Prognostic Analysis Of Early And Delayed Hepatectomy For Spontaneous Rupture Hepatocellular Carcinoma

Objective:To analyze the effects of early surgery and delayed surgery on postoperative prognosis,postoperative recurrence and abdominal metastasis in patients with spontaneous rupture hepatocellular carcinoma,in order to provide a certain reference for the surgical timing of patients with spontaneous rupture hepatocellular carcinoma.Methods:To summarize the clinical data of 52 patients with spontaneous rupture of HCC who underwent surgery in our hospital from January 2012 to December 2017.According to the interval between paroxysm after spontaneous rupture HCC and operation,patients who underwent surgery within 1 week(?7 days)were included in the early operation group,and 1 week after admission(>7 days)were included in the delayed surgery group.Then the factors affecting postoperative prognosis,postoperative recurrence and abdominal cavity metastasis were compared between the two groups.Results: The operation time,intraoperative blood loss,Postoperative complications and the total hospitalization time were no significant difference between the early operation and the delayed operation group(P>0.05).There was no significant difference in postoperative recurrence and abdominal metastasis between the two groups(P>0.05).The disease-free survival time and overall survival time of the early operation group were significantly higher than that of the delayed operation group.The difference was statistically significant(P<0.01);COX risk proportional regression model analysis showed that the timing of surgery(HR=0.393,P=0.018),HBV-DNA positive(HR=2.376,P=0.038)and the maximum diameter of the tumor(HR=1.014,P=0.001)were independent risk factor for the prognosis of patients with spontaneous hepatic rupture(P<0.05).Conclusions:For patients with spontaneous hepatic rupture of primary liver cancer,the survival prognosis of patients with early surgical treatment is better than that of patients with delayed surgery;The timing of surgery,HBV-DNA positive and maximum diameter of tumor are independent risk factors for spontaneous rupture hepatocellular carcinoma.