Brian I Carr1, Vito Guerra2. 1. Izmir Biomedicine and Genome Center, Dokuz Eylul University, Izmir, Turkey. brianicarr@hotmail.com. 2. IRCCS de Bellis, National Institute for Digestive Diseases, Castellana Grotte, Italy.
Abstract
BACKGROUND: Macroscopic portal vein thrombosis (PVT) is a common and dire prognostic feature of patients with hepatocellular carcinoma (HCC) and often precludes many treatments as a result. Little is known about its causes or mechanisms or clinical associations. AIMS: To examine patients with PVT in order to possibly identify prognostically different subsets. METHODS: A large cohort of non-curable patients with advanced and biopsy-proven HCC in which survival was documented, were retrospectively examined. RESULTS: We analyzed a large HCC cohort containing 366 (63.3%) PVT-positive patients and found that PVT is associated with patients having larger tumors and higher levels of alpha-fetoprotein (AFP) and des-gamma carboxyprothrombin (DCP). We identified in patients with normal bilirubin levels (≤ 2.0 mg/dl) two PVT-positive patients, having higher and lower AFP levels, respectively. They differed in the significantly better prognosis of the low AFP patients, which may be useful for patient management decisions. CONCLUSIONS: Patients with PVT are heterogeneous with respect to AFP levels. AFP-negative patients have a significantly better survival than those who have elevated AFP.
BACKGROUND: Macroscopic portal vein thrombosis (PVT) is a common and dire prognostic feature of patients with hepatocellular carcinoma (HCC) and often precludes many treatments as a result. Little is known about its causes or mechanisms or clinical associations. AIMS: To examine patients with PVT in order to possibly identify prognostically different subsets. METHODS: A large cohort of non-curable patients with advanced and biopsy-proven HCC in which survival was documented, were retrospectively examined. RESULTS: We analyzed a large HCC cohort containing 366 (63.3%) PVT-positive patients and found that PVT is associated with patients having larger tumors and higher levels of alpha-fetoprotein (AFP) and des-gamma carboxyprothrombin (DCP). We identified in patients with normal bilirubin levels (≤ 2.0 mg/dl) two PVT-positive patients, having higher and lower AFP levels, respectively. They differed in the significantly better prognosis of the low AFPpatients, which may be useful for patient management decisions. CONCLUSIONS:Patients with PVT are heterogeneous with respect to AFP levels. AFP-negative patients have a significantly better survival than those who have elevated AFP.
Authors: Y Koike; Y Shiratori; S Sato; S Obi; T Teratani; M Imamura; H Yoshida; S Shiina; M Omata Journal: Cancer Date: 2001-02-01 Impact factor: 6.860
Authors: Laura M Kulik; Brian I Carr; Mary F Mulcahy; Robert J Lewandowski; Bassel Atassi; Robert K Ryu; Kent T Sato; Al Benson; Albert A Nemcek; Vanessa L Gates; Michael Abecassis; Reed A Omary; Riad Salem Journal: Hepatology Date: 2008-01 Impact factor: 17.425
Authors: Jeong-Ju Yoo; Goh Eun Chung; Jeong-Hoon Lee; Joon Yeul Nam; Young Chang; Jeong Min Lee; Dong Ho Lee; Hwi Young Kim; Eun Ju Cho; Su Jong Yu; Yoon Jun Kim; Jung-Hwan Yoon Journal: Cancer Res Treat Date: 2017-05-15 Impact factor: 4.679
Authors: Hikmet Akkiz; Brian I Carr; Sedef Kuran; Ümit Karaoğullarından; Oguz Üsküdar; Salih Tokmak; Burcu Arslan; Figen Doran; Hüseyin Tugsan Balli; Abdulalh Ülkü; Tolga Atılgan Akçam; Halil İbrahim Bahçeci; Kamil Yalçın Polat; Necati Örmeci; Halis Şimşek; Abdullah Sonsuz; Ali Demir; Engin Altıntaş; Mehmet Demir; Kendal Yalçın; Nazım Ekinci; Ayşegül Harmancı Özakyol; Mehmet Yücesoy; Ahmet Uygun; Vito Guerra; Anıl Delik; Yaman Tokat; Sezai Yilmaz; Ahmet Bektaş; Murat Kılıç Journal: Can J Gastroenterol Hepatol Date: 2018-06-13