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Butt et al. TAE for ruptured HCC in Pakistan

Our study had certain limitations; this is a retrospective, hepatocellular carcinoma. Br J Surg 1965;52:123-9.
single-center study and our sample size was small. 7. Lai EC, Lau WY. Spontaneous rupture of hepatocellular carcinoma: a
Moreover, none of our study patients had further loco- systematic review. Arch Surg 2006;141:191-8.
regional therapy, or chemotherapy later on that could 8. Hirai K, Kawazoe Y, Yamashita K, Kumagai M, Nagata K, Kawaguchi
S, Abe M, Tanikawa K. Transcatheter arterial embolization for
improve their life expectancy. However, considering spontaneous rupture of hepatocellular carcinoma. Am J Gastroenterol
ruptured HCC is an uncommon, life threatening 1986;81:275-9.
complication, our study could provide some information 9. Liu CL, Fan ST, Lo CM, Tso WK, Poon RT, Lam CM, Wong J.
about its manifestations and treatment options from this Management of spontaneous rupture of hepatocellular carcinoma:
part of the world. The primary aim of managing patients single-center experience. J Clin Oncol 2001;19:3725-32.
with ruptured HCC is control of bleeding which could 10. Aoki T, Kokudo N, Matsuyama Y, Izumi N, Ichida T, Kudo M, Ku
be an important factor in determining early mortality. Y, Sakamoto M, Nakashima O, Matsui O, Makuuchi M; Liver Cancer
Study Group of Japan. Prognostic impact of spontaneous tumor rupture
Considering high success rate in control of bleeding, in patients with hepatocellular carcinoma: an analysis of 1160 cases
lower mortality rates and improvement in survival as from a nationwide survey. Ann Surg 2014;259:532-42.
well as quality of life, TAE could be used as procedure 11. Tan FL, Tan YM, Chung AY, Cheow PC, Chow PK, Ooi LL. Factors
of choice to achieve hemostasis at presentation for affecting early mortality in spontaneous rupture of hepatocellular
ruptured HCC. Larger studies would be required to carcinoma. ANZ J Surg 2006;76:448-52.
support currently available evidence in favor of TAE. 12. Leung KL, Lau WY, Lai PB, Yiu RY, Meng WC, Leow CK.
Spontaneous rupture of hepatocellular carcinoma: conservative
management and selective intervention. Arch Surg 1999;134:1103-7.
In conclusion, ruptured HCC is a life threatening 13. Kim JY, Lee JS, Oh DH, Yim YH, Lee HK. Transcatheter arterial
complication requiring early diagnosis and treatment. chemoembolization confers survival benefit in patients with a
TAE is an effective and well-tolerated treatment in spontaneously ruptured hepatocellular carcinoma. Eur J Gastroenterol
the management of unresectable, ruptured HCC in Hepatol 2012;24:640-5.
patients with liver cirrhosis. 14. Yeh CN, Lee WC, Jeng LB, Chen MF, Yu MC. Spontaneous tumour
rupture and prognosis in patients with hepatocellular carcinoma. Br J
Surg 2002;89:1125-9.
Financial support and sponsorship 15. Karachi the Gatway to Pakistan. Available from: http://www.kmc.gos.
None. pk/Contents.aspx?id=14. [cited August 22, 2016]
16. Bruix J, Sherman M; American Association for the Study of Liver
Conflicts of interest Diseases. Management of hepatocellular carcinoma: an update.
There are no conflicts of interest. Hepatology 2011;53:1020-2.
17. Trevisani F, De Notariis S, Rapaccini G, Farinati F, Benvegnù L,
Patient consent Zoli M, Grazi GL, Del PP, Di N, Bernardi M; Italian Liver Cancer
Consent forms were obtained from the patients. Group. Semiannual and annual surveillance of cirrhotic patients for
hepatocellular carcinoma: effects on cancer stage and patient survival
(Italian experience). Am J Gastroenterol 2002;97:734-44.
Ethics approval 18. Vergara V, Muratore A, Bouzari H, Polastri R, Ferrero A, Galatola G,
The study was conducted by maintaining compliance Capussotti L. Spontaneous rupture of hepatocelluar carcinoma: surgical
with the Helsinki Declaration and was approved by resection and long-term survival. Eur J Surg Oncol 2000;26:770-2.
the Ethical review committee of Aga Khan University 19. Akriviadis EA. Hemoperitoneum in patients with ascites. Am J
Hospital, Karachi. Gastroenterol 1997;92:567-75.
20. Tanaka A, Takeda R, Mukaihara S, Hayakawa K, Shibata T, Itoh K,
REFERENCES Nishida N, Nakao K, Fukuda Y, Chiba T, Yamaoka Y. Treatment of
ruptured hepatocellular carcinoma. Int J Clin Oncol 2001;6:291-5.
1. Altekruse SF, McGlynn KA, Reichman M. Hepatocellular carcinoma 21. Miyamoto M, Sudo T, Kuyama T. Spontaneous rupture of hepatocellular
incidence, mortality, and survival trends in the United States from carcinoma: a review of 172 Japanese cases. Am J Gastroenterol
1975 to 2005. J Clin Oncol 2009;27:1485-91. 1991;86:67-71.
2. Parkin DM, Bray F, Ferlay J, Pisani P. Global cancer statistics, 2002. 22. Choi JH, Kim JH, Won JH, Kim YS, Goo DE, Choi DL. Spontaneous
CA Cancer J Clin 2005;55:74-108. intratumoral hemorrhage into hepatocellular carcinoma during
3. IARC. GLOBOCAN: Country Fast Stat 2008. Available from: http:// transcatheter arterial embolization: a case report. J Korean Med Sci
globocan.iarc.fr/Pages/fact_sheets_population.aspx. [cited August 22, 2004;19:895-7.
2016] 23. Choi BG, Park SH, Byun JY, Jung SE, Choi KH, Han J. The findings
4. Butt AS, Hamid S, Wadalawala AA, Ghufran M, Javed AA, Farooq O, of ruptured hepatocellular carcinoma on helical CT. Br J Radiol
Ahmed B, Haq TU, Jafri W. Hepatocellular carcinoma in Native South 2001;74:142-6.
Asian Pakistani population; trends, clinico-pathological characteristics 24. Lubner M, Menias C, Rucker C, Bhalla S, Peterson CM, Wang
& differences in viral marker negative & viral-hepatocellular L, Gratz B. Blood in the belly: CT findings of hemoperitoneum.
carcinoma. BMC Res Notes 2013;6:137 Radiographics 2007;27:109-25.
5. Abbasi A, Butt N, Bhutto AR, Gulzar K, Munir SM. Hepatocellular 25. Leung CS, Tang CN, Fung KH, Li MK. A retrospective review of
carcinoma: a clinicopathological study. J Coll Physicians Surg Pak transcatheter hepatic arterial embolisation for ruptured hepatocellular
2010;20:510-3. carcinoma. J R Coll Surg Edinb 2002;47:685-8.
6. Ong GB, Chu EP, Yu FY, Lee TC. Spontaneous rupture of 26. Shimada R, Imamura H, Makuuchi M, Soeda J, Kobayashi A, Noike

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