Merits of prophylactic sclerotherapy for esophageal varices concomitant unresectable hepatocellular carcinoma: Prospective randomized study

Tomohiko Akahoshi, Morimasa Tomikawa, Norifumi Tsutsumi, Makoto Hashizume, Yoshihiko Maehara

Research output: Contribution to journalArticlepeer-review

3 Citations (Scopus)

Abstract

Background 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. Patients and Methods 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). Results 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 (P < 0.01). Conclusion 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.

Original languageEnglish
Pages (from-to)172-177
Number of pages6
JournalDigestive Endoscopy
Volume26
Issue number2
DOIs
Publication statusPublished - Mar 2014

All Science Journal Classification (ASJC) codes

  • Radiology Nuclear Medicine and imaging
  • Gastroenterology

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