Spontaneous rupture of hepatocellular carcinoma

A review of 141 taiwanese cases and comparison with nonrupture cases

Chiung-Yu Chen, Xi-Zhang Lin, Jeng Shiann Shin, Ching Yih Lin, Tay Chen Leow, Chi Yi Chen, Ting-Tsung Chang

Research output: Contribution to journalArticle

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Abstract

We reviewed the records and statistics of 560 patients hospitalized with hepatocellular carcinoma (HCC) over a 5-year period. One hundred and forty-one patients (26%) had spontaneous rupture of their HCCs. Different characteristics of the rupture (R) and nonrupture (NR) groups were compared; there were statistically significant differences (p < 0.05) in the size of the tumor (R, 9.83 ± 4.36 cm, and NR, 7.67 ± 4.01 cm; p < 0.001), the presence of the “hump sign” (R, 87.8%, and NR, 45.7%; p < 0.0001), and the minimal thickness of peritumor liver parenchyma (R, 0.03 ± 0.20 cm, and NR, 0.30 ± 0.70 cm; p < 0.001). The percentage of left-lobe tumors was significantly higher in the rupture group than in the nonrupture group (p < 0.05). In addition, the Child-Pugh’s score and serum transaminase levels were higher, and the prothrombin times more prolonged, in the rupture group. Factors that were not statistically significant included sex, age, etiology of cirrhosis, platelet count, portal vein thrombosis, and the presence of a varix. Multivariate logistic regression analysis indicated that the tumor size, the presence of a hump sign, and the Pugh’s score correlated the best with HCC rupture (p < 0.05). Ninety-four patients from the rupture group died during hospitalization. The mortality rate was 66.7%. We conclude that (a) spontaneous rupture of HCC is a likely sequel of progressive expansion of tumor that finally protrudes outside the liver surface and hemorrhages, (b) leftlobe tumor presents a higher risk of rupture, and (c) portal hypertension does not play a major role in the pathogenesis of tumor rupture.

Original languageEnglish
Pages (from-to)238-242
Number of pages5
JournalJournal of clinical gastroenterology
Volume21
Issue number3
DOIs
Publication statusPublished - 1995 Jan 1

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Spontaneous Rupture
Rupture
Hepatocellular Carcinoma
Neoplasms
Liver
Prothrombin Time
Varicose Veins
Portal Hypertension
Portal Vein
Transaminases
Platelet Count
Hospitalization
Thrombosis
Fibrosis
Logistic Models
Regression Analysis
Hemorrhage
Mortality
Serum

All Science Journal Classification (ASJC) codes

  • Gastroenterology

Cite this

@article{4204f657b3924fff9de6203d1fab81b1,
title = "Spontaneous rupture of hepatocellular carcinoma: A review of 141 taiwanese cases and comparison with nonrupture cases",
abstract = "We reviewed the records and statistics of 560 patients hospitalized with hepatocellular carcinoma (HCC) over a 5-year period. One hundred and forty-one patients (26{\%}) had spontaneous rupture of their HCCs. Different characteristics of the rupture (R) and nonrupture (NR) groups were compared; there were statistically significant differences (p < 0.05) in the size of the tumor (R, 9.83 ± 4.36 cm, and NR, 7.67 ± 4.01 cm; p < 0.001), the presence of the “hump sign” (R, 87.8{\%}, and NR, 45.7{\%}; p < 0.0001), and the minimal thickness of peritumor liver parenchyma (R, 0.03 ± 0.20 cm, and NR, 0.30 ± 0.70 cm; p < 0.001). The percentage of left-lobe tumors was significantly higher in the rupture group than in the nonrupture group (p < 0.05). In addition, the Child-Pugh’s score and serum transaminase levels were higher, and the prothrombin times more prolonged, in the rupture group. Factors that were not statistically significant included sex, age, etiology of cirrhosis, platelet count, portal vein thrombosis, and the presence of a varix. Multivariate logistic regression analysis indicated that the tumor size, the presence of a hump sign, and the Pugh’s score correlated the best with HCC rupture (p < 0.05). Ninety-four patients from the rupture group died during hospitalization. The mortality rate was 66.7{\%}. We conclude that (a) spontaneous rupture of HCC is a likely sequel of progressive expansion of tumor that finally protrudes outside the liver surface and hemorrhages, (b) leftlobe tumor presents a higher risk of rupture, and (c) portal hypertension does not play a major role in the pathogenesis of tumor rupture.",
author = "Chiung-Yu Chen and Xi-Zhang Lin and Shin, {Jeng Shiann} and Lin, {Ching Yih} and Leow, {Tay Chen} and Chen, {Chi Yi} and Ting-Tsung Chang",
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Spontaneous rupture of hepatocellular carcinoma : A review of 141 taiwanese cases and comparison with nonrupture cases. / Chen, Chiung-Yu; Lin, Xi-Zhang; Shin, Jeng Shiann; Lin, Ching Yih; Leow, Tay Chen; Chen, Chi Yi; Chang, Ting-Tsung.

