Page 288 - Read Online

Butt et al. Hepatoma Res 2016;2:279-86 Hepatoma Research
DOI: 10.20517/2394-5079.2016.08
www.hrjournal.net
Original Article Open Access

Is transarterial embolization a valuable

treatment option for spontaneous rupture

of hepatocellular carcinoma: experience

from a tertiary care hospital of South-Asia

Amna Subhan Butt , Saeed Hamid , Nazish Butt , Fatima Sharif , Tanveer Ul Haq , Wasim Jafri 1
1
3
1
2
1
1 Section of Gastroenterology, Department of Medicine, The Aga Khan University, Karachi 74800, Pakistan
2 The Aga Khan University, Karachi 74800, Pakistan
3 Department of Radiology, The Aga Khan University, Karachi 74800, Pakistan
Correspondence to: Dr. Amna Subhan Butt, Section of Gastroenterology, Department of Medicine, The Aga Khan University Hospital, Stadium
Road, Karachi 74800, Pakistan. E-mail: amna.subhan@aku.edu
How to cite this article: Butt AS, Hamid S, Butt N, Sharif F, Haq TU, Jafri W. Is transarterial embolization a valuable treatment option for
spontaneous rupture of hepatocellular carcinoma: experience from a tertiary care hospital of South-Asia. Hepatoma Res 2016;2:279-86.

ABSTRACT
Article history: Aim: Transarterial embolization (TAE) has been found beneficial in treatment of ruptured
Received: 04-04-2016 Hepatocellular carcinoma (HCC) in earlier studies. So far no data is available from Pakistan.
Accepted: 02-08-2016 The aim of this study was to evaluate clinicopathological characteristics, outcomes of patients
Published: 21-10-2016 presented with spontaneously ruptured, unresectable HCC treated with or without TAE and
to evaluate the factors associated with 30-day mortality. Methods: This was a cross sectional
Key words: study. Patients ≥ 18 years old, presented with spontaneous rupture of unresectable HCC,
Ruptured hepatocellular carcinoma, were evaluated. The outcome measures were control of bleeding, in-hospital mortality, 30-
transarterial embolization, day mortality and factors associated with 30-days mortality. Results: Out of 850 patients,
Pakistan 24 patients were diagnosed with spontaneously ruptured HCC. Mean age was 58.29 ± 15.26
years. A total of 11 (45.8%) patients were treated conservatively and 13 (54.2%) underwent
TAE. Control of bleeding due to ruptured HCC was significantly higher for those treated via
TAE as compared to those who were treated conservatively (92.3% vs. 36.4%, P = 0.008).
Overall median duration for which the patients remained alive after HCC rupture was longer
for TAE group (39 days vs. 5 days, P = 0.03). In-hospital mortality (30.8% vs.72.7%, P = 0.04)
and 30-day mortality was also lower in TAE group (38.5% vs. 90.9%, P = 0.01). Those who
underwent TAE had lower risk of mortality then conservative group [odds ratio (OR) 0.25,
95% confidence interval (CI) 0.07-0.90, P = 0.03). Failure to control bleeding was associated
with higher 30-day mortality (OR 2.14, 95% CI 1.24-3.68, P = 0.009). Conclusion: Ruptured
HCC is a life threatening complication requiring early diagnosis and treatment. TAE is an
effective and well-tolerated treatment in the management of ruptured HCC.

Quick Response Code:
This is an open access article distributed under the terms of the Creative Commons Attribution-
NonCommercial-ShareAlike 3.0 License, which allows others to remix, tweak, and build upon the work
non-commercially, as long as the author is credited and the new creations are licensed under the identical terms.

For reprints contact: service@oaepublish.com

© 2016 OAE Publishing Inc. www.oaepublish.com 279