Abstract
We evaluated effect of prophylactic treatment on esophageal varices in 126 patients with hepatocellular carcinoma (HCC). A cumulative bleeding rate and a death rate were compared between 54 patients who underwent prophylactic therapy (prophylactic group) and 72 patients who did not undergo the treatment (non-prophylactic group). Cumulative bleeding rate in the prophylactic group was significantly lower than that in the non-prophylactic group (5.6% vs 23.5%, p <0.001). Death rate due to variceal bleeding and hepatic failure following variceal bleeding was significantly lower in the prophylactic group than in the non-prophylactic group (1 case, 2.9% vs 10 cases, 16.1%, p <0.05). A cumulative survival rate in the prophylactic group was significantly higher than that in the non-prophylactic group (p <0.0001). Nine patients with tumor thrombus in the main portal vein (Vp3) had an extremely poor prognosis (survival periods of 66.7 days on average) and there was no statistical difference in the survival period between the cases of bleeding from esophageal varices and of non-bleeding. We conclude that prophylactic therapy for esophago-gastric varices in patients with HCC is valuable, because it decreases the rate of bleeding from esophageal varices and death caused by the bleeding, resulting in a prolonged survival period. The usefulness of prophylactic therapy for Vp3 cases is, however, limited at present.
