting in 2000. Especially in Korea, the Korean Liver Cancer Study Group and the National Cancer Center have collaborated on making treatment guideline for hepatocellular carcinoma in the early stage of setting up the guideline, 2003, and it was a great help to treatment, study and education. However, a need of revision had been raised due to many changes in the latest treatments and an accumulation of international and domestic experience. After the proposal of amending the treatment guideline for Hepatocellular carcinoma in the Cancer Control Forum of the National Cancer Control Planning Board on October 17th, 2008, “2009 Guideline” has been reported in the Conference of the Korean Liver Cancer Study Group held on June 27th, 2009. When revising the guideline, there are some suggestions of continuous modification to reflect evidence based medical knowledge, and recently there are some debates about the drawback of the surgical field which was not handled in EASL and AASLD Guidelines. Therefore, it will broaden your understanding of liver surgical resection and liver transplantation and it will also be a place for the discussion of disputable issues.
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