Document Detail

Patients with cirrhosis and bare-stent TIPS may have increased risk of hepatocellular carcinoma.
MedLine Citation:
PMID:  15726654     Owner:  NLM     Status:  MEDLINE    
A trend toward a higher incidence of hepatocelullar carcinoma (HCC) in patients with cirrhosis treated with bare-stent transjugular intrahepatic portosystemic shunt (TIPS) has been observed in previous studies. To assess the influence of TIPS as a risk factor for developing HCC, we have compared the incidence of HCC in two retrospective cohorts of patients. The TIPS cohort (n = 138) included patients with cirrhosis who underwent TIPS placement for the treatment of portal hypertension-related complications; the non-TIPS cohort was composed of patients admitted at the hospital at the same time of TIPS insertion who were individually matched 1:1 according to age, sex, Child-Turcotte-Pugh class, and cause of cirrhosis. A stratified Cox model was used to assess risk of HCC development. The median time of follow-up was similar in TIPS and non-TIPS cohorts (30.3 [range, 7.8-119.5] and 31.4 [range, 7.8-110.8] months, respectively). The cumulative probability of developing HCC at 1, 3, and 5 years was 3%, 24%, and 34% for the TIPS cohort and 1%, 6%, and 25%, for the non-TIPS cohort, respectively (Breslow test = 5.23, P = .022). The adjusted hazard ratio was 1.52 (95% confidence interval, 1.06-2.19; P = .02). Hepatitis C virus infection and age were independent predictors of HCC development in patients without TIPS. In conclusion, patients with cirrhosis who are treated with TIPS may have a higher incidence of HCC. This observation suggests the need for a strict HCC surveillance program for these patients, especially if they are not expected to undergo a short- or medium-term liver transplantation.
Rafael Bañares; Oscar Núñez; María Escudero; Cristina Fernández; Javier Vaquero; Inmaculada Beceiro; Antonio Echenagusía; Gerardo Clemente; Leandro Santos
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Hepatology (Baltimore, Md.)     Volume:  41     ISSN:  0270-9139     ISO Abbreviation:  Hepatology     Publication Date:  2005 Mar 
Date Detail:
Created Date:  2005-02-28     Completed Date:  2005-03-17     Revised Date:  2005-11-22    
Medline Journal Info:
Nlm Unique ID:  8302946     Medline TA:  Hepatology     Country:  United States    
Other Details:
Languages:  eng     Pagination:  566-71     Citation Subset:  IM    
Liver Unit, Department of Gastroenterology, Hospital Gregorio Marañón, Madrid, Spain.
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MeSH Terms
Carcinoma, Hepatocellular / etiology*
Cohort Studies
Liver Cirrhosis / complications*
Liver Neoplasms / etiology*
Middle Aged
Portasystemic Shunt, Transjugular Intrahepatic / adverse effects*
Retrospective Studies
Comment In:
Nat Clin Pract Gastroenterol Hepatol. 2005 Jun;2(6):256-7   [PMID:  16265225 ]
Hepatology. 2005 Jul;42(1):236; author reply 236-7   [PMID:  15892064 ]

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