Esophagogastric varices associated with poor prognosis in hepatocellular carcinoma
Esophagogastric varices are independent risk factors for poor prognosis and poor liver functional reserves in patients with hepatocellular carcinoma, a new study reports.
The study included 990 hepatocellular carcinoma patients who were treatment-naïve. Those who did not receive esophagogastroduodenoscopy were excluded. The patients were followed up every 3 months for a median of 13.1 months. Radio-immunoassay was performed to measure the serum levels of hepatitis C virus antibody and hepatitis B surface antigen, and overall survival was used as the primary endpoint.
Of the patients, 95.2 percent were screened for esophagogastric varices and the remaining 4.8 percent for bleeding. Esophagogastroduodenoscopy diagnosed esopahgogastric varices in 480 patients; of these, 399 had esophageal varices alone, 12 had gastric varices alone, and 69 had both.
At the end of the follow-up period, 457 patients survived while 533 died. Patients with esophagogastic varices had lower 1-, 3- and 5-year overall survival rates compared with those without esophagogastric varices (49.4 vs 67.7 percent, 34.7 vs 54.9 and 24.9 vs 46.4 percent, respectively; p<0.001).
After stratification according to the Barcelona Clinic Liver Cancer stages, overall survival rates remained lower among patients with esophagogastric varices than among those without esophagogastric varices with the exception of those with stage D disease. The results were similar regardless of whether patients received either curative or non-curative treatment modalities.
The findings thus show that esophagogastric varices are independent risk factors for poorer prognoses in patients with hepatocellular carcinoma.