Portal vein thrombosis in hepatocellular carcinoma: age and sex distribution in an autopsy study

Abstract

The purpose of this work was to investigate the prevalence, associated features and effect on survival of portal vein thrombosis (PVT) complicating hepatocellular carcinoma (HCC). The autopsy data of a series of 72 consecutive patients (57 male, 15 female) with HCC were reviewed. PVT was found in 32/72 patients (44%), and tended to be more common in female patients (10/15 versus 22/57, P = 0.052). Stratifying the data according to gender, it appeared that the mean age of patients with PVT compared to those without was greater in woman (71.9 +/- 5.9 versus 63.2 +/- 6.9 years, P = 0.024) and younger in men (58.8 +/- 8.9 versus 66.0 +/- 9.9 years, P = 0.007). When PVT was present, it was more likely that a definite diagnosis of HCC had been obtained before autopsy (P = 0.0001) and that death had been caused by bleeding complications (P = 0.007). Median survival times were similar, irrespective of the presence of PVT. During the natural history of HCC, PVT occurs in a substantial proportion of patients. Hormonal factors may have a permissive role in thrombus formation or neoplastic vascular invasion. Although in the presence of PVT a diagnosis of HCC is rarely missed and bleeding complications are likely to occur, patient survival does not seem to be significantly affected.

Association of serum levels of epidermal growth factor with disease severity in patients with unresectable hepatocellular carcinoma

“…Vascular invasion was found in 23.5% in our HCC patients. These results are not congruous with the results of Pirisi et al [17] which showed that the portal vein thrombosis represented 44% in an autopsied HCC specimen. Another study done by Abdel-Wahab et al [18] documented that only 15.9% had portal vein thrombosis.…”

Incidence, risk factors and consequences of portal vein and systemic thromboses in hepatocellular carcinoma

“…(25,(28)(29)(30)(31)(32) However, little is known about factors predictive for PVT in patients with HCC. In a single autopsy study of 72 patients with HCC PVT was found in 44%, and female sex and older age were identified as predictive factors (26).…”

“…Like most cancers, HCC is also associated with hemostatic activation, with a reported incidence of PVT ranging from 20%-65% (24)(25)(26)(27). As with other cancer-associated thromboses, the presence of PVT in patients with HCC is associated with reduced survival.…”

Efficacy of therapy for hepatocellular carcinoma with portal vein tumor thrombus

“…It has high morbidity even in small-cell hepatic carcinoma. 1 Chau studied 37 resected specimens whose diameters were less than 2 cm, and 40.5% of these specimens showed vein tumor embolisms under light microscopy. 2 At the same time, the prognosis of hepatic carcinoma with PVTT is very poor.…”

“…1 The prevalence of PVTT is very high even in small-cell hepatocellular carcinoma (HCC). 2 The prognosis of HCC combined with PVTT is poor.…”