Prevalence and Prognostic Significance of the Presence of Esophageal Varices in Patients With Hepatocellular Carcinoma

External Validation of the Platelet Count/Spleen Diameter Ratio for the Diagnosis of Esophageal Varices in Hepatitis C Virus-Related Cirrhosis

“…Varices screening allows identification of patients at risk of bleeding and may determine therapeutic decisions. Furthermore, presence of varices is an independent prognostic determinant in cirrhotic patients with and without hepatocellular carcinoma [33,34]. The platelet count/spleen diameter ratio is a clinical parameter that has recently been proposed for the non-invasive diagnosis of EV in patients with cirrhosis [20].…”

Hepatocellular carcinoma in patients with hepatitis C virus-related chronic liver disease

“…This outcome differs markedly from patients with alcohol-related cirrhosis, the complications of liver failure and portal hypertension being still the leading cause of death [36] , a difference that could be in part explained by compliance of patients to clinical management. For instance, the rates of endoscopic screening of oesophageal varices and preventive measures for haemorrhage or bacterial infection is not clearly stated in most published studies [37] .…”

Improving survival of cirrhosis patients with hepatocellular carcinoma through application of standard of care

“…This finding is clinically meaningful, as we have previously shown that in patients with HCC the presence of varices is independently associated with death, and death due to bleeding is significantly more frequent in patients with varices. 10 However, due to insufficient data our study was not able to identify whether the presence of varices simply identified patients with more advanced disease-and therefore at higher risk of bleeding and death-and which was the proportion of patients on bleeding prophylaxis. In this regard, the study by Ripoll et al shows us that cirrhosis patients with HCC who bled received a suboptimal management, and puts forward the hypothesis that this may be due to the perception that intensive management would not result in a meaningful clinical benefit when HCC is present.…”