Battula Narendra, Srinivasan Parthi, Madanur Mansoor, Chava Srinivas Prabhu, Priest Oliver, Rela Mohamed, Heaton Nigel
Institute of Liver Studies, King's College Hospital, Denmark Hill, London, SE5 9RS, UK.
Hepatobiliary Pancreat Dis Int. 2007 Feb;6(1):49-51.
Transcatheter arterial chemoembolization (TACE) is a recommended first line therapy for unresectable hepatocellular carcinoma (HCC). Serious complications such as neutropenic sepsis and hepatic decompensation are well known, but rupture of HCC following TACE is a rare and potentially fatal complication. The aim of this study was to identify the incidence of ruptured HCC following TACE and the associated risk factors.
A retrospective analysis was performed using our liver database with key words "chemoembolization", "ruptured HCC" covering the patients who received chemoembolization from January 1995 to December 2005. There were no exclusions.
A total of 294 patients received chemoembolization in 530 sessions during the 10-year period. Of these, 2 ruptured following treatment (incidence 0.68%). The mean age was 65 years and the interval between the treatment and rupture was 2 and 24 days. The common factors were male sex, large tumor size (range 11-13 cm), and exophytic tumor growth. One patient died 2 days after rupture with hepatic decompensation while the second is alive after a 6-month follow up without tumor recurrence.
Ruptured HCC following TACE is a rare but serious complication. Large tumor size, male sex, and exophytic growth of tumor may be predisposing factors for rupture.
经导管动脉化疗栓塞术（TACE）是不可切除肝细胞癌（HCC）推荐的一线治疗方法。严重并发症如中性粒细胞减少性脓毒症和肝失代偿广为人知，但TACE术后HCC破裂是一种罕见且可能致命的并发症。本研究的目的是确定TACE术后HCC破裂的发生率及相关危险因素。
利用我们的肝脏数据库进行回顾性分析，关键词为“化疗栓塞”、“破裂的HCC”，涵盖1995年1月至2005年12月接受化疗栓塞的患者。无排除标准。
在这10年期间，共有294例患者接受了530次化疗栓塞。其中，2例在治疗后发生破裂（发生率0.68%）。平均年龄为65岁，治疗与破裂之间的间隔为2天和24天。常见因素为男性、肿瘤体积大（范围11 - 13 cm）和肿瘤外生性生长。1例患者在破裂后2天因肝失代偿死亡，而另1例在6个月随访后存活，无肿瘤复发。
TACE术后HCC破裂是一种罕见但严重的并发症。肿瘤体积大、男性及肿瘤外生性生长可能是破裂的易感因素。
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