{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T04:37:15Z","timestamp":1787027835037,"version":"build-2736575974"},"reference-count":36,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2020,10,13]],"date-time":"2020-10-13T00:00:00Z","timestamp":1602547200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cancers"],"abstract":"<jats:p>VEGF(R)-targeted therapies are associated with an increased risk of thromboembolism and bleeding, which might be pronounced in patients with increased cardiovascular risk. Nevertheless, sorafenib represents an important treatment option in patients with hepatocellular carcinoma (HCC). We retrospectively investigated the risk of arterial\/venous thromboembolic and bleeding events in 252 patients treated with sorafenib for HCC between 05\/2006 and 03\/2020 at the Medical University of Vienna. Cardiovascular risk was assessed using Framingham score. Eight patients (3.2%) experienced 11 arterial\/venous thromboembolic events. Only two patients (0.8%) developed arterial thromboembolism even though cardiovascular risk was low, intermediate, and high in 15 (8.7%), 104 (60%), and 54 (31.2%) of 173 assessable patients. Median overall survival (OS) was shorter in the high risk vs. low\/intermediate risk group 7.4 (95% CI: 3.4\u201311.3) vs. 10.0 (95% CI: 6.8\u201313.2 months) and independently associated with OS in multivariable analysis HR: 1.53 (95% CI: 1.07\u20132.19; p = 0.019). Forty-eight (19%) patients experienced a bleeding, most commonly gastrointestinal bleeding (14%) followed by epistaxis (4.7%). Advanced liver dysfunction was not associated with an increased incidence of bleeding\/venous thromboembolism. Sorafenib represents a safe treatment option even in patients with increased cardiovascular risk. Bleeding complications were comparable with previous reports, even though patients with more advanced liver disease were included.<\/jats:p>","DOI":"10.3390\/cancers12102961","type":"journal-article","created":{"date-parts":[[2020,10,15]],"date-time":"2020-10-15T21:42:21Z","timestamp":1602798141000},"page":"2961","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Vascular Complications in Patients with Hepatocellular Carcinoma Treated with Sorafenib"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2807-3565","authenticated-orcid":false,"given":"Katharina","family":"Pomej","sequence":"first","affiliation":[{"name":"Department of Internal Medicine III, Division of Gastroenterology and Hepatology, Medical University of Vienna, 1090 Vienna, Austria"},{"name":"Liver Cancer (HCC) Study Group Vienna, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4904-5133","authenticated-orcid":false,"given":"Bernhard","family":"Scheiner","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine III, Division of Gastroenterology and Hepatology, Medical University of Vienna, 1090 Vienna, Austria"},{"name":"Liver Cancer (HCC) Study Group Vienna, Medical University of Vienna, 1090 Vienna, Austria"},{"name":"Vienna Hepatic Hemodynamic Laboratory, Medical University of Vienna, 1090 Vienna, Austria"},{"name":"Rare Liver Disease (RALID) Centre of the ERN RARE-LIVER, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dabin","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine III, Division of Gastroenterology and Hepatology, Medical University of Vienna, 1090 Vienna, Austria"},{"name":"Liver Cancer (HCC) Study Group Vienna, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Bauer","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine III, Division of Gastroenterology and Hepatology, Medical University of Vienna, 1090 Vienna, Austria"},{"name":"Liver Cancer (HCC) Study Group Vienna, Medical University of Vienna, 1090 Vienna, Austria"},{"name":"Vienna Hepatic Hemodynamic Laboratory, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorenz","family":"Balcar","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine III, Division of Gastroenterology and Hepatology, Medical University of Vienna, 1090 Vienna, Austria"},{"name":"Liver Cancer (HCC) Study Group Vienna, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1716-9166","authenticated-orcid":false,"given":"Tobias","family":"Meischl","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine III, Division of Gastroenterology and Hepatology, Medical University of Vienna, 1090 Vienna, Austria"},{"name":"Liver Cancer (HCC) Study Group Vienna, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mattias","family":"Mandorfer","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine III, Division of Gastroenterology and Hepatology, Medical University of Vienna, 1090 Vienna, Austria"},{"name":"Vienna Hepatic Hemodynamic Laboratory, Medical University of Vienna, 1090 Vienna, Austria"},{"name":"Rare Liver Disease (RALID) Centre of the ERN RARE-LIVER, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4590-3583","authenticated-orcid":false,"given":"Thomas","family":"Reiberger","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine III, Division of Gastroenterology and Hepatology, Medical University of Vienna, 1090 Vienna, Austria"},{"name":"Vienna Hepatic Hemodynamic Laboratory, Medical University of Vienna, 1090 Vienna, Austria"},{"name":"Rare Liver Disease (RALID) Centre of the ERN RARE-LIVER, Medical University of Vienna, 1090 Vienna, Austria"},{"name":"Christian Doppler Laboratory for Portal Hypertension and Liver Fibrosis, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christian","family":"M\u00fcller","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine III, Division of Gastroenterology and Hepatology, Medical University of Vienna, 1090 Vienna, Austria"},{"name":"Liver Cancer (HCC) Study Group Vienna, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Trauner","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine III, Division of Gastroenterology and Hepatology, Medical University of Vienna, 1090 Vienna, Austria"},{"name":"Rare Liver Disease (RALID) Centre of the ERN RARE-LIVER, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7260-532X","authenticated-orcid":false,"given":"Matthias","family":"Pinter","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine III, Division of Gastroenterology and Hepatology, Medical University of Vienna, 1090 Vienna, Austria"},{"name":"Liver Cancer (HCC) Study Group Vienna, Medical University of Vienna, 1090 Vienna, Austria"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,10,13]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"87","DOI":"10.3322\/caac.21262","article-title":"Global cancer statistics, 2012","volume":"65","author":"Torre","year":"2015","journal-title":"CA Cancer J. 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