# The Clinical Impact of Cardiovascular Thrombosis on Overall Survival in Patients With Hepatocellular Carcinoma After Transarterial Chemoembolization

## TL;DR

This study shows that cardiovascular thrombosis significantly reduces survival in hepatocellular carcinoma patients after a specific treatment.

## Contribution

The study identifies cardiovascular thrombosis as an independent risk factor for mortality in HCC patients post-transarterial chemoembolization.

## Key findings

- CVT was an independent risk factor for overall deaths in HCC patients (HR = 1.751, p < 0.05).
- Patients with CVT had half the median survival time compared to those without CVT (1106 vs. 2707 days).
- Post-recurrence survival was shorter in patients with CVT (1008 days vs. 2150 days).

## Abstract

Progression of hepatocellular carcinoma (HCC) and cardiovascular thrombosis (CVT) has a bidirectional causal relationship. CVT complications will increase in patients with HCC due to etiology shift from viral hepatitis to metabolic dysfunction‐related steatohepatitis.

This study aimed to evaluate the clinical impact of CVT, focusing on patients with HCC treated after transarterial chemoembolization.

A retrospective cohort study enrolled 402 patients including 79 patients with CVT in a single university hospital. Cox proportional hazard model analysis was performed to identify independent prognostic factors. After adjusting for baseline characteristics by propensity score matching, the survival impact of the CVT complication was evaluated using the Kaplan–Meier curve.

A multivariate analysis determined that CVT complication was an independent risk factor for overall deaths in patients with HCC (HR = 1.751, IQR 1.203–2.548, p < 0.05). Propensity score matching generated a pair of 54‐patient cohorts. The median survival time of patients with CVT (1106 days) shortened to half compared to those without CVT (2707 days, HR = 2.298, IQR: 1.399–4.169, p = 0.0020). While recurrence‐free survival was not significantly different (p > 0.05), post‐recurrence survival was shorter in patients with CVT (2150 days vs. 1008 days, HR = 1.945, IQR: 1.150–3.740, p = 0.0188).

Assuming that the expected life expectancy is only half that of uncomplicated cases of CVT, CVT might be a major prognostic factor in patients with HCC, following tumor burden and functional hepatic reserve.