Objective: To determine the clinical features and prognosis of portal hypertension (PH) combined with hepatocellular carcinoma (HCC).
Methods: The clinical data of PH patients combined with HCC (HCC-PH) and the patients with liver cirrhosis-induced PH (LC-PH) admitted and treated in our department during the same 8-year period were retrospectively analyzed. Univariate and multivariate survival analysis were conducted using Cox proportional hazard model. Receiver operating characteristic (ROC) curves were used to determine the cutoff values of continuous variables.
Results: Compared with the clinical features of the LC-PH patients, the HCC-PH patients showed higher incidence of esophagogastric varices, portal hypertensive gastropathy and concomitant portal vein thrombus, but lower incidence of compensatory enlargement of the portal vein luminal diameter (≥1.3 cm) and mild hypersplenism. Compared to LC-PH patients, the HCC-PH patients had worse liver function and poorer survival outcomes after upper gastrointestinal bleeding. Multivariate analysis revealed that the combination of HCC, aspartate aminotransferase (AST) ≥ 65.6 U/L, presence of portal vein (tumor) thrombus, total bilirubin (TBIL) ≥ 34.0 μmol/L and albumin (ALB) value were factors affecting the survival of PH patients.
Conclusion: The clinical features of HCC-PH is different from those of LC-PH, so HCC-PH cannot be simply treated as LC-PH. A combination of HCC is the most important factor affecting the survival of PH patients.