Variceal bleeding is aggravated by portal venous invasion of hepatocellular carcinoma: a matched nested case-control study
DC Field | Value | Language |
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dc.contributor.author | Lim, Jihye | - |
dc.contributor.author | Kim, Ha Il | - |
dc.contributor.author | Kim, Eunju | - |
dc.contributor.author | Kim, Jiyoon | - |
dc.contributor.author | An, Jihyun | - |
dc.contributor.author | Chang, Seheon | - |
dc.contributor.author | Kim, Seon-Ok | - |
dc.contributor.author | Lee, Han Chu | - |
dc.contributor.author | Lee, Yung Sang | - |
dc.contributor.author | Shim, Ju Hyun | - |
dc.date.accessioned | 2021-08-02T08:27:53Z | - |
dc.date.available | 2021-08-02T08:27:53Z | - |
dc.date.created | 2021-05-11 | - |
dc.date.issued | 2021-01 | - |
dc.identifier.issn | 1471-2407 | - |
dc.identifier.uri | https://scholarworks.bwise.kr/hanyang/handle/2021.sw.hanyang/8102 | - |
dc.description.abstract | Background We hypothesized that portal vein tumor thrombosis (PVTT) in hepatocellular carcinoma (HCC) increases portal pressure and causes esophageal varices and variceal bleedings. We examined the incidence of high-risk varices and variceal bleeding and determined the indications for variceal screening and prophylaxis. Methods This study included 1709 asymptomatic patients without any prior history of variceal hemorrhage or endoscopic prophylaxis who underwent upper endoscopy within 30 days before or after initial anti-HCC treatment. Of these patients, 206 had PVTT, and after 1:2 individual matching, 161 of them were matched with 309 patients without PVTT. High-risk varices were defined as large/medium varices or small varices with red-color signs and variceal bleeding. Bleeding rates from the varices were compared between matched pairs. Risk factors for variceal bleeding in the entire set of patients with PVTT were also explored. Results In the matched-pair analysis, the proportion of high-risk varices at screening (23.0% vs. 13.3%; P = 0.003) and the cumulative rate of variceal bleeding (4.5% vs. 0.4% at 1 year; P = 0.009) were significantly greater in the PVTT group. Prolonged prothrombin time, lower platelet count, presence of extrahepatic metastasis, and Vp4 PVTT were independent risk factors related to high-risk varices in the total set of 206 patients with PVTT (Adjusted odds ratios [95% CIs], 1.662 [1.151-2.401]; 0.985 [0.978-0.993]; 4.240 [1.783-10.084]; and 3.345 [1.457-7.680], respectively; Ps < 0.05). During a median follow-up of 43.2 months, 10 patients with PVTT experienced variceal bleeding episodes, 9 of whom (90%) had high-risk varices. Presence of high-risk varices and sorafenib use for HCC treatment were significant predictors of variceal bleeding in the complete set of patients with PVTT (Adjusted hazard ratios [95% CIs], 26.432 [3.230-216.289]; and 5.676 [1.273-25.300], respectively; Ps < 0.05). Conclusions PVTT in HCC appears to increase the likelihood of high-risk varices and variceal bleeding. In HCC patients with PVTT, endoscopic prevention could be considered, at least in high-risk variceal carriers taking sorafenib. | - |
dc.language | 영어 | - |
dc.language.iso | en | - |
dc.publisher | BMC | - |
dc.title | Variceal bleeding is aggravated by portal venous invasion of hepatocellular carcinoma: a matched nested case-control study | - |
dc.type | Article | - |
dc.contributor.affiliatedAuthor | An, Jihyun | - |
dc.identifier.doi | 10.1186/s12885-020-07708-1 | - |
dc.identifier.scopusid | 2-s2.0-85098688240 | - |
dc.identifier.wosid | 000608023000026 | - |
dc.identifier.bibliographicCitation | BMC CANCER, v.21, no.1, pp.1 - 10 | - |
dc.relation.isPartOf | BMC CANCER | - |
dc.citation.title | BMC CANCER | - |
dc.citation.volume | 21 | - |
dc.citation.number | 1 | - |
dc.citation.startPage | 1 | - |
dc.citation.endPage | 10 | - |
dc.type.rims | ART | - |
dc.type.docType | Article | - |
dc.description.journalClass | 1 | - |
dc.description.isOpenAccess | Y | - |
dc.description.journalRegisteredClass | scie | - |
dc.description.journalRegisteredClass | scopus | - |
dc.relation.journalResearchArea | Oncology | - |
dc.relation.journalWebOfScienceCategory | Oncology | - |
dc.subject.keywordPlus | sorafenib | - |
dc.subject.keywordPlus | adult | - |
dc.subject.keywordPlus | Article | - |
dc.subject.keywordPlus | asymptomatic disease | - |
dc.subject.keywordPlus | case control study | - |
dc.subject.keywordPlus | clinical effectiveness | - |
dc.subject.keywordPlus | clinical feature | - |
dc.subject.keywordPlus | controlled study | - |
dc.subject.keywordPlus | digestive tract endoscopy | - |
dc.subject.keywordPlus | drug effect | - |
dc.subject.keywordPlus | drug efficacy | - |
dc.subject.keywordPlus | drug response | - |
dc.subject.keywordPlus | female | - |
dc.subject.keywordPlus | follow up | - |
dc.subject.keywordPlus | hepatic portal vein | - |
dc.subject.keywordPlus | high risk patient | - |
dc.subject.keywordPlus | human | - |
dc.subject.keywordPlus | incidence | - |
dc.subject.keywordPlus | liver cell carcinoma | - |
dc.subject.keywordPlus | liver metastasis | - |
dc.subject.keywordPlus | major clinical study | - |
dc.subject.keywordPlus | male | - |
dc.subject.keywordPlus | middle aged | - |
dc.subject.keywordPlus | platelet count | - |
dc.subject.keywordPlus | portal vein tumor thrombosis | - |
dc.subject.keywordPlus | prothrombin time | - |
dc.subject.keywordPlus | risk factor | - |
dc.subject.keywordPlus | treatment outcome | - |
dc.subject.keywordPlus | tumor invasion | - |
dc.subject.keywordPlus | tumor thrombus | - |
dc.subject.keywordPlus | variceal bleeding | - |
dc.subject.keywordPlus | vein disease | - |
dc.subject.keywordPlus | complication | - |
dc.subject.keywordPlus | esophagus varices | - |
dc.subject.keywordPlus | gastrointestinal hemorrhage | - |
dc.subject.keywordPlus | hepatic portal vein | - |
dc.subject.keywordPlus | liver cell carcinoma | - |
dc.subject.keywordPlus | liver tumor | - |
dc.subject.keywordPlus | pathology | - |
dc.subject.keywordPlus | prognosis | - |
dc.subject.keywordPlus | survival rate | - |
dc.subject.keywordPlus | tumor invasion | - |
dc.subject.keywordAuthor | Hepatocellular carcinoma | - |
dc.subject.keywordAuthor | Portal vein thrombosis | - |
dc.subject.keywordAuthor | Esophageal varices | - |
dc.subject.keywordAuthor | Variceal bleeding | - |
dc.subject.keywordAuthor | Risk factor | - |
dc.identifier.url | https://bmccancer.biomedcentral.com/articles/10.1186/s12885-020-07708-1 | - |
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