PS01.042: THE PRESENCE OF HCC AFFECT LONG-TERM PROGNOSIS AFTER ENDOSCOPIC TREATMENT FOR ESOPHAGEAL VARICES

Abstract

Abstract Background Gastroesophageal varices are present in approximately 50% of patients with cirrhosis, and their rupture is a life-threatening complication. However, mortality rates have declined due to the progress in the management of these patients. Especially advances in endoscopic treatment have contributed to the improved survival rates. In this study, we investigated the prognostic factors associated with long-term survival after endoscopic treatment for esophageal varices. Methods The subjects were 256 patients who underwent initial endoscopic treatment for esophageal varices in our hospital between January 1997 and January 2017. Among them, 143 successfully followed up. The patients’ characteristics were: mean age, 63.8 years (29–85); 97 men and 46 women; and median survival period, 53 months. For analysis, subjects were divided into long-term survival and non-long-term survival groups (n = 59 for each) with a 53-month survival period as a cut-off value. Results The mean age in the long-term/non-long-term survival group was 62.4 ± 9.4 years/67.2 ± 10.5 years, indicating a significantly higher age in the non-long-term group (P < 0.01). Preoperative Child-Pugh score was 6.3 ± 1.2/7.5 ± 2.2 (P < 0.01) and hepatocellular carcinoma (HCC) presence rate was 25.7%/56.2% (P < 0.01), significantly higher in the non-long-term group. Additionally, regarding the treatment method, endoscopic injection sclerotherapy (EIS): endoscopic variceal ligation (EVL) alone in the groups was 50:9/41:18, suggesting a significantly higher EVL rate in the non-long-term group (P < 0.05). Recurrence of esophageal varices occurred in 33 and 22 patients in the long-term and non-long-term groups, respectively, with no significant difference between groups. Analysis of the factors affecting survival period using Cox proportional hazards model showed that Child-Pugh score B or C [hazard ratio(HR):2.0143, P < 0.05], total bilirubin value≧ 2 [HR:2.5573, P < 0.05], and presence of HCC [HR:2.2450, P < 0.01] were noted as significant factors, but the recurrence of esophageal varices was not noted as significant. Only presence of HCC was found to be a significant factor affecting the long-term survival using multiple logistic regression analysis [odds ratio(OR) 0.3463, P < 0.05]. Conclusion Our study revealed that liver function and the presence of HCC affect long-term prognosis after endoscopic treatment for esophageal varices. Disclosure All authors have declared no conflicts of interest.