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©2012 Baishideng Publishing Group Co.
World J Gastroenterol. Apr 28, 2012; 18(16): 1946-1952
Published online Apr 28, 2012. doi: 10.3748/wjg.v18.i16.1946
Published online Apr 28, 2012. doi: 10.3748/wjg.v18.i16.1946
Table 1 Baseline clinical characteristics of patients with Budd-Chiari syndrome (n = 67)
Characteristics | Budd-Chiari syndrome |
Age (yr) | 47 ± 16 |
Gender (male) | 34 (50.7) |
Obstruction site | |
IVC | 56 (83.6) |
Hepatic vein | 5 (7.5) |
Combined | 6 (9.0) |
Alcohol consumption | |
None/social/heavy (> 80 g/d) | 32 (47.8)/15 (22.3)/20 (29.9) |
Positive viral marker | |
HBsAg/anti-HCV | 3 (4.5)/0 (0) |
Liver cirrhosis at diagnosis | 54 (80.6) |
Child-Pugh A/B/C | 25/23/6 (37.3/34.3/9.0) |
MELD score | 11 ± 6 |
Decompensate LC symptoms | 23 (34.3) |
Length of obstruction (cm) | 2.0 ± 4.0 |
HVPG (mmHg) | 15 ± 10 |
Laboratory data | |
ALT (IU/L) | 19 ± 17 |
Bilirubin (mg/dL) | 1.4 ± 1.3 |
Albumin (g/dL) | 3.8 ± 0.7 |
Hemoglobin (g/dL) | 12.3 ± 2.6 |
Platelet count (k/μL) | 109 ± 78 |
Creatinine (mg/dL) | 0.9 ± 0.2 |
PT (%) | 73 ± 27 |
Treatment modality | |
Angioplasty | 27 (40.3) |
Shunt operation | 4 (5.9) |
TIPS | 3 (4.5) |
Thrombolysis | 1 (1.5) |
Symptomatic medical treatment | 32 (47.7) |
Median follow up period (mo) | 103 ± 156 |
Table 2 Characteristics of the patients with hepatocellular carcinoma at the time point of diagnosis (n = 17)
Variables | HCC |
Age (yr) | 53 ± 12 |
Time period from BCS to HCC (mo) | 51 ± 115 |
Child-Pugh class | |
A/B/C | 6 (35.3)/8 (47.1)/3 (17.6) |
Tumor stage (AJCC 6th)1 | |
I/II/III/IV | 8 (47.1)/6 (35.3)/3 (17.6)/0 (0) |
Treatment modality | |
TACE/TACI | 9 (52.9) |
Intra-arterial chemotherapy | 3 (17.6) |
Conservative management | 3 (17.6) |
Operation | 2 (11.9) |
Prognosis | |
Alive | 12 (70.5) |
Death | 3 (17.6) |
F/U loss | 2 (11.9) |
Table 3 Comparison of baseline clinical characteristics between hepatocellular carcinoma group and non hepatocellular carcinoma group
Variables | HCC(n = 17) | Non HCC(n = 50) | P value |
Age (yr) | 47 ± 11 | 47 ± 18 | 0.863 |
Gender (male) | 10 (58.8) | 24 (48) | 0.441 |
Obstructive site | 0.264 | ||
IVC | 15 (88.2) | 41 (82) | |
Hepatic vein | 2 (11.8) | 3 (6) | |
Combined | 0 (0) | 6 (12) | |
Alcohol consumption | 0.329 | ||
None | 6 (35.3) | 26 (52.0) | |
Social | 4 (23.5) | 11 (22.0) | |
Heavy (> 80 g/d) | 7 (41.2) | 13 (26.0) | |
Positive for HBsAg | 0 (0) | 3 (6.0) | 0.554 |
LC at diagnosis | 14 ( 82.4) | 40 (80.0) | 0.832 |
Decompensate LC symptoms | 8 (47.1) | 15 (28.0) | 0.148 |
Child Pugh A/B/C | 5/7/2 | 20/16/4 | 0.647 |
MELD score | 11 ± 6 | 11 ± 6 | 0.778 |
Follow up period (mo) | 103 ± 146 | 103 ± 160 | 0.648 |
Length of obstruction (cm) | 1.0 ± 2.5 | 2.0 ± 4.4 | 0.144 |
HVPG (mmHg) | 21 ± 12 | 14 ± 7 | 0.019 |
Laboratory data | |||
ALT (IU/L) | 21 ± 21 | 18 ± 14 | 0.160 |
Bilirubin (mg/dL) | 1.5 ± 1.9 | 1.3 ± 1.3 | 0.521 |
Albumin (g/dL) | 3.6 ± 0.85 | 3.8 ± 0.72 | 0.245 |
Hemoglobin (g/dL) | 12.5 ± 4.1 | 12.3 ± 2.3 | 0.897 |
Platelet count (k/μL) | 97 ± 59.5 | 113 ± 80.7 | 0.559 |
Creatinine (mg/dL) | 0.9 ± 0.14 | 0.85 ± 0..24 | 0.798 |
PT (%) | 71 ± 31 | 74 ± 22 | 0.756 |
Survival (%) | < 0.001 | ||
5 yr | 79 | 93.4 | |
10 yr | 43.1 | ||
15 yr | 21.5 | 74.7 |
Table 4 Prevalence and characteristics of hepatocellular carcinoma in patients with Budd-Chiari syndrome from the literature
Ref. | Matsui et al[3] | Shin et al[24] | Moucari et al[7] | Gwon et al[6] |
Year, country | 2000, Japan | 2004, South Korea | 2008, France | 2010, South Korea |
Study design | Retrospective | Retrospective | Retrospective | Retrospective |
Study period | Apr 1968-Feb 1999 | Mar 1989-Aug 2001 | 1987-2005 | Mar 1990-Nov 2008 |
No. of patient with BCS | 12 | 73 | 97 | 98 |
HCC (%) | 3 (25) | 15 (20.5) | 11 (11.3) | 23 (23) |
Cumulative incidence of HCC | - | - | 4 yr 3% | 1 yr 7.3% |
7 yr 6% | 5 yr 13.5% | |||
14 yr 12% | 10 yr 31.8% | |||
Tx. for HCC | Resection (1) | TACE (11) | TACE (7) | TACE (20) |
TAE (1) | Resection (2) | LT (3) | TACE + LT (3) | |
iA chemotherapy (1) | Conservative tx. (2) | Conservative tx. (1) | ||
Survival rate of HCC in patients with BCS | ||||
Median survival period (mo) | - | 58 (range, 3-59) | - | - |
Cumulative survival | - | 1 yr 93% | - | 1 yr 90% |
2 yr 84% | 2 yr 85% | |||
3 yr 72% | 3 yr 61% | |||
4 yr 61% | ||||
5 yr 46% | ||||
Risk factors for HCC in patients with BCS | ||||
Risk factors | Chronic congestion in the liver, caused by an outflow block of hepatic veins | - | Male gender, | Female gender2 |
Coagulopathy1, | ||||
IVC obstruction | ||||
Analysis method | No statistical analysis (mere presumption) | - | Univariate analysis | Multivariate analysis |
- Citation: Park H, Yoon JY, Park KH, Kim DY, Ahn SH, Han KH, Chon CY, Park JY. Hepatocellular carcinoma in Budd-Chiari syndrome: A single center experience with long-term follow-up in South Korea. World J Gastroenterol 2012; 18(16): 1946-1952
- URL: https://www.wjgnet.com/1007-9327/full/v18/i16/1946.htm
- DOI: https://dx.doi.org/10.3748/wjg.v18.i16.1946