| Patients with cirrhosis and bare-stent TIPS may have increased risk of hepatocellular carcinoma. | |
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MedLine Citation:
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PMID: 15726654 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Rafael Bañares; Oscar Núñez; María Escudero; Cristina Fernández; Javier Vaquero; Inmaculada Beceiro; Antonio Echenagusía; Gerardo Clemente; Leandro Santos |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Hepatology (Baltimore, Md.) Volume: 41 ISSN: 0270-9139 ISO Abbreviation: Hepatology Publication Date: 2005 Mar |
Date Detail:
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Created Date: 2005-02-28 Completed Date: 2005-03-17 Revised Date: 2005-11-22 |
Medline Journal Info:
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Nlm Unique ID: 8302946 Medline TA: Hepatology Country: United States |
Other Details:
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Languages: eng Pagination: 566-71 Citation Subset: IM |
Affiliation:
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Liver Unit, Department of Gastroenterology, Hospital Gregorio Marañón, Madrid, Spain. rbarnares@telefonica.net |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Aged Carcinoma, Hepatocellular / etiology* Cohort Studies Female Humans Liver Cirrhosis / complications* Liver Neoplasms / etiology* Male Middle Aged Portasystemic Shunt, Transjugular Intrahepatic / adverse effects* Probability Retrospective Studies Risk |
| Comments/Corrections | |
Comment In:
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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 ] |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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