Dr Cristina Ripoll and colleagues from the USA evaluated a total of 213 patients with compensated cirrhosis, portal hypertension and no varices in a trial assessing beta-blockers in preventing varices.
Predictors of the development of hepatocellular carcinoma, including hepatic venous pressure gradient were analyzed.
The team performed baseline laboratory tests, ultrasound and hepatic venous pressure gradient measurements.
Patients were followed prospectively every three months until development of varices or variceal bleeding or end of 2002.
|12% of patients developed hepatocellular carcinoma|
|Journal of Hepatology|
The endpoint was hepatocellular carcinoma development according to standard diagnostic criteria.
Univariate and multivariate Cox regression models were developed to identify predictors of hepatocellular carcinoma.
The researchers found in a median follow-up of 58 months that 12% of patients developed hepatocellular carcinoma.
The research team noted that 8 patients were transplanted, and 28 patients died without hepatocellular carcinoma.
The team observed that 84% of hepatocellular carcinoma developed in patients with Hepatitis C virus.
On multivariate analysis hepatic venous pressure gradient, albumin, and viral etiology were independent predictors of hepatocellular carcinoma development.
The research team found that 10mmHg of hepatic venous pressure gradient was the best cut-off.
Patients who had an hepatic venous pressure gradient above this value had a 6-fold increase in the hepatocellular carcinoma incidence.
Dr Ripoll's team concluded, “Portal hypertension is an independent predictor of hepatocellular carcinoma development.”
“An hepatic venous pressure gradient more than 10mmHg is associated with a 6-fold increase of hepatocellular carcinoma risk.”