Cardiovascular thrombosis reduced median overall survival by half after TACE (1106 vs 2707 days) with HR 2.298 (p=0.002) in hepatocellular carcinoma patients.
Cohort (n=402)
No
Does the presence of cardiovascular thrombosis worsen overall survival in patients with hepatocellular carcinoma treated with transarterial chemoembolization?
Cardiovascular thrombosis is a major independent prognostic factor that significantly shortens overall survival and post-recurrence survival in patients with hepatocellular carcinoma undergoing transarterial chemoembolization.
Effect estimate: HR 2.298 (95% CI 1.399–4.169)
Absolute Event Rate: 1106% vs 2707%
p-value: p=0.0020
ABSTRACT Objectives Progression of hepatocellular carcinoma (HCC) and cardiovascular thrombosis (CVT) has a bidirectional causal relationship. CVT complications will increase in patients with HCC due to etiology shift from viral hepatitis to metabolic dysfunction‐related steatohepatitis. Aim This study aimed to evaluate the clinical impact of CVT, focusing on patients with HCC treated after transarterial chemoembolization. Methods A retrospective cohort study enrolled 402 patients including 79 patients with CVT in a single university hospital. Cox proportional hazard model analysis was performed to identify independent prognostic factors. After adjusting for baseline characteristics by propensity score matching, the survival impact of the CVT complication was evaluated using the Kaplan–Meier curve. Results A multivariate analysis determined that CVT complication was an independent risk factor for overall deaths in patients with HCC (HR = 1.751, IQR 1.203–2.548, p 0.05), post‐recurrence survival was shorter in patients with CVT (2150 days vs. 1008 days, HR = 1.945, IQR: 1.150–3.740, p = 0.0188). Conclusions Assuming that the expected life expectancy is only half that of uncomplicated cases of CVT, CVT might be a major prognostic factor in patients with HCC, following tumor burden and functional hepatic reserve.
FUJITA et al. (Sun,) conducted a cohort in Patients with hepatocellular carcinoma treated with transarterial chemoembolization, including those with cardiovascular thrombosis (n=402). Cardiovascular thrombosis (CVT) presence vs. No cardiovascular thrombosis was evaluated on Overall survival after TACE (HR 2.298, 95% CI 1.399–4.169, p=0.0020). Cardiovascular thrombosis reduced median overall survival by half after TACE (1106 vs 2707 days) with HR 2.298 (p=0.002) in hepatocellular carcinoma patients.
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