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KMID : 1039320140140010023
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Journal of Liver Cancer
2014 Volume.14 No. 1 p.23 ~ p.30
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Hepatic Venous Pressure Gradient and Associated Factors in Survival Prediction in Patients with Liver Cirrhosis and Early and Very Early Hepatocellular Carcinoma
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Kim Tae-Yeob
Kim Moon-Young
Jang Jae-Young
Suk Ki-Tae
Jung Seung-Won
Kim Dong-Joon
Sohn Joo-Hyun
Baik Soon-Koo
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Abstract
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Background/Aims: To analyze the usefulness of hepatic venous pressure gradient (HVPG) in survival prediction in cirrhotic patients with early and very early hepatocellular carcinoma (HCC).
Methods: We consecutively collected data of 45 stable cirrhotic patients (male 41, median age 57.2 years, BCLC A 29) with early-stage HCC undergoing HVPG measurement. Prognostic accuracy of HVPG was analyzed by the area under curve (AUC). Survival curves and the associated factors of HVPG status were obtained using Kaplan-Meier method and logistic regression analysis, respectively.
Results: The AUC value for prediction of survival by HVPG were 0.754 (95% CI, 0.603-0.870, P=0.006). The cut-off value of HVPG to predict death was 12 mmHg. Among the 45 patients, 11 patients (24.4%) died: 11 of 28 patients in the high HVPG group and none of 17 patients in the low HVPG group during followup period (P=0.003). The survival rate with high HVPG group was higher than those of low HVPG group (log rank P=0.008). In Child-Turcott-Pugh (CTP) class, the survival rate with CTP A class was higher than that with CTP B class (log rank P<0.001). The only associated factor with HVPG ≥12 mmHg in CTP A class and early-stage HCC was the presence of medium or large sized esophageal varices (odds ratio 66.8, 95% CI, 1.3-3530.4, P=0.038).
Conclusions: HVPG ≥12 mmHg may be suggested a predictor of survival in cirrhotic patients with early-stage HCC. In CTP A class, the presence of medium or large sized esophageal varices were associated with high HVPG.
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KEYWORD
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Cirrhosis, Hepatic venous pressure gradient, Hepatocellular carcinoma, Survival, Prognosis
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