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Prevalence and risk factors of hepatocellular carcinoma in Budd-Chiari syndrome

This month's issue of the European Journal of Gastroenterology & Hepatology reviews the prevalence and risk factors of hepatocellular carcinoma in Budd-Chiari syndrome.

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Budd–Chiari syndrome can be incidentally complicated by hepatocellular carcinoma, thereby decreasing the survival of these patients.

Dr Ren Weironga and colleagues systematically reviewed the prevalence and risk factors of hepatocellular carcinoma in Budd–Chiari syndrome patients.

The research team performed a PubMed search to identify all original articles that reported the prevalence and risk factors of hepatocellular carcinoma in Budd–Chiari syndrome patients.

Primary items were the prevalence and risk factors of hepatocellular carcinoma in Budd–Chiari syndrome patients.

The researchers reported that of 1487 articles identified, 16 were included.

The prevalence of hepatocellular carcinoma in Budd–Chiari syndrome is 2% to 46% in 12 Asian studies, 40% to 52% in 2 African studies, 11% in 1 European study, and 11% in 1 American study.

Irrespective of hepatitis as the underlying risk factor of hepatocellular carcinoma, the pooled prevalence of hepatocellular carcinoma was 17% in Budd–Chiari syndrome patients, 26% in inferior vena cava obstruction, and 4% in hepatic vein obstruction.

A risk factor included hepatic venous pressure gradient
European Journal of Gastroenterology & Hepatology

As patients with hepatocellular carcinoma and concomitant hepatitis were excluded, the pooled prevalence of hepatocellular carcinoma was 15% in Budd–Chiari syndrome patients.

The research team reported that heterogeneity among studies was statistically significant in these meta-analyses.

The risk factors of hepatocellular carcinoma in Budd–Chiari syndrome included hepatic venous pressure gradient and female sex in 2 Asian studies, and male sex, factor V Leiden mutation, and inferior vena cava obstruction in 1 European study.

Dr Ren's team commented, "Hepatocellular carcinoma was frequent in Budd–Chiari syndrome."

"However, there was a huge variation among studies."

"Routine surveillance for hepatocellular carcinoma is warranted in Budd–Chiari syndrome patients."

"The risk factors of hepatocellular carcinoma in Budd–Chiari syndrome may vary depending on the geographic origin of the studies."

Euro J of Gastroenterol & Hepatol 2013: 25(7): 830-841
24 June 2013

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