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| Risk factors of hepatocellular carcinoma in patients with Budd-Chiari syndrome |
| WANG Qiao-zheng, XU Ke |
| The First Affiliated Hospital of China Medical University, Shenyang 110001, China |
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Abstract Objective: To evaluate the incidence of hepatocellular carcinoma(HCC) and to identify the risk factors of HCC in patients with Budd-Chiari syndrome(BCS). Methods: Between July 1988 and May 2018, 224 consecutive Chinese patients with BCS were treated in our center. One hundred and ninety-nine patients without other risk factors of HCC were involved in our study. Continuous variables were expressed as average values and standard deviations. Categorical variables were summarized as absolute numbers and frequencies. Cumulative incidence of HCC was assessed by Kaplan-Meier curves and compared by log-rank test. Independent predictors of HCC were calculated with the Cox regression model. Results: Interventional therapy was successfully implemented in 166 of the 199 patients, and 32 patients were treated by anticoagulation therapy and symptomatic treatment. Two patients who died 16 h and 48 h after operation(disseminated intravenous coagulation and multiple systemic organ failure, respectively) and seventeen patients lost to follow-up were excluded. The remaining 180 patients were eligible for data analysis. Eleven patients suffered from HCC during follow-up, indicating the incidence was 6.1%. The cumulative 5-, 10-, 20-, 30- incidence of HCC were 0.6%, 4.2%, 7.0%, 18.4%, respectively. In our multivariate Cox regression and analysis, restenosis of hepatic vein or inferior vena cava after interventional treatment was the only significant factor associated with the development of HCC in patients with BCS(P<0.05). The cumulative incidence of HCC was significantly higher in the restenosis group than the other(P<0.05). Conclusion: In patients with BCS, HCC is a long-term complication. Furthermore, restenosis of hepatic venous outflow tract is the only significant factor associated with the development of HCC. Therefore, long-term follow-up should be emphasized to achieve timely diagnosis of early stage HCC and treatment of restenosis.
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Received: 21 May 2019
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2020, Vol. 31 
