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Updated: Nov 4, 2025

Invasive Hemodynamic Characterization of the Portal-hypertensive Syndrome in Cirrhotic Rats
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Portal hypertension and hepatocellular carcinoma: Des liaisons dangereuses…

Manon Allaire1,2, Marika Rudler1,3, Dominique Thabut1,3

  • 1Service d'Hépatolo-gastroentérologie, Hôpitaux Universitaires Pitié Salpêtrière - Charles Foix, AP-HP, Sorbonne Université, Paris, France.

Liver International : Official Journal of the International Association for the Study of the Liver
|May 29, 2021
PubMed

Insights

Portal hypertension (PHT) and hepatocellular carcinoma (HCC) are serious cirrhosis complications. This review explores their shared pathogenesis, focusing on angiogenesis and inflammation, and the challenges in treating coexisting PHT and HCC.

Area of Science:

  • Hepatology
  • Oncology
  • Vascular Biology

Background:

  • Portal hypertension (PHT) and hepatocellular carcinoma (HCC) are significant complications of cirrhosis, leading to high morbidity and mortality.
  • Both PHT and HCC share common pathogenic pathways involving angiogenesis and inflammation.
  • The coexistence of PHT and HCC presents complex therapeutic challenges.

Purpose of the Study:

  • To review the roles of angiogenesis and inflammation in the pathogenesis of PHT and HCC.
  • To discuss the difficulties in managing patients with both PHT and HCC.
  • To highlight the need for effective treatment strategies for coexisting PHT and HCC.

Main Methods:

  • Literature search of PubMed database for studies published in English until March 2021.
  • Review of existing research on the pathogenesis and treatment of PHT and HCC.

Main Results:

  • PHT involves increased intrahepatic vascular resistance, portosystemic collaterals, and neovascularization driven by VEGF.
  • Bacterial translocation-mediated inflammation is a key contributor to PHT.
  • VEGF and chronic inflammation are implicated in HCC development, and their interplay complicates management when PHT and HCC coexist.

Conclusions:

  • Effective management of PHT is crucial for improving outcomes in HCC patients.
  • Current treatment strategies for advanced HCC, such as Atezolizumab and Bevacizumab, may influence PHT, but real-world data are lacking.
  • Further research is needed to address the complexities of treating coexisting PHT and HCC.
Abstract

Keywords:
Atezolizumab/BevacizumabHCCVEGFinflammationportal hypertension

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