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Abstract：
UNASSIGNED: Spontaneous rupture of hepatocellular carcinoma (HCC) is a potentially fatal complication and the third leading cause of death in patients with HCC after tumor progression and liver failure. Previous studies suggested that improved HCC surveillance has decreased the incidence of rupture. This study aims to characterize patients with ruptured HCC over time and identify predictors of rupture.
UNASSIGNED: We retrospectively reviewed a prospectively collected database of 1451 HCC patients to identify cases with rupture and predictors of rupture. Data were divided into three 9-year eras to compare and trend patient/tumor characteristics and rupture.
UNASSIGNED: Fifty-seven patients (3.9%) presented with spontaneous HCC rupture and the following characteristics: mean age 62.6 years, 73.7% males, 41% cirrhosis, and mean tumor size of 8.0 cm. On multivariate analyses, predictors of rupture included obesity, tumor >5 cm, and single tumors, whereas the presence of cirrhosis was a negative predictor for rupture.Across three eras, there were changes in disease etiology and decreases in tumor size, and more HCCs were found with surveillance. However, more patients were noncirrhotic, and the incidence of spontaneous rupture was unchanged over time.
UNASSIGNED: Despite improved early detection of HCC over time, the incidence of rupture has been unchanged. The persistent incidence of rupture may possibly be attributed to increasing proportion of fatty liver-related HCC patients who lack traditional risk factors for surveillance and may not have cirrhosis. Better identification of fatty liver disease and determining which patients need HCC surveillance may be needed in the future to prevent spontaneous rupture.
UNASSIGNED: We retrospectively reviewed a prospectively collected database of 1451 HCC patients to identify cases with rupture and predictors of rupture. Data were divided into three 9-year eras to compare and trend patient/tumor characteristics and rupture.
UNASSIGNED: Fifty-seven patients (3.9%) presented with spontaneous HCC rupture and the following characteristics: mean age 62.6 years, 73.7% males, 41% cirrhosis, and mean tumor size of 8.0 cm. On multivariate analyses, predictors of rupture included obesity, tumor >5 cm, and single tumors, whereas the presence of cirrhosis was a negative predictor for rupture.Across three eras, there were changes in disease etiology and decreases in tumor size, and more HCCs were found with surveillance. However, more patients were noncirrhotic, and the incidence of spontaneous rupture was unchanged over time.
UNASSIGNED: Despite improved early detection of HCC over time, the incidence of rupture has been unchanged. The persistent incidence of rupture may possibly be attributed to increasing proportion of fatty liver-related HCC patients who lack traditional risk factors for surveillance and may not have cirrhosis. Better identification of fatty liver disease and determining which patients need HCC surveillance may be needed in the future to prevent spontaneous rupture.
摘要：
未经证实：肝细胞癌（HCC）自发性破裂是一种潜在的致命并发症，也是HCC患者在肿瘤进展和肝衰竭后的第三大死亡原因。先前的研究表明，改善HCC监测降低了破裂的发生率。本研究旨在表征肝癌破裂患者随时间的变化，并确定破裂的预测因素。
UNASSIGNED：我们回顾性回顾了一个前瞻性收集的1451例HCC患者的数据库，以确定破裂病例和破裂预测因素。数据分为三个9年的时期，以比较和趋势患者/肿瘤特征和破裂。
UNASSIGNED：57例患者（3.9%）表现为自发性肝癌破裂，具有以下特征：平均年龄62.6岁，73.7%男性,41%肝硬化，平均肿瘤大小8.0cm。在多变量分析中，破裂的预测因素包括肥胖，肿瘤>5厘米，和单个肿瘤，而肝硬化的存在是破裂的阴性预测因子。跨越三个时代，有改变的病因和肿瘤大小的减少，和更多的HCC被发现与监测。然而,更多的患者是非肝硬化，自发破裂的发生率随着时间的推移没有变化。
UNASSIGNED：尽管随着时间的推移，肝癌的早期检测有所改善，破裂的发生率没有变化。破裂的持续发生率可能归因于脂肪肝相关HCC患者的比例增加，这些患者缺乏传统的监测危险因素，并且可能没有肝硬化。未来可能需要更好地识别脂肪肝疾病并确定哪些患者需要HCC监测，以防止自发性破裂。
UNASSIGNED：我们回顾性回顾了一个前瞻性收集的1451例HCC患者的数据库，以确定破裂病例和破裂预测因素。
UNASSIGNED：57例患者（3.9%）表现为自发性肝癌破裂，具有以下特征：平均年龄62.6岁，
UNASSIGNED：尽管随着时间的推移，肝癌的早期检测有所改善，
