OBJECTIVES: Portal hypertension has been reported as a negative prognostic factor and a relative contraindication for liver resection. This study considers a possible role of fibrosis evaluation by transient elastography (FibroScan(®)) and its correlation with portal hypertension in patients with cirrhosis, and discusses the use of this technique in planning therapeutic options in patients with hepatocellular carcinoma (HCC). METHODS: A total of 77 patients with cirrhosis, 42 (54.5%) of whom had HCC, were enrolled in this study during 2009-2011. The group included 46 (59.7%) men. The mean age of the sample was 65.2 years. The principle aetiology of disease was hepatitis C virus (HCV)-related cirrhosis (66.2%). Liver function was assessed according to Child-Pugh classification. In all patients liver stiffness (LS) was measured using FibroScan(®). The presence of portal hypertension was indirectly defined as: (i) oesophageal varices detectable on endoscopy; (ii) splenomegaly (increased diameter of the spleen to ≥ 12 cm), or (iii) a platelet count of <100,000 platelets/mm(3). RESULTS: Median LS in all patients was 27.9 kPa. Portal hypertension was recorded as present in 37 patients (48.1%) and absent in 40 patients (51.9%). Median LS values in HCC patients with and without portal hypertension were 29.1 kPa and 19.6 kPa, respectively (r = 0.26, P < 0.04). Liver stiffness was used to implement the Barcelona Clinic Liver Cancer algorithm in decisions about treatment. CONCLUSIONS: The evaluation of liver fibrosis by transient elastography may be useful in the follow-up of patients with cirrhosis and a direct correlation with portal hypertension may aid in the evaluation of surgical risk in patients with HCC and in the choice of alternative therapies.
OBJECTIVES: Portal hypertension has been reported as a negative prognostic factor and a relative contraindication for liver resection. This study considers a possible role of fibrosis evaluation by transient elastography (FibroScan(®)) and its correlation with portal hypertension in patients with cirrhosis, and discusses the use of this technique in planning therapeutic options in patients with hepatocellular carcinoma (HCC). METHODS: A total of 77 patients with cirrhosis, 42 (54.5%) of whom had HCC, were enrolled in this study during 2009-2011. The group included 46 (59.7%) men. The mean age of the sample was 65.2 years. The principle aetiology of disease was hepatitis C virus (HCV)-related cirrhosis (66.2%). Liver function was assessed according to Child-Pugh classification. In all patientsliver stiffness (LS) was measured using FibroScan(®). The presence of portal hypertension was indirectly defined as: (i) oesophageal varices detectable on endoscopy; (ii) splenomegaly (increased diameter of the spleen to ≥ 12 cm), or (iii) a platelet count of <100,000 platelets/mm(3). RESULTS: Median LS in all patients was 27.9 kPa. Portal hypertension was recorded as present in 37 patients (48.1%) and absent in 40 patients (51.9%). Median LS values in HCC patients with and without portal hypertension were 29.1 kPa and 19.6 kPa, respectively (r = 0.26, P < 0.04). Liver stiffness was used to implement the Barcelona Clinic Liver Cancer algorithm in decisions about treatment. CONCLUSIONS: The evaluation of liver fibrosis by transient elastography may be useful in the follow-up of patients with cirrhosis and a direct correlation with portal hypertension may aid in the evaluation of surgical risk in patients with HCC and in the choice of alternative therapies.
Authors: Jean-Nicolas Vauthey; Elijah Dixon; Eddie K Abdalla; W Scott Helton; Timothy M Pawlik; Bachir Taouli; Antoine Brouquet; Reid B Adams Journal: HPB (Oxford) Date: 2010-06 Impact factor: 3.647
Authors: Seung Up Kim; Young Chul Kim; Ji Soo Choi; Kyung Sik Kim; Gi Hong Choi; Jin Sub Choi; Jun Yong Park; Do Young Kim; Sang Hoon Ahn; Eun Hee Choi; Young Nyun Park; Chae Yoon Chon; Kwang-Hyub Han; Myeong-Jin Kim Journal: Magn Reson Imaging Date: 2010-04-15 Impact factor: 2.546
Authors: Krit Kitisin; Vignesh Packiam; Jennifer Steel; Abhinav Humar; T Clark Gamblin; David A Geller; J Wallis Marsh; Allan Tsung Journal: HPB (Oxford) Date: 2011-08-11 Impact factor: 3.647
Authors: Seung Up Kim; Sang Hoon Ahn; Jun Yong Park; Do Young Kim; Chae Yoon Chon; Jin Sub Choi; Kyung Sik Kim; Kwang-Hyub Han Journal: Hepatol Int Date: 2008-09-09 Impact factor: 6.047
Authors: Antonio Pesce; Giovanni Li Destri; Francesca Flavia Amore; Gaetano Magro; Gaetano La Greca; Stefano Puleo Journal: Ann Med Surg (Lond) Date: 2019-10-04