AI Article Synopsis
- Researchers aimed to identify factors that predict early recurrence and mortality in patients with spontaneous rupture of Hepatocellular Carcinoma (srHCC) following surgery.
- In a study of 79 patients who had partial hepatectomy from 2000-2015, the one-year mortality rate was 30.3% and recurrence rate was 41.8%.
- Key predictors for poor outcomes included tumor size greater than 10 cm, free tumor rupture, and high alpha-fetoprotein levels, while inflammatory markers were found to be less reliable indicators.
Article Abstract
Background And Objectives: Spontaneous rupture of Hepatocellular Carcinoma (srHCC) is a life-threatening emergency. We sought to identify the pre-operative predictors of early tumor recurrence/mortality including the role of inflammatory indices after partial hepatectomy for srHCC.
Methods: Between 2000-2015, 79 patients with srHCC were identified to have undergone upfront partial hepatectomy following srHCC. Clinicopathologic data were retrospectively analyzed to identify pre-operative predictors of early (<1 year) recurrence and mortality.
Results: Seventy-nine patients were identified to have undergone partial hepatectomy for srHCC. The 1-year mortality and 1-year recurrence rate in our series was 30.3% and 41.8% respectively. On multivariate analyses, free tumor rupture and a tumor size > 10 cm were identified to be independent predictors of early recurrence while an alpha fetoprotein (AFP) > 200 ng/mL was an independent predictor of early mortality. Neutrophil-to-lymphocyte ratio > 3 and prognostic nutritional index < 40 were predictors of early recurrence while PLR > 180 was a predictor of early mortality on univariate analyses but not multivariate analyses.
Conclusions: Tumor size > 10 cm, free tumor rupture, and an AFP > 200 ng/mL were useful predictors in avoiding "futile surgery" in patients with srHCC undergoing a partial hepatectomy. Preoperative inflammatory markers appear to be less useful as predictors of early recurrence/mortality in this cohort of patients.
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| http://dx.doi.org/10.1002/jso.25281 | DOI Listing |
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