Local and systemic thrombotic complications in cirrhotic patients with hepatocellular carcinoma

Venous thromboembolic events (VTE) represent a significant and common complication in patients with hepatocellular carcinoma (HCC) in the context of cirrhosis. While some patient-related risk factors for VTE are shared with the non-cirrhotic population, the presence of HCC amplifies the risk, potentially due to the pro-thrombotic paraneoplastic alterations associated with the tumor. This review aims to examine the current evidence regarding hemostatic disorders observed specifically in cirrhotic patients with HCC. Additionally, the review comprehensively examines VTE events in cirrhotic patients with HCC, specifically emphasizing portal vein thrombosis (PVT). PVT is the most common thrombotic complication in this population and can have significant implications for the eligibility and success of treatment modalities such as liver transplants or surgical interventions. Identifying risk factors associated with PVT occurrence in these patients is essential to guide preventive measures and enhance patient outcomes. This review aims to provide a clear background for further research and investigations into effective prevention and treatment strategies for VTE in cirrhotic patients with HCC by comprehensively revising the current evidence on these topics.