SynthesisWorld journal of surgical oncology2022
Emergency versus delayed hepatectomy following transarterial embolization in spontaneously ruptured hepatocellular carcinoma survivors: a systematic review and meta-analysis.
Synthesis in World journal of surgical oncology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.
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Who cites it
8 citing papers in PubMed, 11 citations in OpenAlex.
- Case Report: Rare spontaneous hepatic rupture hemorrhage complicated by autoimmune liver disease.Frontiers in medicine · 2026Article
- Resection combined with hyperthermic intraperitoneal chemotherapy in the treatment of spontaneously ruptured hepatocellular carcinoma: a multicenter retrospective study.Therapeutic advances in medical oncology · 2026Article
- Early Hemostatic Treatment Could Improve 30-Day Survival After Spontaneous Rupture of Hepatocellular Carcinoma.Liver international : official journal of the International Association for the Study of the Liver · 2025Observational
- Timely staged hepatectomy following transarterial embolization versus emergency hepatectomy for spontaneous hepatocellular carcinoma rupture.Surgery open science · 2025Article
- Machine learning models for predicting postoperative peritoneal metastasis after hepatocellular carcinoma rupture: a multicenter cohort study in China.The oncologist · 2025Article
- Spontaneous Rupture of Hepatocellular Carcinoma: Pathogenesis, Clinical Management, Prognostic Factors, and Future Directions.Journal of hepatocellular carcinoma · 2025Review
- The prophylactic role of mitomycin C-based hyperthermic intraperitoneal chemotherapy (MMC-based HIPEC) on peritoneal metastasis of spontaneously ruptured hepatocellular carcinoma (srHCC): A pilot study.Global health & medicine · 2023Article
- Selective Arterial Embolization of Ruptured Hepatocellular Carcinoma with N-Butyl Cyanoacrylate and Lipiodol: Safety, Efficacy, and Short-Term Outcomes.Journal of personalized medicine · 2023Article
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Authors and funding
3 authors at 1 institution in 1 country.
Funding
Abstract
backgroundSpontaneous rupture is a life-threatening complication of hepatocellular carcinoma (HCC). Recent trends in surgical treatments avoid emergency hepatectomy (EH) and favor emergency transarterial embolization (TAE) followed by delayed hepatectomy (DH). Still, there is debate on which is the better treatment option and whether delaying hepatectomy increases peritoneal metastasis.
aimTo provide evidence-based references for the optimal management of patients with spontaneously ruptured HCC by comparing the outcomes of EH and DH.
methodsLiterature on postoperative outcomes of EH and DH in patients with spontaneously ruptured HCC published between the date of the database establishment and May 2022, was identified in the PubMed, EMBASE, and Cochrane Library databases. Revman 5.3 software was used for statistical analyses.
resultsNine publications were identified, including a total of 681 patients. Of those, 304 underwent EH, and 377 underwent TAE followed by DH. The meta-analysis results indicated that the in-hospital mortality rate in the EH patient group was significantly higher than that in the DH patient group (relative risk (RR) = 2.17, 95% confidence interval (CI) 1.03-4.57, p =0.04). There was no significant differences in the rates of postoperative complications (RR = 1.21, 95% CI 0.77-1.90, p = 0.40), postoperative hospital stay (WMD = - 0.64, 95% CI - 5.61-4.34, p = 0.80), recurrence (RR = 1.09, 95% CI 0.94-1.25, p = 0.27), peritoneal metastasis (RR = 1.06, 95% CI 0.66-1.71, p = 0.80), 1-year survival (RR = 0.91, 95% CI 0.80-1.02, p = 0.11), or 3-year survival (RR = 0.81, 95% CI 0.61-1.09, p = 0.17) in survivors between the two patient groups.
conclusionThe postoperative outcomes of the spontaneously ruptured HCC survivors who received EH were similar to those who received emergency TAE followed by DH. However, the in-hospital mortality rate was higher in EH patients. Based on the findings, DH with TAE first strategy might be considered over EH as the first line treatment modality. However, these findings await further validation by future high-quality studies.
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