Pre‐operative predictors of early recurrence/mortality including the role of inflammatory indices in patients undergoing partial hepatectomy for spontaneously ruptured hepatocellular carcinoma

Background and Objectives Spontaneous rupture of Hepatocellular Carcinoma (srHCC) is a life‐threatening emergency. We sought to identify the pre‐operative predictors of early tumor recurrence/mortality including the role of inflammatory indices after partial hepatectomy for srHCC. Methods Between 2000‐2015, 79 patients with srHCC were identified to have undergone upfront partial hepatectomy following srHCC. Clinicopathologic data were retrospectively analyzed to identify pre‐operative predictors of early ( 10 cm were identified to be independent predictors of early recurrence while an alpha fetoprotein (AFP) > 200 ng/mL was an independent predictor of early mortality. Neutrophil‐to‐lymphocyte ratio > 3 and prognostic nutritional index 180 was a predictor of early mortality on univariate analyses but not multivariate analyses. Conclusions Tumor size > 10 cm, free tumor rupture, and an AFP > 200 ng/mL were useful predictors in avoiding “futile surgery” in patients with srHCC undergoing a partial hepatectomy. Preoperative inflammatory markers appear to be less useful as predictors of early recurrence/mortality in this cohort of patients.