Clinical profile and outcomes of hepatocellular carcinoma in primary Budd-Chiari syndrome

作者：Ankit Agarwal, Sagnik Biswas, Shekhar Swaroop, Arnav Aggarwal, Ayush Agarwal, Gautam Jain, Anshuman Elhence, Arun Vaidya, Amit Gupte, Ravi Mohanka, Ramesh Kumar, Ashwani Kumar Mishra, Shivanand Gamanagatti, Shashi Bala Paul, Subrat Kumar Acharya, Akash Shukla, S. Shalimar · 发表于：World Journal of Gastrointestinal Oncology · 年份：2024 · DOI：10.4251/wjgo.v16.i3.699 · 被引用次数：7 · 研究领域：Liver Disease and Transplantation、Neurological Complications and Syndromes、Genetic and Kidney Cyst Diseases

BACKGROUND There is scant literature on hepatocellular carcinoma (HCC) in patients with Budd-Chiari syndrome (BCS). AIM To assess the magnitude, clinical characteristics, feasibility, and outcomes of treatment in BCS-HCC. METHODS A total of 904 BCS patients from New Delhi, India and 1140 from Mumbai, India were included. The prevalence and incidence of HCC were determined, and among patients with BCS-HCC, the viability and outcomes of interventional therapy were evaluated. RESULTS In the New Delhi cohort of 35 BCS-HCC patients, 18 had HCC at index presentation (prevalence 1.99%), and 17 developed HCC over a follow-up of 4601 person-years, [incidence 0.36 (0.22-0.57) per 100 person-years]. BCS-HCC patients were older when compared to patients with BCS alone (P = 0.001) and had a higher proportion of inferior vena cava block, cirrhosis, and long-segment vascular obstruction. The median alpha-fetoprotein level was higher in patients with BCS-HCC at first presentation than those who developed HCC at follow-up (13029 ng/mL vs 500 ng/mL, P = 0.01). Of the 35 BCS-HCC, 26 (74.3%) underwent radiological interventions for BCS, and 22 (62.8%) patients underwent treatment for HCC [transarterial chemoembolization in 18 (81.8%), oral tyrosine kinase inhibitor in 3 (13.6%), and transarterial radioembolization in 1 (4.5%)]. The median survival among patients who underwent interventions for HCC compared with those who did not was 3.5 years vs 3.1 mo (P = 0.0001). In contrast to the New Delhi ...