Budd–Chiari Syndrome: East versus West

Chaubal, Alisha; Shukla, Akash

doi:10.1007/978-981-32-9232-1_18

Cited by 2 publications

(1 citation statement)

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“…Table 6 details studies reporting the prevalence of BCS-HCC among patients with BCS. The higher prevalence in Africa and Japan compared to Western countries and India may be due to differences in the patient populations, the follow-up periods, the underlying etiology of BCS, the severity of cirrhosis at the time of diagnosis, and the exclusion or inclusion of patients with chronic viral hepatitis[ 19 , 20 ]. Many previous studies that reported the association of HCC with BCS included cases with HBV or HCV co-infection[ 7 , 21 - 23 ].…”

Section: Discussionmentioning

confidence: 99%

Clinical profile and outcomes of hepatocellular carcinoma in primary Budd-Chiari syndrome

Agarwal,

Biswas,

Swaroop

et al. 2024

World J Gastrointest Oncol

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BACKGROUND There is scant literature on hepatocellular carcinoma (HCC) in patients with Budd-Chiari syndrome (BCS). AIM To assess the magnitude, clinical characteristics, feasibility, and outcomes of treatment in BCS-HCC. METHODS A total of 904 BCS patients from New Delhi, India and 1140 from Mumbai, India were included. The prevalence and incidence of HCC were determined, and among patients with BCS-HCC, the viability and outcomes of interventional therapy were evaluated. RESULTS In the New Delhi cohort of 35 BCS-HCC patients, 18 had HCC at index presentation (prevalence 1.99%), and 17 developed HCC over a follow-up of 4601 person-years, [incidence 0.36 (0.22-0.57) per 100 person-years]. BCS-HCC patients were older when compared to patients with BCS alone (P = 0.001) and had a higher proportion of inferior vena cava block, cirrhosis, and long-segment vascular obstruction. The median alpha-fetoprotein level was higher in patients with BCS-HCC at first presentation than those who developed HCC at follow-up (13029 ng/mL vs 500 ng/mL, P = 0.01). Of the 35 BCS-HCC, 26 (74.3%) underwent radiological interventions for BCS, and 22 (62.8%) patients underwent treatment for HCC [transarterial chemoembolization in 18 (81.8%), oral tyrosine kinase inhibitor in 3 (13.6%), and transarterial radioembolization in 1 (4.5%)]. The median survival among patients who underwent interventions for HCC compared with those who did not was 3.5 years vs 3.1 mo (P = 0.0001). In contrast to the New Delhi cohort, the Mumbai cohort of BCS-HCC patients were predominantly males, presented with a more advanced HCC [Barcelona Clinic Liver Cancer C and D], and 2 patients underwent liver transplantation. CONCLUSION HCC is not uncommon in patients with BCS. Radiological interventions and liver transplantation are feasible in select primary BCS-HCC patients and may improve outcomes.

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