title: Risk factors for esophageal variceal bleeding in patients with hepatocellular carcinoma.
abstract: OBJECTIVE
  To evaluate the risk factors for esophageal variceal bleeding in patients with hepatocellular carcinoma.
  
  
  METHODS
  103 patients with esophageal varices and hepatocellular carcinoma without previous history of varices bleeding or treatment of varices were followed up and the risk factors for variceal bleeding were evaluated by Cox proportional hazards regression.
  
  
  RESULTS
  During an average of 650 days' follow-up, 17 patients (17%) suffered from variceal bleeding, showing an annual incidence rate of 9.3%. Another 8 patients (8%) underwent endoscopic variceal ligation for the aggravation of esophageal varices. Multivariate analysis showed that the red color sign of varices and the size of tumor (> or = 33 mm) were independently associated with an increased risk of variceal bleeding (Risk Ratio = 20.33, P < 0.0001 and Risk Ratio = 2.64, P = 0.0231, respectively).
  
  
  CONCLUSIONS
  The large size of tumor, as well as the red color sign of varices, was a significant risk factor for variceal bleeding in patients with hepatocellular carcinoma.
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-8655, Japan. makanuma@qd6.so-net.ne.jp
authors.forename: Masao
authors.initials: M
authors.lastname: Akanuma
authors.forename: Haruhiko
authors.initials: H
authors.lastname: Yoshida
authors.forename: Makoto
authors.initials: M
authors.lastname: Okamoto
authors.forename: Keiji
authors.initials: K
authors.lastname: Ogura
authors.forename: Shin
authors.initials: S
authors.lastname: Maeda
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Hata
authors.forename: Shinpei
authors.initials: S
authors.lastname: Sato
authors.forename: Shuichiro
authors.initials: S
authors.lastname: Shiina
authors.forename: Takao
authors.initials: T
authors.lastname: Kawabe
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Shiratori
authors.forename: Masao
authors.initials: M
authors.lastname: Omata
mesh_terms: D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000150:complications*; D004932:Esophageal and Gastric Varices / Q000209:etiology* / Q000628:therapy; D004945:Esophagoscopy; D005260:Female; D005500:Follow-Up Studies; D006471:Gastrointestinal Hemorrhage / Q000209:etiology* / Q000628:therapy; D006801:Humans; D008113:Liver Neoplasms / Q000150:complications*; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012307:Risk Factors