In: Journal of clinical gastroenterology, Vol. 21, No. 3, 01.01.1995, p. 238-242.

Research output: Contribution to journalArticle

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T2 - A review of 141 taiwanese cases and comparison with nonrupture cases

AU - Chen, Chiung-Yu

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AU - Chang, Ting-Tsung

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N2 - We reviewed the records and statistics of 560 patients hospitalized with hepatocellular carcinoma (HCC) over a 5-year period. One hundred and forty-one patients (26%) had spontaneous rupture of their HCCs. Different characteristics of the rupture (R) and nonrupture (NR) groups were compared; there were statistically significant differences (p < 0.05) in the size of the tumor (R, 9.83 ± 4.36 cm, and NR, 7.67 ± 4.01 cm; p < 0.001), the presence of the “hump sign” (R, 87.8%, and NR, 45.7%; p < 0.0001), and the minimal thickness of peritumor liver parenchyma (R, 0.03 ± 0.20 cm, and NR, 0.30 ± 0.70 cm; p < 0.001). The percentage of left-lobe tumors was significantly higher in the rupture group than in the nonrupture group (p < 0.05). In addition, the Child-Pugh’s score and serum transaminase levels were higher, and the prothrombin times more prolonged, in the rupture group. Factors that were not statistically significant included sex, age, etiology of cirrhosis, platelet count, portal vein thrombosis, and the presence of a varix. Multivariate logistic regression analysis indicated that the tumor size, the presence of a hump sign, and the Pugh’s score correlated the best with HCC rupture (p < 0.05). Ninety-four patients from the rupture group died during hospitalization. The mortality rate was 66.7%. We conclude that (a) spontaneous rupture of HCC is a likely sequel of progressive expansion of tumor that finally protrudes outside the liver surface and hemorrhages, (b) leftlobe tumor presents a higher risk of rupture, and (c) portal hypertension does not play a major role in the pathogenesis of tumor rupture.

AB - We reviewed the records and statistics of 560 patients hospitalized with hepatocellular carcinoma (HCC) over a 5-year period. One hundred and forty-one patients (26%) had spontaneous rupture of their HCCs. Different characteristics of the rupture (R) and nonrupture (NR) groups were compared; there were statistically significant differences (p < 0.05) in the size of the tumor (R, 9.83 ± 4.36 cm, and NR, 7.67 ± 4.01 cm; p < 0.001), the presence of the “hump sign” (R, 87.8%, and NR, 45.7%; p < 0.0001), and the minimal thickness of peritumor liver parenchyma (R, 0.03 ± 0.20 cm, and NR, 0.30 ± 0.70 cm; p < 0.001). The percentage of left-lobe tumors was significantly higher in the rupture group than in the nonrupture group (p < 0.05). In addition, the Child-Pugh’s score and serum transaminase levels were higher, and the prothrombin times more prolonged, in the rupture group. Factors that were not statistically significant included sex, age, etiology of cirrhosis, platelet count, portal vein thrombosis, and the presence of a varix. Multivariate logistic regression analysis indicated that the tumor size, the presence of a hump sign, and the Pugh’s score correlated the best with HCC rupture (p < 0.05). Ninety-four patients from the rupture group died during hospitalization. The mortality rate was 66.7%. We conclude that (a) spontaneous rupture of HCC is a likely sequel of progressive expansion of tumor that finally protrudes outside the liver surface and hemorrhages, (b) leftlobe tumor presents a higher risk of rupture, and (c) portal hypertension does not play a major role in the pathogenesis of tumor rupture.

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