Baveno VII criteria identify varices needing treatment in patients with hepatocellular carcinoma of different Barcelona Clinic Liver Cancer stages

• Published in: Journal of gastroenterology and hepatology Vol. 38; no. 8; pp. 1381 - 1388
• Main Authors: Wu, Claudia Wing‐Kwan, Wong, Grace Lai‐Hung, Wong, Vincent Wai‐Sun, Yam, Tsz‐Fai, Yip, Terry Cheuk‐Fung, Wong, Angus Chun‐Hei, Chan, Brian Wai‐Nok, Fong, Matthew Man‐Lok, Lai, Jimmy Che‐To, Tse, Yee‐Kit, Lee, Kit‐Fai, Mok, Tony Shu‐Kam, Chan, Henry Lik‐Yuen, Lui, Rashid Nok‐Shun, Chan, Stephen Lam, Ng, Kelvin Kwok‐Chai
• Format: Journal Article
• Language: English
• Published: Australia Wiley Subscription Services, Inc 01.08.2023
• Subjects: Endoscopy; Hepatectomy; Hepatocellular carcinoma; Liver cancer; Liver stiffness measurement; Patients; Platelet count; Platelets; Transient elastography; Variceal bleeding; Liver stiffness measurement; Variceal bleeding; Transient elastography; Platelet count
• ISSN: 0815-9319; 1440-1746
• DOI: 10.1111/jgh.16218

Background Baveno VII criteria for predicting varices needing treatment (VNT) have not been tested in hepatocellular carcinoma (HCC) population. We evaluated Baveno VII consensus for VNT in HCC patients of different stages according to Barcelona Clinic Liver Cancer (BCLC) stages undergoing curative hepatectomy. Methods This was a prospective cohort study of patients with HCC. Patients underwent transient elastography examination before HCC treatment and received at least one upper endoscopic examination afterwards. Patients were prospectively followed for clinical events including VNT. Results Six hundred and seventy‐three patients (83.1% male, median age 62 years) with HCC of BCLC stage 0 (10%), A (57%), B (17%) and C (15%) were recruited and followed for 47 months. The median (range) LSM was 10.5 (6.9–20.4) kPa; 74% had LSM ≤ 20 kPa and 58% had platelet count ≥150 × 10/L, respectively. VNT occurred in 51 (7.6%) patients. In patients who fulfilled Baveno VII criteria, that is, LSM ≤ 20 kPa and platelet count above 150 × 10/L, only 11 (1.6%) patients had VNT. In all BCLC stages of HCC, the proportion of patients with VNT was below 5%, which support the validity and applicability of Baveno VII criteria in all BCLC stages of HCC. Conclusions The Baveno VII criteria are valid and applicable in HCC patients undergoing curative hepatectomy for selecting patients to undergo screening endoscopy for VNT. The validity was consistent across different BCLC stages of HCC.