Deep Vein Thrombosis Research Today is a free monthly online journal that collates and summarizes the latest research about Deep Vein Thrombosis, including details on dvt, prevention, effects, causes, air travel, blood clots.

Prognostic index for patients with hepatocellular carcinoma combined with tumor thrombosis in the major portal vein.

Ikai I, Hatano E, Hasegawa S, Fujii H, Taura K, Uyama N, Shimahara Y

Department of Gastroenterological Surgery, Kyoto University Graduate School of Medicine, Kyoto, Japan. ikai@kuhp.kyoto-u.ac.jp

BACKGROUND: This study sought to analyze prognostic factors in patients with hepatocellular carcinoma and tumor thrombosis in the first branch or trunk of the portal vein, and to provide a prognostic index. STUDY DESIGN: We performed a retrospective cohort study of 78 consecutive patients with hepatocellular carcinoma and tumor thrombosis in the first branch or trunk of the portal vein who underwent liver resection. Multivariate analysis of survival used the Cox's proportional hazard model. RESULTS: Median survival time and 3-year survival rate were 0.74 years and 21.7%, respectively. Six factors, ie, absence of ascites, average elimination rate constant of indocyanine green, prothrombin activity, serum albumin level, maximal tumor diameter, and blood loss at operation were univariately related to survival time. By multivariate analysis, absence of ascites (hazard ratio, 2.23; 95% confidence interval, 1.10 to 4.52; p = 0.027), prothrombin activity > or = 75% (hazard ratio, 2.37; confidence interval, 1.30 to 4.32; p = 0.005), and maximal tumor diameter < 5 cm (hazard ratio, 2.37; confidence interval, 1.14 to 4.94; p = 0.021) were independent prognostic factors with similar hazard ratios. We calculated a prognostic index from these factors as follows: (ascites: absent = 0, present = 1) + (prothrombin activity: > or = 75% = 0, < 75% = 1) + (maximal tumor diameter: < 5 cm = 0, > or = 5 cm = 1). This index provided good stratification ability (log-rank, p < 0.001). Median survival times for patients with prognostic index 0, 1, 2, and 3 were 5.6, 1.6, 0.5, and 0.1 years, respectively. CONCLUSION: This prognostic index is a useful for making appropriate treatment strategy decisions for patients with hepatocellular carcinoma and tumor thrombosis in the major portal vein.

Published 27 February 2006 in J Am Coll Surg, 202(3): 431-8.
Full-text of this article is available online (may require subscription).

© 2004-2008 Deep Vein Thrombosis Research Today. All Rights Reserved.