HCC portal hypertension imaging score derived from CT predicts re-bleeding and mortality after acute variceal bleeding.
Cancer Imaging
; 24(1): 45, 2024 Mar 28.
Article
in En
| MEDLINE
| ID: mdl-38549132
ABSTRACT
BACKGROUND/PURPOSE:
Risk factors for re-bleeding and death after acute variceal bleeding (AVB) in cirrhotic HCC patients are not fully understood.We aimed to (1) explore how the combination of high-risk esophageal varices, HCC status, and portal vein tumor thrombus (i.e., HCC Portal Hypertension Imaging Score [HCCPHTIS]) helps predict increased risk of variceal re-bleeding and mortality; (2) assess predictability and reproducibility of the identified variceal re-bleeding rules.METHODS:
This prospective study included 195 HCC patients with first-time AVB and liver cirrhosis, and conducted multivariable Cox regression analysis and Kaplan-Meier analysis. Receiver operating characteristic curve analysis was calculated to find the optimal sensitivity, specificity, and cutoff values of the variables. The reproducibility of the results obtained was verified in a different but related group of patients.RESULTS:
56 patients (28.7%) had re-bleeding within 6 weeks; HCCPHTIS was an independent risk factor for variceal re-bleeding after AVB (Odd ratio, 2.330; 95% confidence interval 1.728-3.142, p < 0.001). The positive predictive value of HCCPHTIS cut off value > 3 was 66.2%, sensitivity 83.9%, and specificity 82.3%. HCCPHTIS area under the curve was higher than Child-Pugh score (89% vs. 75%, p < 0.001). 74(37.9%) death occurred within 6 weeks; HCCPHTIS > 4 was associated with increased risk of death within 6 weeks after AVB (p < 0.001).CONCLUSION:
HCCPHTIS > 3 is a strong predictor of variceal re-bleeding within the first 6 weeks. However, patients with HCCPHTIS > 4 were at increased risk of death within 6 weeks.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Esophageal and Gastric Varices
/
Carcinoma, Hepatocellular
/
Hypertension, Portal
/
Liver Neoplasms
Limits:
Humans
Language:
En
Journal:
Cancer Imaging
Journal subject:
DIAGNOSTICO POR IMAGEM
/
NEOPLASIAS
Year:
2024
Document type:
Article
Affiliation country:
China