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Abstract
varices and large varices in hepalocellular carcinoma are present in a higher incidence than the cirrhotic patients. Advanced liver disease in form of ascitcs detected by US, prolhrombin concentration and INK. RBC eount and CTP score were found to be associated with presence of varices, however only platelet count was found lo he an independent factor. For prediction of large esophageal varices advanced liver disease in form of ascites detected by US, prothrambin concentration and INK and eytopenia in form of RBC count and platelet eount were the variables that were statistically significant associated with presence of large varices. Multivariate analysis detected platelet count and large tumor size to be the independent factors associated with presence of large varices.HCC patients with large varices have a high risk for variccal bleeding. EVL prevents variceal bleeding and improves survival in HCC patients with large varioes, NSBB had a limited effect in preventing variceal bleeding in our study. Background liver disease was associated with higher risk for variceal bleeding and shorter survival. Similarly, advanced tumor stage was an independent risk factor for bleeding and was associated with shorter survival.These findings suggest that screening for varices and primary prevention by band ligation should be the management of choice to decrease bleeding and improve survival in HCC palients. The rale of NSBB needs to be assessed further in studies that include measurement of HVPG and its response in HCC patients.