Endoscopic Variceal Ligation vs Carvedilol for the Prevention of First Esophageal Variceal Bleeding in Patients With HCC

This study is comparing two approaches to prevent the first episode of bleeding from enlarged veins in the esophagus (esophageal varices) in patients with liver cancer (HCC): endoscopic banding (tying off the veins with rubber bands) versus a beta-blocker pill called carvedilol. **You may be eligible if...** - You have been diagnosed with hepatocellular carcinoma (liver cancer) - You have high-risk enlarged veins in the esophagus confirmed on endoscopy (classified as F2 or F3) - You are between 20 and 90 years old - You have never bled from esophageal varices before - You have not had previous treatment for esophageal varices **You may NOT be eligible if...** - You have a history of bleeding from esophageal varices - You have had previous treatment for esophageal varices (banding, sclerotherapy, shunting, or surgery) - You have conditions that prevent taking beta-blockers (e.g., severe heart block, COPD, asthma, poorly controlled diabetes, severe peripheral artery disease) - You have another end-stage condition (heart failure, kidney failure, other terminal cancer) - You are pregnant Talk to your doctor to see if this trial is right for you.