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KMID : 0338420230380060818
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The Korean Journal of Internal Medicine
2023 Volume.38 No. 6 p.818 ~ p.830
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Hepatic hemangioma: proportion and predictor of surgical treatment with emphasis on its growth rate
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Shin Young-Cheol
Cho Eun-Ju
Na Hee-Young
Cho Jai-Young
Han Ho-Seong
Lee Yoon-Jin
Kim Hae-Ryoung
Jang Sang-Mi
Choi Gwang-Hyeon
Jang Eun-Sun
Kim Jin-Wook
Jeong Sook-Hyang
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Abstract
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Background/Aims : There are limited studies on the management of hepatic hemangiomas (HHs). We investigated the proportion and predictors of surgical resection and analyzed HH growth rates in addition to associated factors.
Methods : A retrospective case-control study of patients treated in 2 centers was conducted. Thirty-six patients who underwent surgical resection were assigned to the case group. Patients who did not undergo surgical treatment were randomly selected at a 1:10 ratio and assigned to the control group (n = 360). Baseline characteristics, clinical course and surgical outcomes were analyzed.
Results : The proportion of surgically treated HH patients was 0.3% (36 per 11,049). The longest diameter at diagnosis (mean ± standard deviation) was 7.7 ± 5.2 cm in the case group and 2.4 ± 1.8 cm in the control group (p < 0.001). In the multivariate analysis, the presence of more than 2 HHs (odds ratio [OR] 7.64, 95% confidence interval [CI] 1.40?41.72) and a growth rate of more than 4.8%/year (OR 30.73, 95% CI 4.86?194.51) were independently associated with surgical treatment. Symptom development during follow-up was related to HH size > 10 cm (OR 10.50, 95% CI 1.06?103.77, p = 0.04). The subgroup analysis showed substantial growth in 41.3% with an overall mean annual growth rate of 0.14 cm.
Conclusions : Approximately one in 300 patients with an HH underwent surgical treatment. Multiple HHs and a growth rate of more than 4.8%/year were indications for surgical treatment. Nearly half of the HHs showed growing pattern in our study.
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KEYWORD
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Hemangioma, Liver, Surgery, Arteriovenous malformation
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