ArticleCancer imaging : the official publication of the International Cancer Imaging Society2024
Management of varices but not anticoagulation is associated with improved outcome in patients with HCC and macrovascular tumour invasion.
Article in Cancer imaging : the official publication of the International Cancer Imaging Society, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.
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Who cites it
7 citing papers in PubMed, 1 synthesis or guideline pooled it, 8 citations in OpenAlex.
- Anticoagulant outcomes in managing tumor thrombus: a systematic review.Frontiers in oncology · 2026Pooled it
- Patient characteristics to guide personalized treatment decisions and prognostication in hepatocellular carcinoma.Hepatic oncology · 2026Review
- Natural History of Treated and Untreated Bland Portal Vein Thrombosis in Patients with Hepatocellular Carcinoma.Cancers · 2026Article
- Role of Liver Function in the Multiparametric Assessment of Hepatocellular Carcinoma.Medicina (Kaunas, Lithuania) · 2026Review
- Thrombotic Risk and Coagulation Imbalance in Cirrhosis and Hepatocellular Carcinoma: Clinical Implications and Management.Cancers · 2025Review
- Venous Thromboembolism in Unusual Locations.The Medical clinics of North America · 2025Review
- TIPS for Portal Hypertension in HCC With Tumour Invasion of the Portal Vein Trunk: Anecdote or Promise?Journal of clinical and experimental hepatologyArticle
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Authors and funding
10 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND &
aimsThe value of bleeding prophylaxis and anticoagulation in patients with hepatocellular carcinoma (HCC) and macrovascular tumour invasion (MVI) is unclear. We evaluated the impact of anticoagulation on thrombosis progression, bleeding events, and overall mortality, and assessed the efficacy of adequate management of varices as recommended for patients with cirrhosis.
methodsHCC patients with MVI who had Child-Turcotte-Pugh A-B7 were included between Q4/2002 and Q2/2022. Localization of the tumour thrombus and changes at 3-6 months were evaluated by two radiologists. Univariable and multivariable logistic/Cox regression analyses included time-dependent variables (i.e., anticoagulation, systemic therapy, non-selective beta blocker treatment).
resultsOf 124 patients included (male: n = 110, 89%), MVI involved the main portal vein in 47 patients (38%), and 49 individuals (40%) had additional non-tumorous thrombus apposition. Fifty of 80 patients (63%) with available endoscopy had varices. Twenty-four individuals (19%) received therapeutic anticoagulation and 94 patients (76%) were treated with effective systemic therapies. The use of therapeutic anticoagulation did not significantly affect the course of the malignant thrombosis at 3-6 months. Systemic therapy (aHR: 0.26 [95%CI: 0.16-0.40]) but not anticoagulation was independently associated with reduced all-cause mortality. In patients with known variceal status, adequate management of varices was independently associated with reduced risk of variceal bleeding (aHR: 0.12 [95%CI: 0.02-0.71]). In the whole cohort, non-selective beta blockers were independently associated with reduced risk of variceal bleeding or death from any cause (aHR: 0.69 [95%CI: 0.50-0.96]).
conclusionAdequate bleeding prophylaxis and systemic anti-tumour therapy but not anticoagulation were associated with improved outcomes in patients with HCC and MVI.
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