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Timely staged hepatectomy following transarterial embolization versus emergency hepatectomy for spontaneous hepatocellular carcinoma rupture

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Názov: Timely staged hepatectomy following transarterial embolization versus emergency hepatectomy for spontaneous hepatocellular carcinoma rupture
Autori: Shuai Liu, Xiangyao Kong, Yuanchuan Gong, Zetao Wu, Luoluo Wang, Yi Ruan, Xinhua Zhou
Zdroj: Surgery Open Science, Vol 27, Iss , Pp 159-165 (2025)
Informácie o vydavateľovi: Elsevier, 2025.
Rok vydania: 2025
Zbierka: LCC:Surgery
Predmety: Staged hepatectomy, Emergency hepatectomy, Transarterial embolization, Spontaneous rupture of hepatocellular carcinoma, Propensity score matching, Overall survival, Surgery, RD1-811
Popis: Objective: To evaluate the efficacy and safety of timely staged hepatectomy (SH) following transarterial embolization (TAE) versus emergency hepatectomy (EH) for spontaneous rupture of hepatocellular carcinoma (SR-HCC). Methods: Between January 2018 and December 2023, 109 patients with SR-HCC were admitted to our center receive SH (34 cases) or EH (75 cases). Performing 1:1 optimal matching propensity score matching (PSM) analysis, resulting in 34 patients in SH group and 34 patients in EH group. We compared perioperative data, peritoneal metastasis rates, recurrence rates, complication rates, and long-term survival outcome between the two matched groups. Results: After PSM, baseline characteristics were well balanced between the SH and EH groups (standardized mean difference [SMD] 0.05). The SH group exhibited a trend toward improved recurrence-free survival (RFS) (Log-rank χ2 = 3.2, P = 0.074), although this did not reach statistical significance. Similarly, overall survival (OS) was comparable between the groups (Log-rank χ2 = 1.78, P = 0.183). Conclusion: Compared with EH, SH demonstrates superior perioperative safety, characterized by less surgical trauma and lower in-hospital mortality, without increasing postoperative complications and the risk of peritoneal metastasis. Therefore, SH may be considered the preferred treatment for SR-HCC, especially in cases of hemodynamic instability or impaired hepatic functional reserve.
Druh dokumentu: article
Popis súboru: electronic resource
Jazyk: English
ISSN: 2589-8450
Relation: http://www.sciencedirect.com/science/article/pii/S2589845025000764; https://doaj.org/toc/2589-8450
DOI: 10.1016/j.sopen.2025.09.001
Prístupová URL adresa: https://doaj.org/article/b9fda6a42a03432dacefbfb38630cdfe
Prístupové číslo: edsdoj.b9fda6a42a03432dacefbfb38630cdfe
Databáza: Directory of Open Access Journals
Popis
Abstrakt:Objective: To evaluate the efficacy and safety of timely staged hepatectomy (SH) following transarterial embolization (TAE) versus emergency hepatectomy (EH) for spontaneous rupture of hepatocellular carcinoma (SR-HCC). Methods: Between January 2018 and December 2023, 109 patients with SR-HCC were admitted to our center receive SH (34 cases) or EH (75 cases). Performing 1:1 optimal matching propensity score matching (PSM) analysis, resulting in 34 patients in SH group and 34 patients in EH group. We compared perioperative data, peritoneal metastasis rates, recurrence rates, complication rates, and long-term survival outcome between the two matched groups. Results: After PSM, baseline characteristics were well balanced between the SH and EH groups (standardized mean difference [SMD] 0.05). The SH group exhibited a trend toward improved recurrence-free survival (RFS) (Log-rank χ2 = 3.2, P = 0.074), although this did not reach statistical significance. Similarly, overall survival (OS) was comparable between the groups (Log-rank χ2 = 1.78, P = 0.183). Conclusion: Compared with EH, SH demonstrates superior perioperative safety, characterized by less surgical trauma and lower in-hospital mortality, without increasing postoperative complications and the risk of peritoneal metastasis. Therefore, SH may be considered the preferred treatment for SR-HCC, especially in cases of hemodynamic instability or impaired hepatic functional reserve.
ISSN:25898450
DOI:10.1016/j.sopen.2025.09.001