Spontaneously ruptured hepatocellular carcinoma on non-cirrhotic liver: A prospective case series.

Autor:	Romero-Gutiérrez M; Complejo Hospitalario Universitario de Toledo, Toledo, Spain. Electronic address: m.romero.gutierrez@gmail.com., Pascual S; Hospital General Universitario Dr. Balmis, Alicante, Spain., Márquez L; Hospital General Universitario Gregorio Marañón, Madrid, Spain., Gómez-Rubio M; Hospital Universitario de Getafe, Madrid, Spain., Miquel M; Hospital Parc Taulí de Sabadell, Barcelona, Spain., Alarcón C; Hospital General de Villalba, Madrid, Spain., Ferrer T; Hospital Universitario Virgen del Rocío, Sevilla, Spain., Aracil C; Hospital Universitario Arnau de Vilanova, Lleida, Spain., Horta D; Hospital Universitario Mútua de Terrassa, Barcelona, Spain., Latorre R; Hospital Universitario Son Llàtzer, Palma de Mallorca, Spain., González Santiago J; Hospital Universitario de Salamanca, Salamanca, Spain., Bernal V; Hospital Universitario Miguel Servet, Zaragoza, Spain., Fernández C; Hospital Universitario de Burgos, Burgos, Spain., Piqueras B; Hospital Universitario de Fuenlabrada, Madrid, Spain., Gutiérrez ML; Hospital Universitario Fundación de Alcorcón, Madrid, Spain., Martín A; Hospital Universitario Doce de Octubre, Madrid, Spain., Morillas J; Hospital Virgen de la Luz, Cuenca, Spain., Morales D; Hospital Universitario de Canarias, Canarias, Spain., Blanco S; Hospital Universitario de Basurto, Bilbao, Spain., Rendón P; Hospital Universitario Puerta del Mar, Cádiz, Spain., Chico I; Hospital Universitario Infanta Elena, Madrid, Spain., Testillano M; Hospital Universitario de Cruces, Vizcaya, Spain., Delgado C; Complejo Hospitalario Universitario de Toledo, Toledo, Spain., Matilla A; Hospital General Universitario Gregorio Marañón, Madrid, Spain., Gómez Rodríguez R; Complejo Hospitalario Universitario de Toledo, Toledo, Spain.
Jazyk:	English; Spanish; Castilian
Zdroj:	Gastroenterologia y hepatologia [Gastroenterol Hepatol] 2024 Aug-Sep; Vol. 47 (7), pp. 683-690. Date of Electronic Publication: 2023 Aug 24.
DOI:	10.1016/j.gastrohep.2023.08.008
Abstrakt:	Background and Aims: Spontaneous ruptured hepatocellular carcinoma is an uncommon complication, and there are scarce data about non-cirrhotic patients. Tumor treatment is not standardized and the risk of peritoneal dissemination is unclear. Aim: we analyzed the treatment and survival in patients with rHCC on non-cirrhotic liver. Methods: One hundred and forty-one non-cirrhotic patients with hepatocellular carcinoma diagnosed by histology were included in a multicenter prospective registry (2018-2022). Seven of them (5%) presented with hemoperitoneum due to spontaneous rupture. Results: Liver disease was associated in three patients (42.9%). A single nodule was detected in three cases (42.9%). One patient had vascular invasion and none extrahepatic spread. Initial hemostatic therapy and sequential treatment was individualized. Patients with single nodule were treated: resection (one case) with recurrence at 4 months treated with TACE and sorafenib. TACE/TAE followed by surgery (two cases) one in remission 43 months later, the other had liver recurrence at 18 months and was transplanted. Patients with multiple lesions were treated: TAE/emergency surgery and subsequent systemic therapy (two cases), one received lenvatinib (1-year survival) and the other sorafenib (5-month survival). TAE and surgery with subsequent systemic therapy (one case). Initial hemostatic surgery, dying on admission (one case). No patient developed intraperitoneal metastasis. All patients with multiple lesions died by tumor. The 3-year survival rate was 42.9%. Conclusions: Initial hemostasis was achieved in all patients by TAE/TACE or surgery. Subsequent treatment was individualized, based on tumor characteristics, regardless of rupture. Long-time remission could be achieved in single nodule patients. (Copyright © 2023 Elsevier España, S.L.U. All rights reserved.)
Databáze:	MEDLINE
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