Clinical Significance of Hepatic Arterioportal Shunts in Patients with Hepatocellular Carcinoma

Choi, Hwang; Kim, Byung Wook; Moon, Sung Bae; Kim, Bo Kyoung; Han, Joon Yeol; Choi, Myung Gyu; Kim, Jae Kwang; Hahn, Seong Tai; Lee, Jae Moon; Chung, Kyu Won; Sun, Hee Sik

Abstract

Arterioportal (AP) shunt is related to hepatocellular carcinoma (HCC) with variable frequency but its clinical significance is not well known. We retrospectively studied the prevalence and clinical significance including mortality of the AP shunt combined with HCC.
METHODS
The clinical data and radiologic features of HCC patients who were performed hepatic angiography from 1992 to 1997 at St. Mary's Hospital in Korea were reviewed. The data of HCC patients with AP shunt were compared with that of randomized samples of HCC patients without AP shunt.
RESULTS
The prevalence of AP shunt in HCC was 7.3%(45/616 HCC patients). There was no significant difference in clinical symptoms and signs such as ascites, encephalopathy, or variceal bleeding and laboratory findings between the HCC patients with AP shunt and those without. The AP shunt was more common in diffuse, poorly demarcated, large HCC. Especially, portal vein thrombosis (PVT) was one of the most common causes of AP shunt. Cumulative survival rate of the HCC patients with AP shunt was lower than that of those without. But only the size of HCC was significantly related with poor prognosis.
CONCLUSION
AP shunt occurred in some HCC which was large in size or combined with PVT. AP shunt did not increase the severity of symptoms and signs, but decreased the survival because of its relation to tumor size.