Abstract: Objective In recent years, the incidence of metastatic liver cancer-related pseudocirrhosis has been gradually increasing However, there is a lack of research about pseudocirrhosis in China at present. Here we have made a preliminary exploration.Methods A retrospective study was performed on 346 patients with metastatic liver cancer admitted from January 2018 to December 2023, and the diagnosis of pseudocirrhosis was retrospectively analyzed, and the clinical features, related complications, diagnosis, treatment, and prognosis were statistically analyzed. A prospective study was conducted on 4 patients with pseudocirrhosis from September 2023 to July 2024 to explore feasible diagnostic procedures, treatment methods, and outcomes.Results Twenty-three cases of pseudocirrhosis were retrospectively diagnosed, with an incidence rate of 6.6%, the median time from the diagnosis of metastatic liver cancer to the discovery of pseudocirrhosis was 23 months, 19/23 (82.6%) had multiple tumor metastases (>10 lesions), 11/23 cases (47.8%) had stable or responding disease at the time of pseudocirrhosis diagnosis. Compared with the control group, patients with pseudocirrhosis had lower platelet count and higher total bilirubin (P<0.001), 20/23 (86.9%) with ascites, 5/23 (21.7%) had newly developed splenomegaly, 8/23 (34.8%) of esophagogastric varices, 1/23 (4.3%) of hepatic encephalopathy, 16/18 (88.9%) of high serum albumin ascites gradient, and 19/23 (82.6%) of patients had been treated with oxaliplatin during the course of the disease. The median survival after diagnosis of pseudocirrhosis was 10 months. In the prospective study, 4 patients with pseudocirrhosis, 1 case with a large amount of ascites effusion who was treated by a combination of non-selective beta-blocker medication significantly improved the symptoms. Another patient with splenomegaly and thrombocytopenia resumed anti-tumor treatment after partial splenic embolization, and the patient’s condition remained stable for a long time.Conclusion Pseudocirrhosis is not rare in long-term survival patients with metastatic liver cancer, An early identification and diagnosis are crucial. Immediate cessation the use of potential inducing drugs or treatment may reverse the condition. A combined treatment with NSBB medication after the onset of pseudocirrhosis can improve symptoms. PSE and TIPS have certain value for the treatment of complications associated with the occurrence of portal hypertension.

Key words: Pseudocirrhosis, Portal hypertension, Tumor