Background/aims: To evaluate the risk factors for esophageal variceal bleeding in patients with hepatocellular carcinoma.
Methodology: 103 patients with esophageal varices and hepatocellular carcinoma without previous history of varices bleeding or treatment of varices were followed up and the risk factors for variceal bleeding were evaluated by Cox proportional hazards regression.
Results: During an average of 650 days' follow-up, 17 patients (17%) suffered from variceal bleeding, showing an annual incidence rate of 9.3%. Another 8 patients (8%) underwent endoscopic variceal ligation for the aggravation of esophageal varices. Multivariate analysis showed that the red color sign of varices and the size of tumor (> or = 33 mm) were independently associated with an increased risk of variceal bleeding (Risk Ratio = 20.33, P < 0.0001 and Risk Ratio = 2.64, P = 0.0231, respectively).
Conclusions: The large size of tumor, as well as the red color sign of varices, was a significant risk factor for variceal bleeding in patients with hepatocellular carcinoma.