The impact of clinically significant portal hypertension on the prognosis of patients with hepatocellular carcinoma after radiofrequency ablation: a propensity score matching analysis

Kuan Chieh Fang, Chien Wei Su, Yi You Chiou, Pei Chang Lee, Nai Chi Chiu, Chien An Liu, Ping Hsien Chen, Wei Yu Kao, Yi Hsiang Huang, Teh Ia Huo, Ming Chih Hou, Han Chieh Lin, Jaw Ching Wu

Research output: Contribution to journalArticle

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Abstract

Objectives: To assess the impact of clinically significant portal hypertension (CSPH) on the prognosis of patients with hepatocellular carcinoma (HCC) undergoing radiofrequency ablation (RFA). Methods: We retrospectively enrolled 280 treatment-naïve early-stage HCC patients who had Child–Pugh grade A or B and received upper gastrointestinal endoscopy at the time of HCC diagnosis. CSPH was defined as (1) a platelet count < 100,000/mm3 associated with splenomegaly and/or (2) the presence of oesophageal/gastric varices by endoscopy. Factors determining poor overall survival and recurrence after RFA were analysed by Cox proportional hazards model and propensity score matching analysis. Results: A total of 192 (68.6 %) patients had CSPH. The cumulative 5-year survival rates were 50.6 % and 76.7 % in patients with and without CSPH, respectively (p = 0.015). Based on multivariate analysis, age > 65 years (hazard ratio (HR) 1.740, p = 0.025), serum albumin levels ≤ 3.5 g/dL (HR 3.268, p < 0.001) and multiple tumours (HR 1.693, p = 0.046), but not CSPH, were independent risk factors associated with poor overall survival after RFA. Moreover, the overall survival rates were comparable between patients with and without CSPH after adjusting for confounding factors via propensity score matching analysis. Conclusions: CSPH was not associated with poor outcomes after RFA. Key points: • CSPH was common in HCC patients who underwent RFA therapy. • CSPH was not an independent risk factor in determining poor prognosis. • Serum albumin level was more important to determine the outcomes.

Original languageEnglish
Pages (from-to)2600-2609
Number of pages10
JournalEuropean Radiology
Volume27
Issue number6
DOIs
Publication statusPublished - Jun 1 2017

Fingerprint

Propensity Score
Portal Hypertension
Hepatocellular Carcinoma
Serum Albumin
Gastrointestinal Endoscopy
Platelet Count
Survival Rate
Survival
Therapeutics

Keywords

  • Hepatocellular carcinoma
  • Oesophageal varices
  • Portal hypertension
  • Prognosis
  • Radiofrequency ablation

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging

Cite this

The impact of clinically significant portal hypertension on the prognosis of patients with hepatocellular carcinoma after radiofrequency ablation : a propensity score matching analysis. / Fang, Kuan Chieh; Su, Chien Wei; Chiou, Yi You; Lee, Pei Chang; Chiu, Nai Chi; Liu, Chien An; Chen, Ping Hsien; Kao, Wei Yu; Huang, Yi Hsiang; Huo, Teh Ia; Hou, Ming Chih; Lin, Han Chieh; Wu, Jaw Ching.

In: European Radiology, Vol. 27, No. 6, 01.06.2017, p. 2600-2609.

Research output: Contribution to journalArticle

Fang, Kuan Chieh ; Su, Chien Wei ; Chiou, Yi You ; Lee, Pei Chang ; Chiu, Nai Chi ; Liu, Chien An ; Chen, Ping Hsien ; Kao, Wei Yu ; Huang, Yi Hsiang ; Huo, Teh Ia ; Hou, Ming Chih ; Lin, Han Chieh ; Wu, Jaw Ching. / The impact of clinically significant portal hypertension on the prognosis of patients with hepatocellular carcinoma after radiofrequency ablation : a propensity score matching analysis. In: European Radiology. 2017 ; Vol. 27, No. 6. pp. 2600-2609.
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T2 - a propensity score matching analysis

AU - Fang, Kuan Chieh

AU - Su, Chien Wei

AU - Chiou, Yi You

AU - Lee, Pei Chang

AU - Chiu, Nai Chi

AU - Liu, Chien An

AU - Chen, Ping Hsien

AU - Kao, Wei Yu

AU - Huang, Yi Hsiang

AU - Huo, Teh Ia

AU - Hou, Ming Chih

AU - Lin, Han Chieh

AU - Wu, Jaw Ching

PY - 2017/6/1

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N2 - Objectives: To assess the impact of clinically significant portal hypertension (CSPH) on the prognosis of patients with hepatocellular carcinoma (HCC) undergoing radiofrequency ablation (RFA). Methods: We retrospectively enrolled 280 treatment-naïve early-stage HCC patients who had Child–Pugh grade A or B and received upper gastrointestinal endoscopy at the time of HCC diagnosis. CSPH was defined as (1) a platelet count < 100,000/mm3 associated with splenomegaly and/or (2) the presence of oesophageal/gastric varices by endoscopy. Factors determining poor overall survival and recurrence after RFA were analysed by Cox proportional hazards model and propensity score matching analysis. Results: A total of 192 (68.6 %) patients had CSPH. The cumulative 5-year survival rates were 50.6 % and 76.7 % in patients with and without CSPH, respectively (p = 0.015). Based on multivariate analysis, age > 65 years (hazard ratio (HR) 1.740, p = 0.025), serum albumin levels ≤ 3.5 g/dL (HR 3.268, p < 0.001) and multiple tumours (HR 1.693, p = 0.046), but not CSPH, were independent risk factors associated with poor overall survival after RFA. Moreover, the overall survival rates were comparable between patients with and without CSPH after adjusting for confounding factors via propensity score matching analysis. Conclusions: CSPH was not associated with poor outcomes after RFA. Key points: • CSPH was common in HCC patients who underwent RFA therapy. • CSPH was not an independent risk factor in determining poor prognosis. • Serum albumin level was more important to determine the outcomes.

AB - Objectives: To assess the impact of clinically significant portal hypertension (CSPH) on the prognosis of patients with hepatocellular carcinoma (HCC) undergoing radiofrequency ablation (RFA). Methods: We retrospectively enrolled 280 treatment-naïve early-stage HCC patients who had Child–Pugh grade A or B and received upper gastrointestinal endoscopy at the time of HCC diagnosis. CSPH was defined as (1) a platelet count < 100,000/mm3 associated with splenomegaly and/or (2) the presence of oesophageal/gastric varices by endoscopy. Factors determining poor overall survival and recurrence after RFA were analysed by Cox proportional hazards model and propensity score matching analysis. Results: A total of 192 (68.6 %) patients had CSPH. The cumulative 5-year survival rates were 50.6 % and 76.7 % in patients with and without CSPH, respectively (p = 0.015). Based on multivariate analysis, age > 65 years (hazard ratio (HR) 1.740, p = 0.025), serum albumin levels ≤ 3.5 g/dL (HR 3.268, p < 0.001) and multiple tumours (HR 1.693, p = 0.046), but not CSPH, were independent risk factors associated with poor overall survival after RFA. Moreover, the overall survival rates were comparable between patients with and without CSPH after adjusting for confounding factors via propensity score matching analysis. Conclusions: CSPH was not associated with poor outcomes after RFA. Key points: • CSPH was common in HCC patients who underwent RFA therapy. • CSPH was not an independent risk factor in determining poor prognosis. • Serum albumin level was more important to determine the outcomes.

KW - Hepatocellular carcinoma

KW - Oesophageal varices

KW - Portal hypertension

KW - Prognosis

KW - Radiofrequency ablation

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