Preserved liver function, portal thrombosis and absence of oesophageal varices are risk factors for metastasis of hepatocellular carcinoma

Addario, Luigi; Tritto, Giovanni; Cavaglià, Enrico; Amodio, Francesco; Giannelli, Eduardo; Costanzo, Giovan Giuseppe Di

doi:10.1016/j.dld.2010.09.003

Cited by 20 publications

(17 citation statements)

References 37 publications

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“…Addario et al . reported that HCC patients with better hepatic function show an increased risk for metastases . The results of these reports suggested an indirect relationship between platelet counts and EHM of HCC, and we have confirmed that relationship in the present study.…”

Section: Discussionsupporting

confidence: 91%

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Involvement of platelets in extrahepatic metastasis of hepatocellular carcinoma

Morimoto

Nouso

Wada

et al. 2014

Hepatology Research

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Section: Discussionsupporting

confidence: 91%

“…Similar result was reported by Addario et al . as described previously . It is hard to verify the reason; however, we speculated it to be as follows.…”

Section: Discussionmentioning

confidence: 84%

Involvement of platelets in extrahepatic metastasis of hepatocellular carcinoma

Morimoto

Nouso

Wada

et al. 2014

Hepatology Research

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“…A main finding was an association between presence of metastasis and significantly lower levels of cirrhosis than in nonmetastatic HCC patients, as well as relatively larger primary tumors with associated lower levels of thrombocytopenia (table 1). Similar findings for HCC metastasis have been noted previously [29,30,31]. Lower levels of cirrhosis, absence of thrombocytopenia (low platelets being a reflection of liver fibrosis) and large sizes of HCCs have been documented together [32].…”

Section: Discussionsupporting

confidence: 70%

Hepatocellular Carcinoma Extrahepatic Metastasis in Relation to Tumor Size and Alkaline Phosphatase Levels

Carr

Guerra

2016

Oncology

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Background: Hepatocellular carcinoma (HCC) is known to metastasize. However, there are few reports on patients with metastasis at the time of HCC diagnosis. Aims: To evaluate the incidence and characteristics of extrahepatic metastasis patients presenting at baseline with noncurable, advanced HCC. Results: The total HCC cohort was initially dichotomized into 2 subcohorts, with (n = 214) and without (n = 719) extrahepatic metastasis (‘metastasis'), and patient baseline characteristics were compared. The main findings for patients with metastasis (22.9% of total cohort) compared with other, nonmetastatic patients were: more advanced tumors, as judged by larger tumor diameters, more tumor multifocality and percent with portal vein thrombosis, higher blood α-fetoprotein and des γ-carboxy prothrombin levels and alkaline phosphatase (ALKP), but not bilirubin levels, and a lower incidence of cirrhosis. There was a strong correlation between increases in tumor size and percent of patients with metastasis. A subset of patients with larger tumors was identified with low blood ALKP levels and better survival. Survival in the total metastasis cohort was lower than in the non-metastasis cohort, as expected, but only in patients with smaller tumors. In patients with larger tumors, survival with or without metastasis was similar and poor. Conclusions: There was a lower incidence of cirrhosis in HCC patients with metastasis, and they had larger and more aggressive primary tumors. Patients with smaller, but not larger, tumors and metastasis had worse prognosis than patients without metastasis. A distinct subset of metastatic patients was identified that had better prognosis and low ALKP levels.

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“…29,30 Based on clinical observations, an interesting result is that hepatic metastases rarely occur from primary extrahepatic carcinoma in patients with cirrhosis, 20,37,38 whereas the risk for metastases increases in HCC patients with better liver function. 39 This finding further indicates the bidirectional relationship between PLT and liver diseases. 40 Regarding the relationship between PLT counts and HCC prognosis, Roayaie et al 21 reported that PLT counts < 150 000/μl are associated with poor outcomes after liver resection, whereas Kondo et al 22 revealed that the postoperative survival of HCC patients was not associated with low PLT counts.…”

Section: Discussionmentioning

confidence: 74%

“…Advanced liver disease, such as liver fibrosis and cirrhosis, often present in parallel with a reduced PLT count . Based on clinical observations, an interesting result is that hepatic metastases rarely occur from primary extrahepatic carcinoma in patients with cirrhosis, whereas the risk for metastases increases in HCC patients with better liver function . This finding further indicates the bidirectional relationship between PLT and liver diseases …”

Section: Discussionmentioning

confidence: 95%

Thrombocytopenia: A prognostic factor for hepatocellular carcinoma patients with portal vein tumor thrombus after hepatectomy

Cheng

Wang

Zhang

et al. 2018

J of Gastro and Hepatol

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Background and Aim Portal vein tumor thrombus (PVTT) predicts a poor prognosis in hepatocellular carcinoma (HCC) patients. Platelets (PLTs) play an important role in HCC progression and metastasis. However, the relationship between PLTs and PVTT remains unclear. This study aimed to evaluate the value of PLT counts in the prognosis of HCC patients with PVTT after hepatectomy. Methods From January 2002 to December 2012, 694 HCC patients with PVTT after hepatectomy were evaluated. The patients were divided into the thrombocytopenia group (PLT < 100 × 109/L), the normal group, and the thrombocytosis group (PLT > 300 × 109/L) based on the preoperative PLT level. A propensity score matching (PSM) analysis was used. Results Before the PSM, PVTT patients with thrombocytopenia exhibited longer recurrence‐free survival (RFS) and overall survival (OS) compared with those with normal PLT counts (both P < 0.001) or thrombocytosis (P = 0.008 and P = 0.046). For the thrombocytopenia group and the normal group, the 1‐, 2‐, and 3‐year RFS values were 30.0%, 17.6%, and 15.7% and were 10.8%, 6.6%, and 5.8% (P < 0.001), respectively; the 1‐, 2‐, and 3‐year OS values were 61.9%, 37.9%, and 31.2% and were 38.3%, 23.3%, and 16.0% (P < 0.001), respectively. After the PSM, the median survival time was 16.6 versus 8.6 months (P < 0.002) in the two groups. A subgroup analysis revealed that thrombocytopenia is associated with improved OS in those with type I PVTT (P = 0.021) or type II PVTT (P = 0.029). Conclusion According to the PSM, preoperative thrombocytopenia predicts an increased RFS and OS in HCC patients with PVTT after hepatectomy.

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Preserved liver function, portal thrombosis and absence of oesophageal varices are risk factors for metastasis of hepatocellular carcinoma

Cited by 20 publications

References 37 publications

Involvement of platelets in extrahepatic metastasis of hepatocellular carcinoma

Involvement of platelets in extrahepatic metastasis of hepatocellular carcinoma

Hepatocellular Carcinoma Extrahepatic Metastasis in Relation to Tumor Size and Alkaline Phosphatase Levels

Thrombocytopenia: A prognostic factor for hepatocellular carcinoma patients with portal vein tumor thrombus after hepatectomy

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