AIM:The effect of treatment response to anticoagulant therapy on prognosis of patients with cirrhosis and portal vein thrombosis (PVT) remains unclear. METHODS:Forty-one patients with cirrhosis and first PVT treated with intravenous anticoagulant therapy between January 2015 and April 2018 at 10 Japanese hospitals were included. Treatment response was defined based on change in size of PVT after anticoagulant therapy as the following: complete response (CR, 0%), partial response (PR, ≤ 50%), stable disease (SD, 51%-100%), and progressive disease (PD, ≥ 101%). CR and PR were combined as the effective group and SD and PD formed as the ineffective group. RESULTS:The median age was 69 years, and 56% of the patients had Child-Pugh class B. Overall, 5 (12%) achieved CR, 22 (54%) achieved PR, 12 (29%) had SD and 2 (5%) had PD. During a median follow-up of 31.8 months from the date of assessment of treatment response, 17 patients died. The overall survival rates at 1- and 3-year were 82.5% and 65.1%, respectively. In the multivariate analysis, the model for end-stage liver disease-Na score was significantly associated with overall survival, whereas treatment response was not significant. Twenty-five patients experienced liver-related events with hospitalization, and the 3-year cumulative rate of liver-related events was 63.9%. In the multivariate analysis, treatment response was significantly associated with liver-related events. The 3-year cumulative rates of liver-related events were 56.7% and 75.5% in the effective and ineffective groups, respectively (p = 0.008). CONCLUSIONS:Among patients with cirrhosis, treatment response to anticoagulant therapy for PVT correlated with the incidence of liver-related hospitalization events.
Long-term nucleos(t)ide analog (NUC) treatment improves the outcomes of patients with chronic hepatitis B virus (HBV) infection. However, only a limited number of patients treated with NUC can achieve hepatitis B surface antigen (HBsAg) seroclearance, the so-called “functional cure.” However, it remains unclear how on-treatment viral factors affect HBsAg seroclearance during long-term NUC treatment. We aimed to investigate whether the baseline and on-treatment HBV markers can predict HBsAg seroclearance and reduction in patients treated with long-term NUC treatment. This study included two independent cohorts consisting of 843 patients in the derivation cohort and 1781 patients in the validation cohort. HBsAg seroclearance was infrequent (3.7–6.2
Abstract Objective This study aimed to evaluate whether the preoperative FAN score—composed of the fibrosis‐4 (Fib‐4) index, albumin–bilirubin (ALBI) score and neutrophil–lymphocyte ratio (NLR)—predicts recurrence‐free, cancer‐specific and overall survival after radical cystectomy for bladder cancer. Patients and Methods We retrospectively analysed 1121 patients who underwent radical cystectomy at 13 institutions between April 2010 and March 2024. Associations between the FAN score and recurrence‐free survival (RFS), cancer‐specific survival (CSS) and overall survival (OS) were evaluated. Prognostic performance was assessed in an independent cohort of 296 patients from three institutions. Results FAN score distribution was 0 (n = 600, 53.5%), 1 (n = 409, 36.5%) and ≥2 (n = 112, 10.0%). Patients with a FAN score ≥2 had significantly worse RFS (median: not reached vs 12.3 months; p < 0.0001), CSS (not reached vs 22.8 months; p < 0.0001) and OS (112.5 vs 16.1 months; p < 0.0001) than those with a FAN score ≤1. On multivariable analysis, a FAN score ≥2 was an independent predictor of poorer RFS (HR 2.12, 95% CI 1.55–2.91; p < 0.0001), CSS (HR 2.80, 95% CI 2.00–3.92; p < 0.0001) and OS (HR 2.70, 95% CI 2.03–3.59; p < 0.0001). These associations were consistently observed in an independent cohort of 296 patients. Conclusions The FAN score is an independent prognostic marker of adverse outcomes after radical cystectomy for bladder cancer and may help stratify patients for perioperative management and follow‐up.
