Brief Article
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World J Gastroenterol. Nov 14, 2013; 19(42): 7447-7454
Published online Nov 14, 2013. doi: 10.3748/wjg.v19.i42.7447
Prognostic factors in non-malignant and non-cirrhotic patients with portal cavernoma: An 8-year retrospective single-center study
Xing-Shun Qi, Ming Bai, Chuang-Ye He, Zhan-Xin Yin, Wen-Gang Guo, Jing Niu, Fei-Fei Wu, Guo-Hong Han
Xing-Shun Qi, Ming Bai, Chuang-Ye He, Zhan-Xin Yin, Wen-Gang Guo, Jing Niu, Fei-Fei Wu, Guo-Hong Han, Department of Liver Diseases and Digestive Interventional Radiology, Xijing Hospital of Digestive Diseases, Fourth Military Medical University, Xi’an 710032, Shaanxi Province, China
Author contributions: Han GH is the guarantor of the study; Qi XS and Han GH designed the study; He CY, Yin ZX, Guo WG and Han GH treated the patients; Niu J, Wu FF, He CY, Yin ZX, Guo WG, Han GH and Qi XS followed up the patients; Qi XS, Bai M, He CY, Yin ZX, Guo WG and Han G analyzed the data and interpreted the results; Qi XS drafted the paper; Bai M, He CY, Yin ZX, Guo WG, Niu J, Wu FF and Han GH revised the paper; Qi XS, Bai M and He CY contributed equally to this work.
Correspondence to: Guo-Hong Han, Professor, Department of Liver Diseases and Digestive Interventional Radiology, Xijing Hospital of Digestive Diseases, Fourth Military Medical University, No. 27 West Changle Road, Xi’an 710032, Shaanxi Province, China. guohhan@126.com
Telephone: +86-29-84771537 Fax: +86-29-82539041
Received: June 6, 2013
Revised: August 1, 2013
Accepted: August 28, 2013
Published online: November 14, 2013
Processing time: 164 Days and 23.9 Hours
Abstract

AIM: To evaluate the outcome of non-malignant and non-cirrhotic patients with portal cavernoma and to determine the predictors for survival.

METHODS: Between July 2002 and June 2010, we retrospectively enrolled all consecutive patients admitted to our department with a diagnosis of portal cavernoma without abdominal malignancy or liver cirrhosis. The primary endpoint of this observational study was death and cause of death. Independent predictors of survival were identified using the Cox regression model.

RESULTS: A total of 64 patients were enrolled in the study. During a mean follow-up period of 18 ± 2.41 mo, 7 patients died. Causes of death were pulmonary embolism (n = 1), acute leukemia (n = 1), massive esophageal variceal hemorrhage (n = 1), progressive liver failure (n = 2), severe systemic infection secondary to multiple liver abscesses (n = 1) and accident (n = 1). The cumulative 6-, 12- and 36-mo survival rates were 94.9%, 86% and 86%, respectively. Multivariate Cox regression analysis demonstrated that the presence of ascites (HR = 10.729, 95%CI: 1.209-95.183, P = 0.033) and elevated white blood cell count (HR = 1.072, 95%CI: 1.014-1.133, P = 0.015) were independent prognostic factors of non-malignant and non-cirrhotic patients with portal cavernoma. The cumulative 6-, 12- and 36-mo survival rates were significantly different between patients with and without ascites (90%, 61.5% and 61.5% vs 97.3%, 97.3% and 97.3%, respectively, P = 0.0008).

CONCLUSION: The presence of ascites and elevated white blood cell count were significantly associated with poor prognosis in non-malignant and non-cirrhotic patients with portal cavernoma.

Keywords: Extrahepatic portal vein obstruction; Portal cavernoma; Survival; Prognostic factors; Ascites

Core tip: Little is known regarding the prognostic factors of non-malignant and non-cirrhotic patients with portal cavernoma. We conducted a retrospective single-center study of 64 patients admitted to our department between July 2002 and June 2010 to evaluate this issue. Multivariate Cox regression analysis demonstrated that the presence of ascites was an independent prognostic factor of non-malignant and non-cirrhotic patients with portal cavernoma.