Macroscopic Portal Vein Thrombosis in HCC Patients

Hikmet Akkiz, Brian I Carr, Sedef Kuran, Ümit Karaoğullarından, Oguz Üsküdar, Salih Tokmak, Burcu Arslan, Figen Doran, Hüseyin Tugsan Balli, Abdulalh Ülkü, Tolga Atılgan Akçam, Halil İbrahim Bahçeci, Kamil Yalçın Polat, Necati Örmeci, Halis Şimşek, Abdullah Sonsuz, Ali Demir, Engin Altıntaş, Mehmet Demir, Kendal YalçınNazım Ekinci, Ayşegül Harmancı Özakyol, Mehmet Yücesoy, Ahmet Uygun, Vito Guerra, Anıl Delik, Yaman Tokat, Sezai Yilmaz, Ahmet Bektaş, Murat Kılıç

Research output: Contribution to journalArticlepeer-review

Abstract

Macroscopic portal vein invasion (PVT) by hepatocellular carcinoma (HCC) in the liver is one of the most important negative prognostic factors for HCC patients. The characteristics of a large cohort of such patients were examined. We found that the percent of patients with PVT significantly increased with increasing maximum tumor diameter (MTD), from 13.7% with tumors of MTD <5cm to 56.4% with tumors of MTD >10cm. There were similar numbers of HCC patients with very large tumors with and without PVT. Thus, MTD alone was insufficient to explain the presence of PVT, as were high AFP levels, since less than 50% of high AFP patients had PVT. However, the percent of patients with PVT was also found to significantly increase with increasing blood alpha-fetoprotein (AFP) levels and tumor multifocality. A logistic regression model that included these 3 factors together showed an odds ratio of 17.9 for the combination of MTD>5.0cm plus tumor multifocality plus elevated AFP, compared to low levels of these 3 parameters. The presence or absence of macroscopic PVT may therefore represent different HCC aggressiveness phenotypes, as judged by a significant increase in tumor multifocality and AFP levels in the PVT positive patients. Factors in addition to MTD and AFP must also contribute to PVT development.

Original languageEnglish
Pages (from-to)3120185
Number of pages8
JournalCanadian Journal of Gastroenterology and Hepatology
Volume2018
DOIs
Publication statusPublished - 2018

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