[Clinical evaluation of prophylactic sclerotherapy for esophageal varices in patients with unresectable hepatocellular carcinoma--based on patients treated with transcatheter arterial embolization].
A clinical study on efficacy of prophylactic sclerotherapy for esophageal varices was carried out on 220 patients with unresectable hepatoma treated with TAE. They were classified into 3 groups: 1) Prophylactic group with prophylactic sclerotherapy for RC sign positive varices (45 cases), 2) Non-prophylactic group with RC sign positive varices without prophylactic sclerotherapy (31 cases), 3) RC negative group in which RC sign was negative in whole time (144 cases). Although atypical RC sign or venous dilatation was noticed in 54% of patients in prophylactic group at 1-year after sclerotherapy, cumulative bleeding rates after detection of RC sign positive varices in prophylactic group (27% at 2-years) were significantly lower (p < 0.001) than those in non-prophylactic group (91% at 2-years). The incidence of death by variceal bleeding in prophylactic group (6%) was significantly lower (p < 0.005) than that in non-prophylactic group (36%). 50% survival period of prophylactic group (25.0 months) was significantly longer (p < 0.001) than that of non-prophylactic group (12.5 months), and there was no significant difference of 50% survival period between prophylactic group and RC negative group (21.6 months). We conclude that, prophylactic sclerotherapy not only decrease incidence of variceal bleeding and of death due to bleeding, but also improve survival rate in hepatoma patients with RC sign positive esophageal varices.
Hayashi
S
S
Department of Internal Medicine, Tokyo Metropolitan Komagome Hospital.
D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000628:therapy*; D004621:Embolization, Therapeutic; D004932:Esophageal and Gastric Varices / Q000517:prevention & control*; D005260:Female; D006471:Gastrointestinal Hemorrhage / Q000517:prevention & control*; D006499:Hepatic Artery; D006801:Humans; D008113:Liver Neoplasms / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D015911:Sclerotherapy