• J Chin Med Assoc · Jun 2022

    Comparison of prognoses between cirrhotic and non-cirrhotic patients with hepatocellular carcinoma and esophageal varices undergo surgical resection.

    • Yu-Jen Chen, Chien-Wei Su, Cheng-Yi Wei, Gar-Yang Chau, Ping-Hsien Chen, Yee Chao, Yi-Hsiang Huang, Jaw-Ching Wu, Tsung-Chieh Yang, Pei-Chang Lee, and Ming-Chih Hou.
    • Division of Gastroenterology and Hepatology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan, ROC.
    • J Chin Med Assoc. 2022 Jun 1; 85 (6): 679-686.

    BackgroundEsophageal varices (EV) is common and is a poor prognostic factor for patients with hepatocellular carcinoma (HCC). However, the outcomes between cirrhotic and noncirrhotic HCC patients with EV is not well studied. The present study aimed to investigate the clinical manifestations and prognoses of HCC patients after surgical resection stratified by the cirrhosis status.MethodsA total of 111 patients with HCC and EV, who underwent surgical resection, were retrospectively enrolled between July 2003 and July 2019. The diagnosis of liver cirrhosis was established using the Ishak fibrosis score F5 or F6 in the nontumor part of liver specimens. Prognostic factors were analyzed using the Cox proportional hazards model.ResultsThere were 85 (76.6%) and 26 (23.4%) patients with and without cirrhosis, respectively. Compared with those without cirrhosis, there were more females, less seropositive rate of hepatitis B surface antigen (HBsAg), more seropositive rate of antibody against to hepatitis C virus (HCV), less albumin-bilirubin (ALBI) grade 1, lower platelet count, and more had tumor burden within the Milan criteria in cirrhotic patients. Cirrhotic patients had a higher risk of posthepatectomy decompensation compared to noncirrhotic patients (hazard ratio 9.577, p = 0.017). No difference was observed in overall survival and recurrence-free survival between patients with or without cirrhosis.ConclusionCompared with patients without cirrhosis, cirrhotic patients with HCC and EV are vulnerable to posthepatectomy decompensation. However, cirrhosis is not a poor prognostic factor of overall survival and recurrence for HCC patients after surgical resection.Copyright © 2022, the Chinese Medical Association.

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