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Original ArticleOpen Access
Ruptured Primary Hepatocellular Carcinoma at Chulalongkorn University Hospital: A Retrospective Study of 32 Cases
Pawarode A 
,
Voravud N
,
Voravud N Rupture of Primary hepatocellular carcinoma (HCC) is relatively common in high incidence
areas including Thailand. There have been attempts to establish a standard treatment to
manage this phenomenon. We retrospectively reviewed the records of patients with HCC from
January 1989 to June 1997, and ten per cent (32/306) had tumor rupture during the course of the
disease. Overall median survival of the patients with tumor rupture was 2.7 months [95% confidence
interval (CI), 0-5.9 months] that was not significantly different from that of the patients
without rupture (median 6.6 months; 95% CI, 4.0- 9.1 months) (P = 0.4605). Among the ruptured
group, the patients treated with surgical intervention survived longer than those receiving supportive
care alone (median= 15.5 months; 95% CI, 8.7-22.2 months and median= 0.4 months; 95% CI,
0.2-0.5 months, P = 0.0027). The resectional and non-resectional surgical subgroups also had
better survival than the supportive group (P = 0.0300 and P = 0.0209, respectively). In conclusion,
surgical intervention, if applicable, should be performed in managing ruptured HCC.
areas including Thailand. There have been attempts to establish a standard treatment to
manage this phenomenon. We retrospectively reviewed the records of patients with HCC from
January 1989 to June 1997, and ten per cent (32/306) had tumor rupture during the course of the
disease. Overall median survival of the patients with tumor rupture was 2.7 months [95% confidence
interval (CI), 0-5.9 months] that was not significantly different from that of the patients
without rupture (median 6.6 months; 95% CI, 4.0- 9.1 months) (P = 0.4605). Among the ruptured
group, the patients treated with surgical intervention survived longer than those receiving supportive
care alone (median= 15.5 months; 95% CI, 8.7-22.2 months and median= 0.4 months; 95% CI,
0.2-0.5 months, P = 0.0027). The resectional and non-resectional surgical subgroups also had
better survival than the supportive group (P = 0.0300 and P = 0.0209, respectively). In conclusion,
surgical intervention, if applicable, should be performed in managing ruptured HCC.
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