Clinical outcome of portal vein thrombosis in patients with digestive cancers: A large AGEO multicenter study

Regnault, Hélène; Emambux, Sheik; Lecomte, Thierry; Doat, Solène; Dhooge, Marion; Besson, M. da Rocha; Dubreuil, Olivier; Moryoussef, F.; Silvain, Christine; Bachet, Jean‐Baptiste; Tougeron, David

doi:10.1016/j.dld.2017.11.001

Cited by 11 publications

(8 citation statements)

References 25 publications

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“…In this scenario, regorafenib might have a dual beneficial effect, considering that angiogenesis is a driver of liver fibrosis [ 27 ]. Furthermore, gastrointestinal cancers have thrombotic potential and might lead to portal vein thrombosis, thereby yielding complications for patients and reducing life expectancy [ 28 , 29 ]. Here, the pleiotropic effects of regorafenib might extend treatment options with better overall management, improving survival and quality of life in these patients.…”

Section: Discussionmentioning

confidence: 99%

The multikinase inhibitor regorafenib decreases angiogenesis and improves portal hypertension

et al. 2018

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Background and AimsAngiogenesis is critically involved in the development of liver fibrosis, portal hypertension (PHT) and hepatocellular carcinoma (HCC). Regorafenib is a novel second-line therapy for HCC, but might also be beneficial in fibrosis and PHT even in absence of HCC. This study investigated the effects of regorafenib in experimental models without HCC.MethodsFibrosis (in vivo and in vitro), inflammation, liver damage (aminotransferases), angiogenesis (matrigel implantation) and in vivo systemic and portal hemodynamics were assessed in different mouse and rat models (bile duct ligation, CCl4, partial portal vein ligation) after acute and chronic treatment with regorafenib.ResultsLong-term treatment with regorafenib improved portal hypertension most likely due to blunted angiogenesis, without affecting fibrosis progression or regression. Interestingly, acute administration of regorafenib also ameliorated portal hemodynamics. Although regorafenib treatment led to hepatotoxic side effects in long-term treated fibrotic animals, in partial portal vein ligated rats, no liver toxicity due to regorafenib was observed.DiscussionRegorafenib might be especially suitable as therapy in patients with PHT and preserved liver function.

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Section: Discussionmentioning

confidence: 99%

The multikinase inhibitor regorafenib decreases angiogenesis and improves portal hypertension

et al. 2018

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“…Other researchers have noted that laparoscopic surgery may lead to portal vein thrombosis attributable to elevated intra-abdominal pressure. 12 Ogrenet al 13 reported that abdominal local infection was a risk factor for portal vein thrombosis; both patients described here had this underlying risk. However, there are no reports to date of portal vein thrombosis caused by chemotherapy.…”

Section: Discussionmentioning

confidence: 58%

Portal vein thrombosis secondary to postoperative gastric cancer: Report of two cases

et al. 2019

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Few cases of portal vein thrombosis secondary to gastric cancer surgery have been reported. Here we report the diagnosis and management of two such cases. Case 1: Gastric carcinoma with acute hematemesis was detected by endoscopy in the gastric body of a 48-year-old woman. Histologic examination revealed signet-ring cell carcinoma with marked invasion of the vessels and nerves. Laparoscopic partial gastrectomy and Roux-en-Y gastrogastrostomy were performed. One month after surgery, imaging examination showed the formation of thrombi in the main portal vein and the right hepatic vein. Case 2: Gastric carcinoma with pyloric obstruction was clinically diagnosed in a 66-year-old woman. Laparoscopic partial gastrectomy and Billroth Roux-en-Y gastrogastrostomy were again performed. Two months after surgery, an abdominal imaging examination detected a thrombus in the right hepatic vein. Clinicians should consider portal vein thrombosis in patients with hyperthermia combined with an abnormal increase in procalcitonin.

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“…While the true incidence of SVT remains unclear, as many cases remain undiagnosed, the hospitalization rates are clearly higher for hepatic cancer associated SVT than the other GI tumors. A large, multi-hospital study analyzing PVT in patients with gastrointestinal tumors, excluding HCC, showed similar trends, with pancreatic adenocarcinoma and colorectal cancer accounting for about 75% of all cases [14]. PVTs are present in 10–40% of HCC at the time of diagnosis and are an adverse prognostic factor, noted to be associated with a higher rate of hospitalization than the other GI malignancies [15].…”

Section: Discussionmentioning

confidence: 95%

“…Interestingly, males were noted to be more likely to be hospitalized due to SVTs in hepatic and esophageal cancer, with females instead being more commonly admitted for SVT related to pancreatic cancer. According to Regnault et al [14], the male gender was more at risk to develop PVT in all digestive cancer patients. In the same study, male sex also was noted to be a risk factor for gastrointestinal bleeding associated with portal hypertension (PHT), a known and frequent complication of PVT.…”

Section: Discussionmentioning

confidence: 99%

Trends and In-Hospital Outcomes of Splanchnic Vein Thrombosis Associated with Gastrointestinal Malignancies: A Nationwide Analysis

Handa

Gupta

Sterpi

et al. 2021

Gastrointest Tumors

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Introduction: Gastrointestinal cancers have a strong association with splanchnic vein thrombosis (SVT), yet the hospitalization data is unknown. Objective and Methods: We analyzed around 78 million discharges from the 2007–2017 Nationwide Inpatient Sample with an inclusion criterion of adult patients admitted for portal or hepatic vein thrombosis as a primary diagnosis with a gastrointestinal or hepatobiliary malignancy as a secondary diagnosis. The outcomes were in-hospital mortality, complication rates, and resource utilization. Odds ratios (OR) and means were adjusted for confounders using multivariate regression analysis models. Results: Out of the total 32,324 hospitalizations for SVT, 3,220 (10%) were associated with a GI malignancy, of which hepatocellular carcinoma (HCC) and pancreatic cancer were the most common. Portal vein thrombosis accounted for 95% of these hospitalizations. Admissions for pancreatic cancer-associated SVT have increased by 7.2 times from 2007 to 2017. Patients with SVT and concomitant GI malignancies were significantly older and had a higher comorbidity score than those with SVT without GI malignancy. Risk of inpatient mortality for SVT patients were significantly higher for patients with gastric cancer (rate: 12.1%, OR 8.6, 95% CI: 1.8–39.7) and HCC (rate: 7.6%, OR 2.77, 95% CI 1.5–4.8) as compared to non-GI malignancy-related SVT. Odds of variceal bleeding were significantly higher for patients with HCC (OR 1.67, 95% CI: 1.2–2.34) than patients without GI malignancy. Conclusions: Digestive cancer-associated SVTs constitute 10% of all SVT related hospitalizations and are significantly increasing in the past decade. We report the baseline characteristics and predictors of inpatient mortality in this study.

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Clinical outcome of portal vein thrombosis in patients with digestive cancers: A large AGEO multicenter study

Cited by 11 publications

References 25 publications

The multikinase inhibitor regorafenib decreases angiogenesis and improves portal hypertension

The multikinase inhibitor regorafenib decreases angiogenesis and improves portal hypertension

Portal vein thrombosis secondary to postoperative gastric cancer: Report of two cases

Trends and In-Hospital Outcomes of Splanchnic Vein Thrombosis Associated with Gastrointestinal Malignancies: A Nationwide Analysis

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