Clinical profile and outcomes of hepatocellular carcinoma in primary Budd-Chiari syndrome

查看全文 作　　者：Ankit [1]Agarwal;Sagnik [1]Biswas;Shekhar [1]Swaroop;Arnav [1]Aggarwal;Ayush [1]Agarwal;Gautam [2]Jain;Anshuman [1]Elhence;Arun [2]Vaidya;Amit [3]Gupte;Ravi [4]Mohanka;Ramesh [5]Kumar;Ashwani Kumar [6]Mishra;Shivanand [7]Gamanagatti;Shashi Bala [7]Paul;Subrat Kumar [1]Acharya;Akash [2]Shukla;[1]Shalimar

机构地区：[1]Department of Gastroenterology and Human Nutrition,All India Institute of Medical Sciences,New Delhi 110029,Delhi,India;[2]Department of Gastroenterology,Seth Gordhandas Sunderdas Medical College and KEM Hospital,Mumbai 400012,Maharashtra,India;[3]Department of Gastroenterology,Sir HN Reliance Foundation Hospital,Mumbai 400004,India;[4]Department of Liver Transplant and HPB,Sir HN Reliance Foundation Hospital,Mumbai 400004,India;[5]Department of Gastroenterology,All India Institute of Medical Sciences,Patna 801507,India;[6]Professor of Biostatistics,National Drug Dependence Treatment Centre(NDDTC),All India Institute of Medical Sciences,New Delhi 110029,India;[7]Department of Radiodiagnosis,All India Institute of Medical Sciences,New Delhi 110029,Delhi,India

出　　处：《World Journal of Gastrointestinal Oncology》索引2024年第16卷第3期,共17页

基　　金：This study was reviewed and approved by the Ethics Committee of the All India Institute of Medical Sciences,New Delhi(Approval No.IEC/NP-458/12.12.2014,RP 22-2015). 摘　　要：BACKGROUND There is scant literature on hepatocellular carcinoma(HCC)in patients with Budd-Chiari syndrome(BCS).AIM To assess the magnitude,clinical characteristics,feasibility,and outcomes of treatment in BCS-HCC.METHODS A total of 904 BCS patients from New Delhi,India and 1140 from Mumbai,India were included.The prevalence and incidence of HCC were determined,and among patients with BCS-HCC,the viability and outcomes of interventional therapy were evaluated.RESULTS In the New Delhi cohort of 35 BCS-HCC patients,18 had HCC at index presentation(prevalence 1.99%),and 17 developed HCC over a follow-up of 4601 person-years,[incidence 0.36(0.22-0.57)per 100 person-years].BCS-HCC patients were older when compared to patients with BCS alone(P=0.001)and had a higher proportion of inferior vena cava block,cirrhosis,and long-segment vascular obstruction.The median alpha-fetoprotein level was higher in patients with BCS-HCC at first presentation than those who developed HCC at follow-up(13029 ng/mL vs 500 ng/mL,P=0.01).Of the 35 BCS-HCC,26(74.3%)underwent radiological interventions for BCS,and 22(62.8%)patients underwent treatment for HCC[transarterial chemoembolization in 18(81.8%),oral tyrosine kinase inhibitor in 3(13.6%),and transarterial radioembolization in 1(4.5%)].The median survival among patients who underwent interventions for HCC compared with those who did not was 3.5 years vs 3.1 mo(P=0.0001).In contrast to the New Delhi cohort,the Mumbai cohort of BCS-HCC patients were predominantly males,presented with a more advanced HCC[Barcelona Clinic Liver Cancer C and D],and 2 patients underwent liver transplantation.CONCLUSION HCC is not uncommon in patients with BCS.Radiological interventions and liver transplantation are feasible in select primary BCS-HCC patients and may improve outcomes. 关键词：Budd chiari syndrome Cancer Cirrhosis THROMBOSIS Liver VARICES Transarterial chemoembolization Hepatic venous outflow tract obstruction

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Clinical profile and outcomes of hepatocellular carcinoma in primary Budd-Chiari syndrome

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