Merits of prophylactic sclerotherapy for esophageal varices concomitant unresectable hepatocellular carcinoma: Prospective randomized study. Issue 2 (8th May 2013)

• Record Type: Journal Article
• Authors: Akahoshi, Tomohiko; Tomikawa, Morimasa; Tsutsumi, Norifumi; Hashizume, Makoto; Maehara, Yoshihiko
• Is Part Of: Digestive endoscopy. Volume 26:Issue 2(2014:Mar.)
• Page Start: 172
• Page End: 177
• Publication Date: 2013-05-08
• Subjects: Digestive organs -- Diseases -- Periodicals; Digestive organs -- Diseases -- Diagnosis -- Periodicals; Endoscopy -- Periodicals; Digestive System Diseases -- diagnosis -- Periodicals; Digestive System Diseases -- therapy -- Periodicals; Endoscopy -- Periodicals; 616.3
• DOI: 10.1111/den.12119
• Languages: English
• ISSNs: 0915-5635

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="den12119-sec-0001" sec-type="section"> <title>Background</title> <p>Several clinical studies of prophylactic therapy for esophageal varices have led to the conclusion that prophylactic therapy is of no value, and it is generally not accepted in the Western world. However, this is not the case in Japan. The present study evaluated the efficacy of prophylactic endoscopic injection sclerotherapy (EIS) in patients with unresectable hepatocellular carcinoma (HCC) and risky esophageal varices.</p> </sec> <sec id="den12119-sec-0002" sec-type="section"> <title>Patients and Methods</title> <p>Twenty‐seven patients with 'likely‐to‐bleed' esophageal varices concomitant with unresectable HCC were randomly allocated to two groups. Thirteen patients underwent prophylactic EIS (EIS group), whereas the remaining 14 patients were observed conservatively (control group).</p> </sec> <sec id="den12119-sec-0003" sec-type="section"> <title>Results</title> <p>No bleeding from esophageal varices occurred in the EIS group during the entire period of this study, whereas in thecontrol group the cumulative bleeding rate was 44.8% in 6 months. Cumulative survival rates of patients in the EIS group and in the control group were 48.8% and 7.7% in 2 years, respectively. There was a statistically significant difference between the two groups in cumulative bleeding rate and survival rate (<italic>P</italic> < 0.01).</p> </sec> <sec id="den12119-sec-0004" sec-type="section"> <title>Conclusion</title> <p>This prospective study demonstrated that prophylactic EIS could prolong the survival of the patients with esophageal varices concomitant with unresectable HCC. Prophylactic EIS for patients with unresectable HCC may be, in part, justified according to the present study.</p> </sec> </abstract>