Carr, BrianDonghia, RossellaYilmaz, Sezai2026-04-042026-04-0420250030-24141423-0232https://doi.org/10.1159/000542774https://hdl.handle.net/11616/109052Introduction: Presence of macroscopic portal vein thrombosis (PVT) in patients with hepatocellular carcinoma (HCC) has been found to be a major poor prognosis characteristic. Aims: The aim of the study was to examine patients with PVT for their clinical characteristics and factors related to both PVT and survival. Methods: A large HCC database containing 1,094 patients with PVT and 2,513 patients without PVT was examined. Patients had routine baseline serum liver parameters and alpha-fetoprotein (AFP) levels measured, as well as radiological assessment of maximum tumor diameter (MTD), tumor number, presence of macroscopic PVT, plus survival. Results: The percent of patients with PVT increased with increase in both MTD and serum AFP levels and liver parameter levels were worse in patients with PVT than without it. A logistic regression model showed that the combination of MTD >5 cm plus AFP >100 IU/mL plus albumin <3.5 g/dL had an odds ratio of 10.988 for the presence of PVT. Normal serum albumin levels significantly reduced the hazard ratio for death in a Cox proportional hazard model and were associated with decreased liver failure. Conclusion: Logistic regression showed the significance of MTD, AFP, and albumin in the presence of PVT, and the Cox model highlighted the importance of albumin levels in decreasing death.eninfo:eu-repo/semantics/openAccessHepatocellular carcinomaPortal vein thrombosisMultifocalityAlpha-fetoproteinPlatelet-to-lymphocyte ratioSurvivalArticle10386676763965302310.1159/0005427742-s2.0-85214836313Q2WOS:001394279900001Q40000-0002-6111-5077