Retrospective Study
Copyright ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Aug 7, 2017; 23(29): 5379-5385
Published online Aug 7, 2017. doi: 10.3748/wjg.v23.i29.5379
Efficacy of tolvaptan for the patients with advanced hepatocellular carcinoma
Masayuki Miyazaki, Masayoshi Yada, Kosuke Tanaka, Takeshi Senjyu, Takeshi Goya, Kenta Motomura, Motoyuki Kohjima, Masaki Kato, Akihide Masumoto, Kazuhiro Kotoh
Masayuki Miyazaki, Masayoshi Yada, Kosuke Tanaka, Takeshi Senjyu, Kenta Motomura, Akihide Masumoto, Department of Hepatology, Iizuka Hospital, Iizuka 820-8505, Japan
Takeshi Goya, Motoyuki Kohjima, Masaki Kato, Department of Medicine and Bioregulatory Science, Graduate School of Medical Science, Kyushu University, Fukuoka 810-0065, Japan
Kazuhiro Kotoh, Department of Hepatology, Harasanshin Hospital, Fukuoka 812-0033, Japan
Author contributions: Miyazaki M, Motomura K and Kotoh K wrote the paper; Yada M, Tanaka K, Senjyu T and Kotoh K analyzed the data; Kohjima M, Kato M and Masumoto A supervised writing of the paper; all authors contributed to this manuscript.
Institutional review board statement: This study protocol was approved by the Ethics Committees at Iizuka Hospital (approval No. 15174).
Informed consent statement: For this type of retrospective study formal consent in not required. Only patient administered tolvaptan at 15 mg/day received a sufficient explanation of the aim and contents of this study.
Conflict-of-interest statement: The authors declare no conflict of interest in this study.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Correspondence to: Masayuki Miyazaki, MD, Department of Hepatology, Iizuka Hospital, 3-83 Yoshio, Iizuka 820-8505, Japan.
Telephone: +81-948-223800 Fax: +81-948-29574
Received: January 19, 2017
Peer-review started: January 19, 2017
First decision: February 23, 2017
Revised: March 10, 2017
Accepted: April 21, 2017
Article in press: April 21, 2017
Published online: August 7, 2017
Core Tip

Core tip: Efficacy of tolvaptan (TLV) for hepatic ascites has been confirmed but some patients are resistant to the drug. We investigate influencing factors of the efficacy of TLV. As a result, coexistent hepatocellular carcinoma (HCC) was the only significant predictive variable that attenuated the efficacy of TLV. In stratified analysis, high doses of furosemide decreased the efficacy of TLV in patients with HCC, and increased efficacy in those without HCC. This study suggests that development of ascites may differ between patients with liver failure and those with HCC progression. A sufficient preceding dose of furosemide decreases diuretic effect of TLV.