Evidence map›Paper›PMID 42088985›Full record

ArticleJournal of hepatocellular carcinoma2026

Esophagogastric Variceal Bleeding in Cirrhotic Patients with Hepatocellular Carcinoma Receiving Systemic Therapy: A Retrospective Cohort Study.

Yaxin Li, Ajuan Zeng, Yangjie Li, Yuwei Wang, Yueyang Yu, Lingna Lyu, Ying Han, Huiguo Ding

Abstract read
In one paragraph

Article in Journal of hepatocellular carcinoma, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

0numbers the graph read from it
0cells of the map it votes in
0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Yaxin Li *Department of Gastroenterology and Hepatology, Laboratory for Clinical Medicine, Beijing You'an Hospital, Capital Medical University, Beijing, 100069, People's Republic of China.ORCID 0009-0002-6636-3659
Ajuan Zeng *Department of Gastroenterology and Hepatology, Laboratory for Clinical Medicine, Beijing You'an Hospital, Capital Medical University, Beijing, 100069, People's Republic of China.
Yangjie Li *Department of Gastroenterology and Hepatology, Laboratory for Clinical Medicine, Beijing You'an Hospital, Capital Medical University, Beijing, 100069, People's Republic of China.
Yuwei WangDepartment of Gastroenterology and Hepatology, Laboratory for Clinical Medicine, Beijing You'an Hospital, Capital Medical University, Beijing, 100069, People's Republic of China.
Yueyang YuDepartment of Gastroenterology and Hepatology, Laboratory for Clinical Medicine, Beijing You'an Hospital, Capital Medical University, Beijing, 100069, People's Republic of China.
Lingna LyuDepartment of Gastroenterology and Hepatology, Laboratory for Clinical Medicine, Beijing You'an Hospital, Capital Medical University, Beijing, 100069, People's Republic of China.
Ying HanDepartment of Gastroenterology and Hepatology, Laboratory for Clinical Medicine, Beijing You'an Hospital, Capital Medical University, Beijing, 100069, People's Republic of China.ORCID 0000-0002-5776-7160
Huiguo DingDepartment of Gastroenterology and Hepatology, Laboratory for Clinical Medicine, Beijing You'an Hospital, Capital Medical University, Beijing, 100069, People's Republic of China.ORCID 0000-0002-8716-4926

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Purpose: Systemic therapy has improved outcomes in advanced hepatocellular carcinoma (HCC), but the risk of esophagogastric variceal (EGV) bleeding remains a concern. This study investigated the incidence and risk factors for EGV bleeding and mortality in cirrhotic HCC patients receiving systemic therapy. Patients and Methods: This single-center retrospective study included cirrhotic patients with intermediate to advanced HCC who initially received systemic therapy with tyrosine kinase inhibitors (TKIs) alone or in combination with anti-programmed cell death-1 antibodies (anti-PD-1). HCC was diagnosed based on histology or typical radiological findings and staged according to the Barcelona Clinic Liver Cancer (BCLC) classification system. EGV bleeding was confirmed by oesophagogastroduodenoscopy. The treatment efficacy was evaluated using the modified Response Evaluation Criteria in Solid Tumors. Results: A total of 263 patients were included, predominantly male (85.9%), with a median age of 59 years. BCLC stages B and C accounted for 59.3% and 40.7% of cases, respectively. The 1-year and 2-year cumulative incidence of EGV bleeding were 16.7% and 21.6%, respectively. Portal vein thrombosis (PVT), ascites, and severe varices were independently associated with 1-year EGV bleeding. The 1-year mortality rate was 6.1%. The mortality was independently associated with EGV bleeding, AFP levels >400 ng/mL, type of portal vein tumor thrombus, and tumor progression. The overall objective response rate (ORR) was 32.0%, with TKIs plus anti-PD-1 achieving higher ORR than TKIs alone (39.5% vs. 27.7%, P=0.017) without increasing the bleeding risk or mortality (all P>0.05). Among 162 HBV-related HCC patients receiving long-term antiviral therapy, HBV DNA negative conversion (37.5% vs. 29.6%, P=0.739) and HBsAg decline (-15.1% vs. -14.3%, P=0.883) were comparable between TKIs plus anti-PD-1 and TKIs alone group. Conclusion: In cirrhotic patients with advanced HCC, PVT, ascites and high-risk EGV were predictors of variceal bleeding, regardless of the tumor response. TKIs plus anti-PD-1 achieved higher ORR than TKIs alone without increasing EGV bleeding risk or mortality, supporting their use in selected patients with careful assessment of EGV bleeding risk.

Indexed as

hepatitis B virusimmunotherapyportal hypertensiontyrosine kinase inhibitors

Identifiers

PMID42088985
PMCPMC13136030

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.