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 25 June 2018

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News

Increased risk of hepatocellular carcinoma with transjugular shunt

Findings in the recent issue of Hepatology suggest the need for a strict hepatocelullar carcinoma surveillance program for patients, especially if they are not expected to undergo a liver transplantation.

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A trend toward a higher incidence of hepatocelullar carcinoma in patients with cirrhosis treated with bare-stent transjugular intrahepatic portosystemic shunt has been observed in previous studies.

Dr Bañares and colleagues from Spain assessed the influence of transjugular intrahepatic portosystemic shunt as a risk factor for developing hepatocelullar carcinoma.

The researchers compared the incidence of hepatocellular carcinoma in 2 retrospective cohorts of patients.

The research team included in the transjugular intrahepatic portosystemic shunt cohort patients with cirrhosis who underwent transjugular intrahepatic portosystemic shunt placement for the treatment of portal hypertension-related complications (n= 138).

The team used a non- transjugular intrahepatic portosystemic shunt control group composed of patients admitted at the hospital at the same time of transjugular intrahepatic portosystemic shunt insertion group.

Hep C is a predictor of hepatocelullar carcinoma in patients without transjugular intrahepatic portosystemic shunt
Hepatology

The researchers ensured that the groups were individually matched 1:1 according to age, sex, Child-Turcotte-Pugh class, and cause of cirrhosis.

A stratified Cox model was used by the researchers to assess risk of hepatocelullar carcinoma development.

The investigators found that he median time of follow-up was similar in transjugular intrahepatic portosystemic shunt and non- transjugular intrahepatic portosystemic shunt cohorts; 30.3 and 31.4 months, respectively.

The researchers also showed that the probability of developing hepatocelullar carcinoma at 1, 3, and 5 years was 3%, 24%, and 34% for the transjugular intrahepatic portosystemic shunt cohort and 1%, 6%, and 25%, for the control, respectively, with a hazard ratio of 1.52.

Hepatitis C virus infection and age were independent predictors of hepatocelullar carcinoma development in patients without transjugular intrahepatic portosystemic shunt.

Dr Bañares concluded, “Patients with cirrhosis who are treated with transjugular intrahepatic portosystemic shunt may have a higher incidence of hepatocelullar carcinoma.”

“This observation suggests the need for a strict hepatocelullar carcinoma surveillance program for these patients, especially if they are not expected to undergo a short- or medium-term liver transplantation.”

Hepatology 2005: 41(3): 566-571
25 February 2005

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