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Rebleeding prophylaxis improves outcomes in patients with hepatocellular carcinoma. A multicenter case-control study
Cristina Ripoll1, Joan Genescà, Isis K Araujo
1Servicio de Aparato Digestivo, Hospital Universitario Gregorio Marañón, IiSGM, CiberEHD, Universidad Complutense, Madrid, Spain.
Hepatology (Baltimore, Md.)
|August 3, 2013
Summary
Patients with hepatocellular carcinoma (HCC) experiencing variceal bleeding (VB) have a worse prognosis. Secondary prophylaxis significantly improves survival in these patients.
Area of Science:
- Hepatology
- Gastroenterology
- Oncology
Background:
- Variceal bleeding (VB) is a serious complication in patients with liver disease.
- The outcomes of VB in patients with hepatocellular carcinoma (HCC) remain unclear.
Purpose of the Study:
- To compare the outcomes of variceal bleeding in patients with and without hepatocellular carcinoma.
- To identify factors influencing mortality and rebleeding rates in patients with variceal bleeding.
Main Methods:
- A retrospective study comparing 146 patients with HCC and VB to 146 matched patients without HCC.
- Matched analysis based on age and Child-Pugh class.
- Follow-up until death, transplantation, or June 2011.
Main Results:
- No significant differences in initial presentation or endoscopic treatment between groups.
- Patients with HCC had higher 6-week rebleeding rates (16% vs. 7%) and mortality (30% vs. 15%).
- HCC patients received less secondary prophylaxis, experienced higher prophylaxis failure rates, and had significantly shorter survival (5 months vs. >38 months).
Conclusions:
- Hepatocellular carcinoma significantly worsens the prognosis for patients with variceal bleeding.
- Secondary prophylaxis is crucial and offers a survival benefit for patients with HCC and variceal bleeding.
