HCC complicated by PVT: Outcome and the role of anticoagulation therapy
| Autor: | Ahmed Kayal, Rebecca Carvalho, Alan Weiss, Vladimir Marquez, T Malek Mahmoudi |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
0301 basic medicine
medicine.medical_specialty genetic structures business.industry Retrospective cohort study General Medicine medicine.disease behavioral disciplines and activities digestive system diseases Surgery Portal vein thrombosis 03 medical and health sciences 030104 developmental biology 0302 clinical medicine Hepatocellular carcinoma mental disorders medicine 030211 gastroenterology & hepatology business Original Research |
| Zdroj: | Can Liver J |
| ISSN: | 2561-4444 |
| Popis: | BACKGROUND: This retrospective study investigated the clinical impact of PVT on the course of patients with HCC who were and were not treated with anticoagulation (AC). METHODS: We retrospectively evaluated a cohort of 60 patients diagnosed with HCC and PVT. Nine patients were excluded for lack of follow-up. HCC, PVT diagnosis, and imaging follow-up were performed using contrast-enhanced computed tomography or MRI. Of the 51 patients evaluated, 12 received AC and 39 did not. RESULTS: Forty-two patients were male; mean age was 60.3 years. Mean survival after HCC diagnosis was 32.9 months; after PVT diagnosis, it was 18.4 months. No symptoms directly related to PVT development were reported. AC therapy was initiated for 12 patients and had to be discontinued for 3 patients because of complications. AC was not associated with a difference in PVT progression (49% in non-AC group vs. 50% in AC group). After adjusting for age, HCC type (single vs. multifocal), and Child–Pugh score, AC was associated with an improved survival after HCC diagnosis (adjusted hazard ratio [HR] = 0.37; 95% confidence interval [CI] 0.14 to 0.99) and after PVT diagnosis (HR = 0.34; 95% CI 0.13 to 0.88). CONCLUSION: Patients with HCC complicated by PVT in both AC and non-AC groups had a similar rate of progression. Neither group had symptoms attributable to PVT. Possible AC-related complications need to be considered before proceeding with therapy in patients with HCC and PVT. AC may be associated with a survival advantage in patients with HCC and PVT. |
| Databáze: | OpenAIRE |
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