Spontaneous tumour rupture and prognosis in patients with hepatocellular carcinoma

Yeh, Chi-Ju; Lee, W. C.; Jeng, Long‐Bin; Chen, M. F.; Yu, Ming–Chin

doi:10.1046/j.1365-2168.2002.02188.x

Cited by 102 publications

(122 citation statements)

References 8 publications

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“…Our findings also suggest that interaction between VEGF and Ang2 may play a critical role in tumor angiogenesis in HCC. Hepatocellular carcinoma (HCC) is a highly vascular tumor, and this increased vascularity can lead to tumor rupture (1). Angiogenesis, formation of new microvessels, is critical for the growth and progression of various human solid tumors because it enables delivery of oxygen and nutrients (2).…”

Section: Hepatocellular Carcinoma (Hcc) Is Becoming One Of the Most Cmentioning

confidence: 99%

Overexpression of VEGF and Angiopoietin 2: A Key to High Vascularity of Hepatocellular Carcinoma?

et al. 2003

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Hepatocellular carcinoma (HCC) is becoming one of the most common malignant tumors worldwide and is characterized by a high vascularity. Angiogenesis, formation of new microvessels, is critical for the growth and progression of various human solid tumors. Vascular endothelial growth factor (VEGF) and angiopoietins (Ang1 and Ang2) are endothelial cell-specific vasculogenic and angiogenic growth factors, but their expression and roles in HCC have not been extensively explored. The aim of this study was to determine the expression and cellular localization of VEGF, Ang1, and Ang2 in specimens of resected human HCC using in situ hybridization and immunohistochemical staining and to examine their relationship to microvessel density (MVD) and tumor size. We also investigated whether mutation of p53 protein might affect the expression of the above angiogenic growth factors. VEGF and Ang2 were strongly expressed and localized predominantly to cancer cells, whereas Ang1 was detected in supportive cells of large blood vessels, stromal cells, endothelial cells, and tumor cells. Expression of the VEGF protein and the Ang2 (but not Ang1) mRNA were strongly correlated with MVD (P < .05, P ‫؍‬ .001) and tumor size (P < .05). There was also a strong correlation between VEGF protein and Ang2 mRNA expression (P < .001). However, no significant correlation was found between overexpression of p53 and the expression of VEGF, angiopoietins, or MVD. These findings suggest that overproduction of the angiogenic growth factors VEGF and Ang2 by HCC cells may increase vascularity and tumor growth in a paracrine manner. Our findings also suggest that interaction between VEGF and Ang2 may play a critical role in tumor angiogenesis in HCC.

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Section: Hepatocellular Carcinoma (Hcc) Is Becoming One Of the Most Cmentioning

confidence: 99%

Overexpression of VEGF and Angiopoietin 2: A Key to High Vascularity of Hepatocellular Carcinoma?

et al. 2003

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“…Tumors characterized by progressive growth and/or subglissonian locations are at high risk for rupture [1]. In areas like Asia or Africa, where the incidence of HCC is high, rupture is a common presenting symptom (11-26 % as compared to 2-3 % of cases diagnosed in Spain and Italy) [2][3][4].…”

