Portal Hypertension Worsens Prognosis in Some Liver Cancer Patients

Clinically evident portal hypertension (CEPH) significantly affects prognosis in patients with hepatocellular carcinoma (HCC) who undergo transarterial chemoembolization (TACE), according to a recent study.

From January 2000 to June 2014, the researchers evaluated 388 treatment-naïve patients with both HCC and Child-Pugh A cirrhosis who had undergone TACE as first-line treatment. The presence of CEPH was defined as esophageal or gastric varices or a platelet count of less than 100,000/mm³ associated with splenomegaly.
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Any differences between patients with and without CEPH in regard to cumulative occurrence rate of complete response (CR), progression free survival (PFS), and overall survival (OS) were noted and compared.

CEPH was diagnosed in 252 (64.9%) of 388 patients, while the remaining 136 (35.1%) demonstrated no evidence of CEPH. Findings revealed that CR was significantly less likely to occur in patients with CEPH vs those without CEPH, and that median PFS was substantially shorter in patients with CEPH vs those without CEPH.

Furthermore, based on the results of a multivariate analysis, CEPH was found to be the most potent factor for determining poor prognosis in regard to CR (adjusted hazard ratio [aHR] 0.16), PFS (aHR 5.01), and OS (aHR 2.95).

“The presence of CEPH should be considered as a major negative prognostic factor for patients with HCC who will undergo TACE,” the researchers concluded.

—Christina Vogt

Reference:

Kim NH, Lee T, Cho YK, Kim BI, Kim HJ. Impact of clinically evident portal hypertension on clinical outcome of patients with hepatocellular carcinoma treated by transarterial chemoembolization [Published online January 3, 2018]. Hepatology. doi:10.1111/jgh.14083.