Abstract
We investigated Tolvaptan efficacy and long-term prognosis with focus on nutrition in 20 patients with refractory hepatic ascites in hepatocellular carcinoma (HCC). Bloating improved in 55% of patients, as determined using a Japanese version of the Support Team Assessment Schedule. Nutritional status improved with Tolvaptan treatment, based on the Controlling Nutritional Status score and Onodera’s prognostic nutritional index. Long-term prognosis was better in responders than in non-responders (mean survival time: 308 days vs. 97 days, p = 0.031). Tolvaptan was even effective in many patients with HCC, with additional improvement in long-term prognosis expected with improvement in the nutritional status.
Highlights
Hyponatremia, edema, and ascites related to liver cirrhosis greatly reduce the quality of life of patients [1], and ascites worsens the prognosis in particular [2]
We retrospectively studied the data of 20 patients with refractory hepatic ascites in hepatocellular carcinoma (HCC) who did not respond adequately to conventional diuretics treatment with a loop diuretic and/or an anti-aldosterone agent between April 2011 and March 2017 with Tolvaptan
The STAS-J score [8] was improved in 55% of the patients with refractory hepatic ascites in HCC who did not respond adequately to conventional diuretics
Summary
Hyponatremia, edema, and ascites related to liver cirrhosis greatly reduce the quality of life of patients [1], and ascites worsens the prognosis in particular [2]. Tolvaptan therapy for HCC with refractory ascites has not been thoroughly studied.
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