Regnault H, et al. - This multicenter study was performed to examine the management and outcome of portal vein thrombosis (PVT) in patients with digestive cancers other than hepatocellular carcinoma (HCC). The researchers found a high rate of variceal bleeding leading to death in this cohort. They recommended a further prospective study to evaluate the endoscopic screening and the efficacy of prophylactic treatment of variceal bleeding.

Methods

• Trunk or branch PVT were the main inclusion criteria in patients with locally advanced or metastatic digestive cancers.
• The researchers assessed predictive factors of bleeding and overall survival (OS) in the univariate and multivariate analysis.

Results

• The researchers identified 118 patients with PVT and digestive cancers between 2012 and 2016.
• Pancreatic cancer was observed in the majority of patients (50%).
• They observed trunk PVT location in 66% of patients.
• They performed endoscopic screening of portal hypertension in only 7 patients (1%) and 5 had esophageal varices.
• In 22 patients (19%), gastrointestinal bleeding occurred and 12 patient deaths (17%) were associated with a gastrointestinal hemorrhage.
• In multivariate analysis, metastatic disease (HR = 2.83 [95%CI 1.47-5.43], p < 0.01) and gastrointestinal hemorrhage (HR = 1.68 [95%CI 1.01-2.78], p=0.04) were correlated with OS.
• In multivariate analysis, only trunk PVT location was significantly correlated with gastrointestinal hemorrhage (HR = 5.56 [95%CI 1.18-26.32], p=0.03).