Prognostic Factors For Survival After Curative Resection Of Spontaneous Rupture With Hemorrhage Of Primary Hepatic Carcinoma

Objective:To investigate the clinical characteristic and the prognostic factors by curative operation for Spontaneous rupture with hemorrhage of primary hepatic carcinoma (SRHC). Methods:The clinical data and followed up results of 26 patients with SRHC treated by curative operation in the first affiliated hospital of Xi Jiang Medical University from January 2000 to December 2010, followed up to January 2011, were retrospectively analyzed.The prognostic factors affecting survival were studied by univariate and multivariate analysis.Results:26 patients with SRHC had all underwent acute surgical treatment.9 patients underwent TAE after curative operation.2 cases died in one month because of liver failure after operation and the early death rate was 7.69%.The survival rate of 1-year,3-year,5-year were respectively 80.0%,34.0%,13.0%.26 cases were followed up to January 2010 and mean survival time was 22.63±18.73 months, univariate analysis showed that Child-pugh class,degree of accomanying cirrhosis,tumor size, operation time,blood transfusion,postoperative transcatheter hepatic arterial chemoembolization (TACE) were significant prognostic factors. The use of Coxs multivariate proportional hazard model indicated that significant prognostic factors by curative operation for SRHC were degree of accomanying cirrhosis, blood transfusion and postoperative TACE for cumulative survival rates. Conclusion:Curative operation is the best choice for treatment SRHC. The factors affecting prognosis were degree of accomanying cirrhosis, blood transfusion and postoperative TACE which can be concluded to three aspects about hepatopathy background,tumor factors and treatment factors. Preoperative precise appraisal, avoiding blood transfusion and postoperation TACE are effective measures to improve prosnosis in curative operation for SRHC.