Brief Article
Copyright ©2012 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Apr 28, 2012; 18(16): 1946-1952
Published online Apr 28, 2012. doi: 10.3748/wjg.v18.i16.1946
Hepatocellular carcinoma in Budd-Chiari syndrome: A single center experience with long-term follow-up in South Korea
Hana Park, Jin Young Yoon, Kyeong Hye Park, Do Young Kim, Sang Hoon Ahn, Kwang-Hyub Han, Chae Yoon Chon, Jun Yong Park
Hana Park, Jin Young Yoon, Kyeong Hye Park, Do Young Kim, Sang Hoon Ahn, Kwang-Hyub Han, Chae Yoon Chon, Jun Yong Park, Department of Internal Medicine, Yonsei University College of Medicine, Seoul 120-752, South Korea
Do Young Kim, Sang Hoon Ahn, Kwang-Hyub Han, Chae Yoon Chon, Jun Yong Park, Institute of Gastroenterology, Yonsei University College of Medicine, Seoul 120-752, South Korea
Do Young Kim, Sang Hoon Ahn, Kwang-Hyub Han, Chae Yoon Chon, Jun Yong Park, Liver Cirrhosis Clinical Research Center, Seoul 120-752, South Korea
Sang Hoon Ahn, Kwang-Hyub Han, Brain South Korea 21 Project for Medical Science, Seoul 120-752, South Korea
Author contributions: Park H designed the research/study, analyzed the data, performed the study and wrote the paper; Yoon JY designed the research/study and reviewed the data of study population; Park KH performed the study and wrote the paper; Kim DY collected the data; Ahn SH collected the data; Han KH collected the data; Chon CY collected the data; and Park JY designed the research/study, collected the data and performed the study.
Supported by A grant of the South Korea Healthcare Technology R and D Project, Ministry of Health and Welfare, South Korea, No. A102065
Correspondence to: Jun Yong Park, MD, Department of Internal Medicine, Yonsei University College of Medicine, Seoul 120-752, South Korea. drpjy@yuhs.ac
Telephone: +82-2-22281994 Fax: +82-2-3936884
Received: September 26, 2011
Revised: October 27, 2011
Accepted: February 16, 2012
Published online: April 28, 2012
Abstract

AIM: To evaluate long-term clinical course of Budd-Chiari syndrome (BCS) and predictive factors associated with the development of hepatocellular carcinoma (HCC) and survival.

METHODS: We analyzed 67 patients with BCS between June 1988 and May 2008. The diagnosis of BCS was confirmed by hepatic venous outflow obstruction shown on abdominal ultrasound sonography, computed tomography, magnetic resonance imaging, or venography. The median follow-up period was 103 ± 156 [interquartile range (IQR)] mo.

RESULTS: The median age of the patients was 47 ± 16 (IQR) years. At diagnosis, 54 patients had cirrhosis, 25 (37.3%) Child-Pugh class A, 23 (34.3%) Child-Pugh class B, and six (9.0%) patients Child-Pugh class C. During the follow-up period, HCC was developed in 17 patients, and the annual incidence of HCC in patients with BCS was 2.8%. Patients in HCC group (n = 17) had higher hepatic venous pressure gradient (HVPG) than those in non-HCC group (n = 50) (21 ± 12 mmHg vs 14 ± 7 mmHg, P = 0.019). The survival rate of BCS patients was 86.2% for 5 years, 73.8% for 10 years, and 61.2% for 15 years. In patients with BCS and HCC, survival was 79% for 5 years, 43.1% for 10 years, and 21.5% for 15 years.

CONCLUSION: The incidence of HCC in patients with BCS was similar to that in patients with other etiologic cirrhosis in South Korea. The HVPG is expected to provide additional information for predicting HCC development in BCS patients.

Keywords: Budd-Chiari syndrome; Hepatocellular carcinoma; Prognosis