title: Characteristics and Impacts of Venous Thromboembolism in Patients with Hepatocellular Carcinoma.
abstract: BACKGROUND
  Venous thromboembolism (VTE) is a common complication in cancer patients, and is associated with worse prognosis in such population. Hepatocellular carcinoma (HCC) poses high risk for VTE; however, data is scarce regarding the characteristics and consequences of VTE in HCC patients.
  
  
  METHODS
  We retrospectively reviewed the electronic medical records (EMR) of 270 patients diagnosed with HCC from 2000 to 2015 in Cook County Health and Hospitals System. We report the cumulative incidence of VTE in the present cohort, and identified through multivariate logistic regression the independent risk factors of the development of VTE. Overall prognosis of patients with and without VTE were presented and compared.
  
  
  RESULTS
  Sixteen cases (5.93%) of VTE were documented in the present study. In multivariate analysis, obesity, Child B cirrhosis, intra-hepatic lesions more than 3, and multi-organ extrahepatic metastasis were significantly associated with VTE development (p < 0.05). The presence of VTE was an independent risk factor for mortality in multivariate analysis (HR = 3.62, p = 0.021), together with male gender, Child C cirrhosis, and extrahepatic metastasis.
  
  
  CONCLUSIONS
  Obesity, Child B cirrhosis, more intra-hepatic lesions, and multi-organ extrahepatic metastasis are associated with cancer-associated VTE. VTE will adversely affect the prognosis of patients with HCC; therefore, primary thromboprophylaxis may be warranted in such population.
authors.affiliation: Department of Internal Medicine, John H. Stroger, Jr. Hospital of Cook County, 1900 West Polk Street, Chicago, IL, 60612, USA. ywang4@cookcountyhhs.org.
authors.forename: Yuchen
authors.identifier: http://orcid.org/0000-0002-6507-1438
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Division of Gastroenterology and Hepatology, John H. Stroger, Jr. Hospital of Cook County, Chicago, IL, USA.|Department of Gastroenterology, Rush University Medical Center, Chicago, IL, USA.
authors.forename: B M
authors.initials: BM
authors.lastname: Attar
authors.affiliation: Collaborative Research Unit, John H. Stroger, Jr. Hospital of Cook County, Chicago, IL, USA.
authors.forename: K
authors.initials: K
authors.lastname: Hinami
authors.affiliation: Department of Internal Medicine, John H. Stroger, Jr. Hospital of Cook County, 1900 West Polk Street, Chicago, IL, 60612, USA.
authors.forename: H E
authors.initials: HE
authors.lastname: Fuentes
authors.affiliation: Department of Internal Medicine, John H. Stroger, Jr. Hospital of Cook County, 1900 West Polk Street, Chicago, IL, 60612, USA.
authors.forename: P
authors.initials: P
authors.lastname: Jaiswal
authors.affiliation: Collaborative Research Unit, John H. Stroger, Jr. Hospital of Cook County, Chicago, IL, USA.
authors.forename: H
authors.initials: H
authors.lastname: Zhang
authors.affiliation: Department of Internal Medicine, John H. Stroger, Jr. Hospital of Cook County, 1900 West Polk Street, Chicago, IL, 60612, USA.
authors.forename: C S
authors.initials: CS
authors.lastname: Simons-Linares
authors.affiliation: Cardiology-Vascular Medicine, NorthShore University HealthSystem, Evanston, IL, USA.
authors.forename: A J
authors.initials: AJ
authors.lastname: Tafur
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000150:complications* / Q000188:drug therapy / Q000401:mortality / Q000601:surgery; D002641:Chicago / Q000453:epidemiology; D015331:Cohort Studies; D005260:Female; D006801:Humans; D015994:Incidence; D008113:Liver Neoplasms / Q000150:complications* / Q000188:drug therapy / Q000401:mortality / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis; D054556:Venous Thromboembolism / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology / Q000401:mortality*
keywords: Hepatocellular carcinoma; Venous thromboembolism