Volume 2, Issue 1, June 2018, Page: 18-23
Ruptured Hepatocellular Carcinoma-Experience in a Tertiary Centre in Western Australia
Sarah Ng, Department of Gastroenterology & Hepatology, Royal Perth Hospital, Perth, Australia
Justin Chin, Department of Gastroenterology & Hepatology, Royal Perth Hospital, Perth, Australia
Sudhakar Rao, Department of General Surgery, Royal Perth Hospital, Perth, Australia
Nick Kontorinis, Department of Gastroenterology & Hepatology, Royal Perth Hospital, Perth, Australia
James Anderson, Department of Radiology, Royal Perth Hospital, Perth, Australia
Suresh Navadgi, Department of General Surgery, Royal Perth Hospital, Perth, Australia
Jee Kong, Department of Gastroenterology & Hepatology, Royal Perth Hospital, Perth, Australia
Adam Doyle, Department of Gastroenterology & Hepatology, Royal Perth Hospital, Perth, Australia
Wendy Cheng, Department of Gastroenterology & Hepatology, Royal Perth Hospital, Perth, Australia; School of Medicine and Health Services, Edith Cowan University, Perth, Australia; Department of Medicine, University of Western Australia, Perth, Australia
Received: Sep. 15, 2018;       Accepted: Oct. 8, 2018;       Published: Nov. 7, 2018
DOI: 10.11648/j.ijg.20180201.14      View  65      Downloads  2
Abstract
Hepatocellular carcinoma (HCC) is a leading cause of cancer-related deaths worldwide. Spontaneous tumour rupture (STR) is uncommon, with incidence rates around 10-15% in Asia, but below 3% in Western countries. Nonetheless, serious complications lead to high mortality rates. To our knowledge, experience of HCC rupture has not been published in Australia. We identified 9 retrospective cases of ruptured HCC from 2008 to 2017 through patient case notes, electronic laboratory system, and imaging reports. Our case series presents 8 male and 1 female patient with a mean age of 56 years, and a median 11 month follow-up period. Sixty-six percent of patients were non-cirrhotic, and 33% cirrhotic, with a median post- tumour rupture survival rate of 10 months and 12 months, respectively. Seventy-eight percent of patients presented with abdominal pain and a mean tumour size of 8cm at time of rupture. Initial management involved: trans-arterial chemoembolisation (TACE)/ trans-arterial embolisation (TAE) in 4 patients, emergency hepatic resection in 3 patients, sorafenib in 1 patient and conservative/ supportive treatment in 1 patient. Reasons for our low HCC rupture incidence at 0.3% could be due to: none of our patients experiencing rebleeding (one of the common causes of mortality); strict surveillance programmes in Australia identifying early tumours; and majority of our patients being younger and non-cirrhotic with a better underlying liver reserve at time of rupture, and therefore improved outcomes.
Keywords
Ruptured Hepatocellular Carcinoma, Trans-Arterial Chemoembolisation, Trans-Arterial Embolisation
To cite this article
Sarah Ng, Justin Chin, Sudhakar Rao, Nick Kontorinis, James Anderson, Suresh Navadgi, Jee Kong, Adam Doyle, Wendy Cheng, Ruptured Hepatocellular Carcinoma-Experience in a Tertiary Centre in Western Australia, International Journal of Gastroenterology. Vol. 2, No. 1, 2018, pp. 18-23. doi: 10.11648/j.ijg.20180201.14
Copyright
Copyright © 2018 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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