ArticleUnited European gastroenterology journal2016
Determinants of esophageal varices bleeding in patients with advanced hepatocellular carcinoma treated with sorafenib.
Article in United European gastroenterology journal, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers.
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Who cites it
12 citing papers in PubMed, 25 citations in OpenAlex.
- Gastrointestinal bleeding in hepatocellular carcinoma under systemic therapy: Real-world incidence and clinical predictors.Clinics (Sao Paulo, Brazil) · 2026Article
- Development and validation of a score model for predicting the risk of first esophagogastric variceal hemorrhage and mortality in patients with hepatocellular carcinoma.Annals of medicine · 2025Article
- The Real-World Prevalence of Esophagogastric Varices, Bleeding, Emergency Room Visits, and Hospitalization Among Patients with Advanced Hepatocellular Carcinoma in the United States: A Retrospective Cohort Study.Journal of hepatocellular carcinoma · 2025Article
- Chronic Psychological Stress in Oncogenesis: Multisystem Crosstalk and Multimodal Interventions.Research (Washington, D.C.) · 2025Review
- Primary Prophylaxis for High-Risk Varices in Patients with Hepatocellular Carcinoma and Portal Vein Tumor Thrombus Delayed Hepatic Decompensation: A Retrospective, Propensity Score Matching Study.Journal of hepatocellular carcinoma · 2025Article
- Validation of a Machine Learning Algorithm, EVendo, for Predicting Esophageal Varices in Hepatocellular Carcinoma.Digestive diseases and sciences · 2024Article
- Incidence and Predictors of Esophagogastric Varices Bleeding in Patients with Hepatocellular Carcinoma in Lenvatinib.Liver cancer · 2024Article
- Complications of immunotherapy in advanced hepatocellular carcinoma.Journal of liver cancer · 2024Article
- Article
- Case Report: Exacerbation of varices following atezolizumab plus bevacizumab treatment of hepatocellular carcinoma: A case series and literature review.Frontiers in oncology · 2022Article
- Prophylactic Endoscopic Therapy for Variceal Bleeding in Patients with Hepatocellular Carcinoma.Journal of Cancer · 2019Article
- The oncologic burden of hepatitis C virus infection: A clinical perspective.CA: a cancer journal for clinicians · 2017Review
Corrections and comments
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Authors and funding
7 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND AND
aimsSorafenib is the standard of care for patients with advanced hepatocellular carcinoma (HCC), yet treatment safety may be challenged by portal hypertension. We therefore assessed the prevalence, risk factors and clinical consequences of esophageal varices (EVs) in sorafenib-treated patients with HCC.
methodsStarting in 2008, all compensated patients with advanced or intermediate HCC not eligible for other therapies were consecutively enrolled in a prospective evaluation of sorafenib therapy, all with pretreatment by upper-gastrointestinal endoscopy (UGE).
resultsA total of 150 patients received sorafenib for 4.6 (95% CI, 3.3-5.6) months. At baseline, 61 (41%) patients were EV free (group A), 78 (52%) had EVs (61 small EVs (group B), 17 medium/large EVs (group C)) and 11 (7%) previously endoscopically treated EVs (group D). Propranolol was given to all patients with medium/large EVs and those with previous bleeding. Twelve patients (8%) bled from EVs after 36 (18-260) days of sorafenib. During sorafenib, bleeding occurred in six of 26 group B patients with neoplastic portal vein thrombosis (nPVT), three of nine group C patients with nPVT, two of five group D patients with nPVT and one of six without nPVT (p < 0.0001), nPVT being the strongest independent predictor of bleeding by multivariate analysis (HR = 15.4, 95% CI 1.84-129.6).
conclusionUGE screening is worthwhile in HCC patients allocated to sorafenib since it identifies patients with EVs at risk of bleeding during therapy, particularly those with nPVT.
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