Abstract 200P
Background
Spontaneous tumor rupture is a distinctive disease pattern in patients with hepatocellular carcinoma (HCC). The application of hyperthermic intraperitoneal chemotherapy (HIPEC) in spontaneously ruptured hepatocellular carcinoma (srHCC) is debatable. Our study aimed to explore the role of postoperative HIPEC in patients with srHCC after hepatectomy.
Methods
196 patients with srHCC treated in our hospital between 2018 and 2023 were retrospectively enrolled. Depending on the treatment approach, the patients were divided into the control group (resection) and the HIPEC group (hyperthermic intraperitoneal perfusion chemotherapy combined with resection). The patients were followed up by outpatient or through telephone until April 1, 2024. SPSS 27.0 software was applied for data analysis. Progression free survival time, overall survival time, and other major risk factors were analyzed using the logistic or Cox regression model. Variables with P <0.1 in the univariate analysis were included in the multivariate analysis.
Results
There were 86 cases in the control group and 110 cases in the HIPEC group. There were no significant differences in the clinical and pathological conditions of the patient. Multivariate analysis revealed R-HIPEC was associated with lower risk of overall survival (OR=0.625, 95% CI 0.404–0.968, P=0.035). AFP >400 ng/mL was associated with high risk of overall survival (OR=2.321, 95% CI 1.498–3.596, P=0.035). The median progression free survival time of HIPEC was 15.5 months, which was longer than 7.7 months in the control group (P < 0.05). The median overall survival time of HIPEC was 45.6 months，which was longer than 26.4 months in the control group (P < 0.05). For patients with AFP < 400 ng/mL, R-HIPEC can increase the median survival time from 38.8 months to 51.4 months (P < 0.05). For patients with AFP ≥ 400 ng/mL, R-HIPEC can increase the median survival time from 18.4 months to 21.9 months (P < 0.05). The 3-year survival rates of the two groups were 59.8% vs. 43.5%, and the 5-year survival rates were 38.3% vs. 33.5%, respectively (P < 0.05).
Conclusions
HIPEC combined with resection for srHCC can effectively prolong survival time.
Legal entity responsible for the study
The authors.
Funding
Has not received any funding.
Disclosure
All authors have declared no conflicts of interest.