Journal article
Gastrointestinal bleeding in cirrhotic patients with hepatocellular carcinoma undergoing intrahepatic artery chemotherapy
Gastrointestinal endoscopy, Vol.46(5), pp.430-434
1997
DOI: 10.1016/S0016-5107(97)70036-1
PMID: 9402117
Abstract
Background:
Hepatocellular carcinoma in cirrhotic patients increases the risk of variceal bleeding. We sought to characterize bleeding in a cirrhotic patient population undergoing intrahepatic artery chemotherapy for hepatocellular carcinoma and to determine the possible influence of this treatment on gastrointestinal bleeding.
Methods:
We retrospectively reviewed 179 patients with hepatocellular carcinoma who underwent intrahepatic artery doxorubicin and cis-platinum chemotherapy to determine the incidence of gastrointestinal bleeding and compared them with 434 hepatocellular carcinoma historic controls not undergoing regional chemotherapy.
Results:
Of the 179 patients, 27 patients (15.1%) developed upper gastrointestinal bleeding over a mean follow-up of 15.2 months; 18 of the 27 (66.7%) bled from a variceal source and 9 (33.3%) bled from a nonvariceal source: ulcer (n = 6), gastropathy (n = 1), Mallory-Weiss (n = 1), erosive gastritis (n = 1). Twenty-one patients developed bleeding after initiation of chemotherapy (14 variceal and 7 nonvariceal). The number of chemotherapy sessions among patients with variceal and nonvariceal bleeding was similar (2.1 ± 0.4 and 4.0 ± 1.2;
p = Not significant). Patients with variceal and nonvariceal bleeding were comparable with respect to Child-Pugh classification, pTNM stage, age, time to bleeding, and gender.
Conclusions:
Regional intra-arterial chemotherapy for hepatocellular carcinoma is associated with a low risk of variceal bleeding. Nonvariceal sources of upper gastrointestinal bleeding in this population account for a significant component of bleeding episodes. (Gastrointest Endosc 1997;46:430-4.)
Details
- Title: Subtitle
- Gastrointestinal bleeding in cirrhotic patients with hepatocellular carcinoma undergoing intrahepatic artery chemotherapy
- Creators
- Steven G DesautelsAdam SlivkaRobert E SchoenBrian CarrMordechai RabinovitzWilliam Silverman
- Resource Type
- Journal article
- Publication Details
- Gastrointestinal endoscopy, Vol.46(5), pp.430-434
- Publisher
- Mosby, Inc
- DOI
- 10.1016/S0016-5107(97)70036-1
- PMID
- 9402117
- ISSN
- 0016-5107
- eISSN
- 1097-6779
- Language
- English
- Date published
- 1997
- Academic Unit
- Gastroenterology and Hepatology; Internal Medicine
- Record Identifier
- 9984094625302771
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