Characteristics of HCC Patients with Portal Vein Thrombosis: Albumin and Survival

Introduction: Presence of macroscopic portal vein thrombosis (PVT) in patients with hepatocellular carcinoma (HCC) has been found to be a major poor prognosis characteristic.

Aims: The aim of the study was to examine patients with PVT for their clinical characteristics and factors related to both PVT and survival.

Methods: A large HCC database containing 1,094 patients with PVT and 2,513 patients without PVT was examined. Patients had routine baseline serum liver parameters and alpha-fetoprotein (AFP) levels measured, as well as radiological assessment of maximum tumor diameter (MTD), tumor number, presence of macroscopic PVT, plus survival.

Results: The percent of patients with PVT increased with increase in both MTD and serum AFP levels and liver parameter levels were worse in patients with PVT than without it. A logistic regression model showed that the combination of MTD >5 cm plus AFP >100 IU/mL plus albumin <3.5 g/dL had an odds ratio of 10.988 for the presence of PVT. Normal serum albumin levels significantly reduced the hazard ratio for death in a Cox proportional hazard model and were associated with decreased liver failure.

Conclusion: Logistic regression showed the significance of MTD, AFP, and albumin in the presence of PVT, and the Cox model highlighted the importance of albumin levels in decreasing death.