Abstract: Objective The purpose of this study was to compare the two-year survivals in primary liver cancer (PLC) patients with spontaneous tumor rupture underwent hepatectomy at early or late operation time windows. Methods A total of 74 PLC patients with spontaneous tumor rupture were admitted to our hospital between January 2014 and January 2019, and all received hepatectomy, greater omentum resection and abdominal heat perfusion. 31 patients (early surgery) received theoperation within two weeks, and 43 patients (late surgery) received the operation two weeks after onset of the disease. All patients were followed-up for two years. Results Within two year follow-up period, the incidence of greater omentum invasion in patients receiving early operation was 3.2%, much lower than 20.9%(P＜0.05) in patients receiving late operation, while there were no significant differences as respect to the incidences of intrahepatic tumor recurrence, pulmonary metastasis and intraperitoneal metastasis (P＞0.05) between the two groups; post-operationally, there were no significant differences as respect to the incidences of complications, such as bleeding, ascites, liver failure and peritoneal infections(25.8% vs. 32.6%,P＞0.05); during two-year follow-up period, 5 patients died and 26 patients (83.9%) survived in patients receiving early operation, and 8 patients died and 35 patients (81.4%,P＞0.05) survived in patients receiving late surgery; the median disease-free survival in patients receiving early operation was 17(10, 23) months, significantly longer than 11(4,14) months(Z=3.865, P＜0.05) in patients receiving late operation; the overall survival in patients receiving early operation was 22(16, 24) months, not significantly different as compared to 20(14, 24) months in patients receiving late operation (P＞0.05). Conclusion The hepatectomy could rescue the PLC patients’ life when tumor rupture occurs, so the clinicians should actively prepare for the operation no mater early or late times.

Key words: Hepatoma, Spontaneous tumor rupture, Greater omentum resection, Abdominal heat perfusion therapy, Operation time window, Therapy