ABSTRACT
Systemic treatment is the first choice for patients with advanced hepatocellular carcinoma. Atezolizumab combined with bevacizumab can bring better survival for patients with advanced hepatocellular carcinoma. The authors introduce the efficacy and safety management of a hepatocellular carcinoma case with postoperative recurrence who received treatment of atezoli-zumab combined with bevacizumab. The patient had a probability of pseudoprogression during treatment, and had a good result of a continuous partial response over 2 years.
ABSTRACT
Objective To observe the risk factors for portal vein thrombosis (PVT) in cirrhotic patients prior to receiving endoscopic treatment to prevent gastroesophageal varices rebleeding.Methods A retrospective analysis was conducted on cirrhotic patients admitted to Zhongshan Hospital,Fudan University from 2008 to 2013 for secondary prevention of gastroesophageal varices bleeding via endoscopic treatment.Relevant information and data were collected,followed by an univariate analysis and multiple Logistic regression analysis in attempt to identify potential factors affecting the formation of PVT.Results Totally 591 patients were enrolled in the present study and were classified as present-PVT group (n =122,20.64 ％) and absent-PVT group (n =469,79.36 ％).Univariate analysis showed that MELD score,hemoglobin,platelet count,total bilirubin,alanine aminotransferase,blood urea nitrogen,splenectomy ratio all achieved statistical significance between the two groups (P＜0.05).The multiple Logistic regression showed that MELD score,lowered blood urea nitrogen,elevated D-dimer and history of splenectomy were independent factors associated with the formation of PVT (P values were separately 0.016,0.026,0.014 and ＜0.001).Conclusions Cirrhotic patients should receive regular surveillance for MELD score,liver function,D-dimer and portal vein ultrasonography,especially in patients received with a previous history of splenectomy.