Early Hemostatic Treatment Could Improve 30‐Day Survival After Spontaneous Rupture of Hepatocellular Carcinoma

作者：Apolline Commin, Chloé Metivier, Manon Allaire, Jean Lubrano, Amandine Claudinot, Audrey Coilly, Marc‐Antoine Allard, Charles Roux, Olivier Scatton, Jean‐Charles Nault, Olivier Sutter, Nathalie Ganne‐Carrié, Thuy Vi Ngo, Valérie Le Goff, Zeineb Ben Ali, Husni Tedlaouti, Josephine Papin, Marion Habireche, Louise Lebedel, Claire Pérignon, Thông Dao, Rémy Morello, Isabelle Ollivier‐Hourmand · 发表于：Liver International · 年份：2025 · DOI：10.1111/liv.70332 · 被引用次数：3 · 研究领域：Hepatocellular Carcinoma Treatment and Prognosis、Cancer Research and Treatments、Abdominal Trauma and Injuries

INTRODUCTION: Spontaneous rupture of hepatocellular carcinoma (SRHCC) presents a critical clinical challenge, with early haemostasis often difficult to achieve and limited data available on subsequent treatment strategies. This study aims to evaluate whether the initial hemostatic approach influences early prognosis and facilitates further treatment of HCC. METHODS: This retroprospective multicentric cohort included patients with SRHCC since 2008. Cox and Kaplan-Meier models analysed factors associated with overall survival (OS). RESULTS: 112 patients with SRHCC were included. Hemostatic treatment was administered in 54.4% of cases (83.6% embolization, 9.8% surgery and 6.6% embolization plus surgery). The 30-day mortality rate was 28.6%. Factors associated with 30-day mortality included ALBI score > 2 (HR = 4.23; p = 0.001), shock (HR = 2.37; p = 0.029), acute kidney injury (HR = 4.40; p = 0.003), and BCLC stage C/D (HR = 14.29; p = 0.010). Early hemostatic intervention was associated with improved 30-day survival (HR = 0.42; p = 0.033). Palliative care was initiated in 27% of patients (10% after embolization and 17% upon admission). One-third of patients received subsequent HCC treatment after a median of 84 days [IQR: 39-176] (55.3% surgery and 18.4% systemic therapy). Among these, 63% (n = 24) had undergone early hemostatic treatment. The one-year OS rate was 39.3%, the median follow-up duration was 136 days (95% CI: 20.3-739.5), and the median OS was 6.6 ± 4.1 months (95%...