Characteristics of HCC Patients with Portal Vein Thrombosis: Albumin and Survival.

INTRODUCTION

Presence of macroscopic portal vein thrombosis (PVT) in patients with hepatocellular carcinoma (HCC) has been found to be a major poor prognosis characteristic.

AIMS: The aim of the study was to examine patients with PVT for their clinical characteristics and factors related to both PVT and survival.

METHODS

A large HCC database containing 1,094 patients with PVT and 2,513 patients without PVT was examined. Patients had routine baseline serum liver parameters and alpha-fetoprotein (AFP) levels measured, as well as radiological assessment of maximum tumor diameter (MTD), tumor number, presence of macroscopic PVT, plus survival.

RESULTS

The percent of patients with PVT increased with increase in both MTD and serum AFP levels and liver parameter levels were worse in patients with PVT than without it. A logistic regression model showed that the combination of MTD >5 cm plus AFP >100 IU/mL plus albumin <3.5 g/dL had an odds ratio of 10.988 for the presence of PVT. Normal serum albumin levels significantly reduced the hazard ratio for death in a Cox proportional hazard model and were associated with decreased liver failure.

CONCLUSION

Logistic regression showed the significance of MTD, AFP, and albumin in the presence of PVT, and the Cox model highlighted the importance of albumin levels in decreasing death.