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Cardiovascular systemic invasion by hepatocellular carcinoma: incidence and pattern in a west African population
E A Ayoola1, I O Olubuyide, J Thomas
1Department of Medicine, University College Hospital, Ibadan, Nigeria.
Insights
Cardiovascular system invasion by hepatocellular carcinoma (HCC) is common in Nigerian patients, affecting 44%. This invasion is difficult to detect clinically and does not alter the poor prognosis of liver cancer.
Area of Science:
- Hepatobiliary Surgery
- Oncology
- Cardiovascular Pathology
Background:
- Hepatocellular carcinoma (HCC) is a primary liver cancer with a significant global burden.
- Cardiovascular system (CVS) invasion by HCC is a known but infrequently reported complication.
- Understanding the frequency and impact of CVS invasion is crucial for patient management and prognosis.
Purpose of the Study:
- To investigate the prevalence of cardiovascular system invasion in patients with hepatocellular carcinoma.
- To identify any clinicopathological factors associated with CVS invasion.
- To assess the impact of CVS invasion on the overall prognosis of HCC.
Main Methods:
- Retrospective autopsy-based study.
- Inclusion of 81 Nigerian patients diagnosed with hepatocellular carcinoma.
- Examination for the presence of tumor thrombi or metastases within the cardiovascular system.
Main Results:
- Cardiovascular system invasion was identified in 36 out of 81 patients (44%).
- No significant clinicopathological differences were observed between patients with and without CVS invasion.
- CVS invasion did not demonstrably worsen the prognosis in this cohort of HCC patients.
Conclusions:
- Cardiovascular system invasion by HCC is a frequent occurrence.
- Clinical diagnosis of CVS invasion is challenging.
- While imaging may exclude invasion before hepatic resection, routine screening is unlikely to improve the overall poor prognosis for most HCC patients.
Abstract:
To determine the frequency of cardiovascular systemic invasion by hepatocellular carcinoma (HCC). Eighty-one Nigerian patients who had autopsy examinations were studied. Of these, 36 (44%) had tumour thrombi within the cardiovascular system (CVS) or metastases to the heart itself. Compared with the patients without CVS invasion, no clinicopathologic findings distinguished these two groups from each other. Furthermore, CVS invasion did not worsen the generally bad prognosis of these patients with liver cancer. It is concluded that CVS invasion is frequent and difficult to diagnose by clinical examination. Patients who are selected to undergo hepatic resection must be assessed by imaging techniques to exclude CVS invasion. However, it is unlikely that frequent and routine imaging procedures will affect the generally bad prognosis of the majority of the patients.