Usefulness of Endoscopic Therapy for Risky Esophageal Varices Associated with Hepatocellular Carcinoma

Abstract

The efficacy of endoscopic therapy for risky esophageal varices associated with hepatocellular carcinoma (HCC) was evaluated. Total of 43 HCC patients with esophageal varices and of 21 patients without esophageal varices were enrolled in this study. Although endoscopic injection sclerotherapy (EIS) was performed for the majority of the cases, esophageal variceal ligation (EVL) was operated on a part of patients who had severe liver dysfunction or portal vein thrombosis grading greater than Vp3. The clinical factors which potentially influenced the prognosis after endoscopic therapy were examined by multivariate analysis. There was no significant difference in the survival period between HCC patients with esophageal varices and those without esophageal varices. It was revealed that the Child-Pugh classification and HCC stage significantly influenced prognosis. It is suggested that suitable endoscopic therapy for the esophageal varices should improve the prognosis of HCC patients with esophageal varices. However, in case of severe liver dysfunction and advanced HCC, indication of the treatment may not influence prognosis.