Publication: Clinical outcome and predictive factors of variceal bleeding in patients with hepatocellular carcinoma in Thailand
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Issued Date
2018
Resource Type
File Type
application/pdf
ISSN
15137368
Other identifier(s)
2-s2.0-85057272501
Rights Holder(s)
มหาวิทยาลัยศรีนครินทรวิโรฒ
Bibliographic Citation
Asian Pacific Journal of Cancer Prevention. Vol 19, No.11 (2018), p.3301-3305
Suggested Citation
Kerdsuknirun J., Vilaichone V., Vilaichone R.-K. Clinical outcome and predictive factors of variceal bleeding in patients with hepatocellular carcinoma in Thailand. Asian Pacific Journal of Cancer Prevention. Vol 19, No.11 (2018), p.3301-3305. doi:10.31557/APJCP.2018.19.11.3301 Retrieved from: https://hdl.handle.net/20.500.14740/3930
Author(s)
Abstract
Objective: Hepatocellular carcinoma (HCC) is common cancer in ASEAN. Variceal bleeding (VB) is considered to be fatal complication of cirrhosis with HCC. However, limited studies were reported in ASEAN. Aim of this study was to evaluate overall survival rate and predictors of VB in HCC patients. Methods: We conducted a retrospective cohort study of HCC patients aged ≥ 15 years between January 2012-January 2016 and follow up through June 2016 at Thammasat University Hospital, Thailand. Clinical information and radiologic findings were collected from reviewing computer database of medical records. Results: 333 patients had completely retrievable information. Of which, 27 patients (8.1%) had documented with VB. Clinical presentations with weight loss and jaundice were higher in VB than non-VB groups (40.74% vs. 34.64%, p=0.525 and 7.41% vs. 2.29%, p=0.116) but the differences were not significant. The most common causes of cirrhosis in HCC patients with VB were chronic HBV infection (55.56%). In multivariate analysis; presence of ascites, Child-Pugh score > 6, presence of varices were independent risk factors of having VB in HCC patients (OR=7.59, 95%CI=1.13-50.88, p=0.037; OR=5.07, 95%CI=1.08-23.76, p=0.039; OR=23.51, 95%CI=4.71-117.35, p < 0.001, respectively). In HCC patients with VB, 1-year and 2.5-year survival rates were 56.6% and 28.3%. Conclusions: HCC patients with ascites, Child-Pugh score > 6 and presence of varices might be important predictive factors of VB. Having VB were greatly impact to the survival rate of HCC patients. Clinical suspicion and regular surveillance of VB in HCC patients at risk could improve treatment outcomes. © 2018 Asian Pacific Organization for Cancer Prevention.
Subject(s)
Complication
Esophagus varices
Female
Follow up
Gastrointestinal hemorrhage
Human
Liver cell carcinoma
Liver cirrhosis
Liver tumor
Male
Middle aged
Mortality
Pathology
Prognosis
Retrospective study
Survival rate
Thailand
Carcinoma, Hepatocellular
Esophageal and Gastric Varices
Female
Follow-Up Studies
Gastrointestinal Hemorrhage
Humans
Liver Cirrhosis
Liver Neoplasms
Male
Middle Aged
Prognosis
Retrospective Studies
Survival Rate
Thailand
Esophagus varices
Female
Follow up
Gastrointestinal hemorrhage
Human
Liver cell carcinoma
Liver cirrhosis
Liver tumor
Male
Middle aged
Mortality
Pathology
Prognosis
Retrospective study
Survival rate
Thailand
Carcinoma, Hepatocellular
Esophageal and Gastric Varices
Female
Follow-Up Studies
Gastrointestinal Hemorrhage
Humans
Liver Cirrhosis
Liver Neoplasms
Male
Middle Aged
Prognosis
Retrospective Studies
Survival Rate
Thailand