Section: Hepatocellular Carcinomamentioning

confidence: 99%

Acute nontraumatic liver lesions

Caremani¹,

Tacconi²,

Lapini³

2013

J Ultrasound

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The principal conditions requiring emergency/ urgent intervention in patients with nontraumatic liver lesions are hemorrhage (with or without tumor rupture), rupture of hydatid cysts (with or without infection), complications arising from liver abscesses or congenital liver cysts, rupture related to peliosis hepatis, and in rare cases spontaneous hemorrhage. This article examines each of these conditions, its appearance on ultrasound (the first-line imaging method of choice for assessing any urgent nontraumatic liver lesion) and indications for additional imaging studies.Keywords Acute liver disorders Á Ultrasound Á Contrast-enhanced ultrasound Sommario Le principali cause di emergenza/urgenza in patologia epatica non traumatica sono l'emorragia con o senza rottura di neoplasie epatiche, la rottura con o senza infezione delle cisti idatidee, le complicanze degli ascessi epatici, delle cisti congenite del fegato, l'emorragia, la rottura in corso di peliosi epatica e la rara emorragia spontanea. Dopo aver esaminato singolarmente le varie cause di emergenza/urgenza, i rispettivi aspetti ecografici e l'integrazione con altre metodiche di imaging si conclude che nei pazienti con patologia epatica l'ecografia, con o senza mezzo di contrasto, è la metodica da utilizzare in prima istanza ad ogni emergenza/urgenza non traumatica del fegato.

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“…Liu et al [15] concluded that survival after two-stage liver resection post-HCC rupture was inferior compared to patients who did not have this complication, whereas Yeh et al [17] found that ruptured HCC had similar overall survival rates compared to non-ruptured HCC but inferior disease-free survival rates. Mizuno et al [18] noted that there was no difference in overall survival between ruptured and non-ruptured HCC.…”

Section: [16]mentioning

confidence: 99%

Outcomes of emergency and interval hepatectomy for ruptured resectable hepatocellular carcinoma: a single tertiary referral centre experience

Fung¹,

Chong²,

Lee³

et al. 2017

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How to cite this article: Fung AKY, Chong CCN, Lee KF, Wong J, Cheung YS, Fong AKW, Lai PBS. Outcomes of emergency and interval hepatectomy for ruptured resectable hepatocellular carcinoma: a single tertiary referral centre experience. Hepatoma Res 2017;3:196-204. Aim: The short and long term outcomes of patients who underwent emergency and interval hepatectomy for ruptured and resectable hepatocellular carcinoma (HCC) were analysed. Methods: The data of patients with ruptured HCC presenting between April 2004 and October 2015 were analysed. Emergency hepatectomy was defined as hepatectomy within 48 h of the clinico-radiological diagnosis of HCC rupture. Results: Thirty patients underwent hepatectomy for ruptured HCC. Nine (30%) patients underwent emergency hepatectomy. The median age was 56 and 54 years (P = 0.13) with a similar gender distribution. The mean HCC size (10.5 vs. 8.3 cm, P = 0.17), total blood loss (3,000 vs. 850 mL, P = 0.002) and total units of red blood cell transfusion (1.9 vs. 0.5 units, P = 0.27) were greater in the emergency hepatectomy group. The complication rate was 44% and 38% (P = 0.53), with median length of hospital stay of 10 and 12 days (P = 0.07) in the emergency and interval hepatectomy groups, respectively, and no 30-day mortality in both groups. The median overall survival was 29 and 15.7 months (P = 0.25), with survival rates of 78%, 45%, 0% and 85%, 43% and 5% at 1, 3 and 5 years in the emergency and interval hepatectomy groups, respectively. Conclusion: Hepatectomy should be considered for ruptured HCC provided the patient could tolerate curative resection. Key words:Hepatocellular carcinoma, rupture, hepatectomy ABSTRACTArticle history:

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Spontaneous tumour rupture and prognosis in patients with hepatocellular carcinoma

Abstract: The presence of sudden-onset abdominal pain is the only independent indicator of ruptured HCC. Hepatic resection, when feasible, is the treatment of choice and can result in an overall survival rate comparable to that of patients with non-ruptured HCC.

Cited by 102 publications

References 8 publications

Overexpression of VEGF and Angiopoietin 2: A Key to High Vascularity of Hepatocellular Carcinoma?

Overexpression of VEGF and Angiopoietin 2: A Key to High Vascularity of Hepatocellular Carcinoma?

Acute nontraumatic liver lesions

Outcomes of emergency and interval hepatectomy for ruptured resectable hepatocellular carcinoma: a single tertiary referral centre experience

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