Risk factors for esophageal variceal bleeding in patients with hepatocellular carcinoma.
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.
Akanuma
Masao
M
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
Yoshida
Haruhiko
H
Okamoto
Makoto
M
Ogura
Keiji
K
Maeda
Shin
S
Hata
Yasuo
Y
Sato
Shinpei
S
Shiina
Shuichiro
S
Kawabe
Takao
T
Shiratori
Yasushi
Y
Omata
Masao
M
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