Transarterial embolization for hemorrhage due to spontaneous rupture in hepatocellular carcinoma / 中华肿瘤杂志

ABSTRACT

<p><b>OBJECTIVE</b>To evaluate the efficacy of transarterial embolization (TAE) for intraperitoneal hemorrhage due to spontaneous rupture in hepatocellular carcinoma (HCC).</p><p><b>METHODS</b>Fourty-two patients with ruptured HCC were divided into 4 groups according to the type of their previous treatment Group A-TAE followed by elective hepatectomy 15, Group B- TAE alone 11, Group C-emergency operation 6 and group D-medical conservative management 10.</p><p><b>RESULTS</b>Celiac arteriography done before the present treatment showed extravasation of contrast material in 7 (26.9%) of the 26 patients in group A and B, and hypervascular tumor was observed in the rest. The hemostasis success rate of group A, B and C were 100%, which were much higher than that of group D (40%) (P < 0.05). The in-hospital mortality rates of group A, B and C were 0, 3.8% and 16.7% (P > 0.05), which were much lower than that of group D (80%) (P < 0.01). The 1-year survival rate of group A (76.3%) was higher than those in groups B (47.5%) and C (43.7%) (P < 0.05). There was no 1-year survivor in group D.</p><p><b>CONCLUSION</b>Transarterial embolization is safe and effective for hemorrhage due to spontaneous rupture in hepatocellular carcinoma. For resectable lesions, TAE is a preferential treatment to be given first, then followed by elective hepatectomy.</p>