Universität zu Köln

Mueller, Lukas, Hahn, Felix, Maehringer-Kunz, Aline, Stoehr, Fabian ORCID: 0000-0002-2797-6252, Gairing, Simon Johannes ORCID: 0000-0003-3240-5152, Foerster, Friedrich, Weinmann, Arndt, Galle, Peter Robert, Mittler, Jens, dos Santos, Daniel Pinto, Pitton, Michael Bernhard, Dueber, Christoph, Fehrenbach, Uli, Auer, Timo Alexander, Gebauer, Bernhard and Kloeckner, Roman (2022). Prevalence and clinical significance of clinically evident portal hypertension in patients with hepatocellular carcinoma undergoing transarterial chemoembolization. United European Gastroenterol. J., 10 (1). S. 41 - 54. CHICHESTER: JOHN WILEY & SONS LTD. ISSN 2050-6414

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Abstract

Background Clinically evident portal hypertension (CEPH) was previously identified as a prognostic factor for patients with hepatocellular carcinoma (HCC). However, little is known about the prognostic influence of CEPH on the long-term outcome of patients with HCC undergoing transarterial chemoembolization (TACE), particularly in Western populations. Objectives This study investigated the prevalence and prognostic influence of CEPH in a Western population of patients with HCC undergoing TACE. Methods This retrospective study included 349 treatment-naive patients that received initial TACE treatment at our tertiary care center between January 2010 and November 2020. CEPH was defined as a combination of ascites, esophageal/gastric varices, splenomegaly and a low platelet count. We assessed the influence of CEPH and its defining factors on median overall survival (OS) in HCC patients. We compared the effects of CEPH to those of well-known prognostic factors. Results Of the 349 patients included, 304 (87.1%) patients had liver cirrhosis. CEPH was present in 241 (69.1%) patients. The median OS times were 10.6 months for patients with CEPH and 17.1 months for patients without CEPH (log rank p = 0.036). Median OS without a present surrogate was 17.1 months, while patients with one respectively more than two present CEPH surrogates had a median OS of 10.8 and 9.4 months (log rank p = 0.053). In multivariate analysis, CEPH was no significant risk factor for OS (p = 0.190). Of the CEPH-defining factors, only ascites reached significance in a univariate analysis. Conclusion CEPH was present in more than two thirds of the patients with HCC undergoing TACE in our cohort of Western patients. Patients with CEPH had a significantly impaired survival in univariate analysis. However, no significance was reached in multivariate analysis. Thus, when TACE treatment is deemed oncologically reasonable, patients should not be excluded from TACE treatment due to the presence of surrogates of portal hypertension alone.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Mueller, Lukas UNSPECIFIED UNSPECIFIED UNSPECIFIED Hahn, Felix UNSPECIFIED UNSPECIFIED UNSPECIFIED Maehringer-Kunz, Aline UNSPECIFIED UNSPECIFIED UNSPECIFIED Stoehr, Fabian UNSPECIFIED orcid.org/0000-0002-2797-6252 UNSPECIFIED Gairing, Simon Johannes UNSPECIFIED orcid.org/0000-0003-3240-5152 UNSPECIFIED Foerster, Friedrich UNSPECIFIED UNSPECIFIED UNSPECIFIED Weinmann, Arndt UNSPECIFIED UNSPECIFIED UNSPECIFIED Galle, Peter Robert UNSPECIFIED UNSPECIFIED UNSPECIFIED Mittler, Jens UNSPECIFIED UNSPECIFIED UNSPECIFIED dos Santos, Daniel Pinto UNSPECIFIED UNSPECIFIED UNSPECIFIED Pitton, Michael Bernhard UNSPECIFIED UNSPECIFIED UNSPECIFIED Dueber, Christoph UNSPECIFIED UNSPECIFIED UNSPECIFIED Fehrenbach, Uli UNSPECIFIED UNSPECIFIED UNSPECIFIED Auer, Timo Alexander UNSPECIFIED UNSPECIFIED UNSPECIFIED Gebauer, Bernhard UNSPECIFIED UNSPECIFIED UNSPECIFIED Kloeckner, Roman UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-584701
DOI:	10.1002/ueg2.12188
Journal or Publication Title:	United European Gastroenterol. J.
Volume:	10
Number:	1
Page Range:	S. 41 - 54
Date:	2022
Publisher:	JOHN WILEY & SONS LTD
Place of Publication:	CHICHESTER
ISSN:	2050-6414
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language DIAGNOSIS; CIRRHOSIS; TRIAL; TACE Multiple languages Gastroenterology & Hepatology Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/58470