A comparative study of pathological staging systems in predicting recurrent hepatocellular carcinoma after liver transplantation

Okuno, Tomoko; Tsuruyama, Tatsuaki; Haga, Hironori; Ueda, Mikiko; Takada, Yasutsugu; Maetani, Yoji; Manabe, Toshiaki; Tamaki, Keiji

doi:10.1007/s00534-009-0110-x

Cited by 3 publications

(3 citation statements)

References 15 publications

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“…There are some relatively recent studies suggesting that the TNM system has the highest predictive value after liver transplantation. 37,38 Unfortunately, the TNM system has other limitations, including a broad tumor range in stage 2, at which transplantation may be considered.…”

Section: What Are the Best Hcc Staging Systems For Making Decisions Amentioning

confidence: 99%

“…Additional staging features that are prognostically important and can be diagnosed by an examination of the explanted liver include microscopic vascular invasion, satellite nodules, and lymph node metastases. 37,[59][60][61][62] Important prognostic information can also be obtained from features that are related to the tumor grade rather than the stage, such as differentiation (including nuclear size/atypia and mitotic activity). A 4-point grading scheme proposed by Edmondson and Steiner in 1954 is still widely cited in studies of prognostic factors for recurrence.…”

Section: What Staging System Is Best For Determining the Prognosis Afmentioning

confidence: 99%

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What is the best staging system for hepatocellular carcinoma in the setting of liver transplantation?

et al. 2011

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Section: What Are the Best Hcc Staging Systems For Making Decisions Amentioning

confidence: 99%

Section: What Staging System Is Best For Determining the Prognosis Afmentioning

confidence: 99%

What is the best staging system for hepatocellular carcinoma in the setting of liver transplantation?

et al. 2011

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“…The prognosis is evaluated according to these criteria. However, it has been observed that a number of Predicting tumor recurrence using metabolic indices of 18 F-FDG PET/CT prior to orthotopic liver transplantationfor hepatocellular carcinoma patients with similar clinical features display a different prognosis profile according to the Milan criteria (4,5). Therefore, the biological characteristic of tumors must be considered when evaluating patient prognosis.…”

Section: Introductionmentioning

confidence: 99%

Predicting tumor recurrence using metabolic indices of 18F‑FDG PET/CT prior to orthotopic liver transplantationfor hepatocellular carcinoma

Ding

Wei

et al. 2020

Oncol Lett

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The present study analyzed the ability of metabolic burden indices from 18 F-fluorodeoxyglucose (18 F-FDG) positron emission tomography/computed tomography (PET/CT) to predict tumor recurrence following orthotopic liver transplantation (OLT) in patients with hepatocellular carcinoma (HCC). Seven major metabolic indices were measured by 18 F-FDG PET/CT in 93 patients with HCC, prior to OLT. The Mann-Whitney U test was then used to predict the association of metabolic indices, including the maximum standardized uptake value (SUVmax), tumor-to-mediastinum SUV ratio, tumor-to-normal-liver SUV ratio, SUV normalized to lean body mass metabolic tumor volume (MTV), total lesion glycolysis (TLG) and uptake-volume product (UVP), with the recurrence risk. The Deauville-like scoring system was used to quantify the recurrence risk. Univariate and multivariable Cox regression models were performed to determine survival rate. The results showed that Deauville-like score (PET-negative vs.-positive), MTV (cutoff value, 13.36), TLG (cutoff value, 62.21) and UVP (cutoff value, 66.60) had high prediction performance for tumor recurrence (P<0.05). TLG had the highest receiver operating characteristics area under the curve of 0.725. Among the clinical factors, high level of α-fetoprotein (AFP, ≥144 ng/ml), Milan criteria, tumor number (>3), involvement of both right and left lobes, and tumor size (>5 cm) were found to be significant predictors of tumor recurrence. Patients in the low metabolic group had longer recurrence-free survival (RFS) times compared with those in the high metabolic group, regardless of whether they met the Milan criteria or not. AFP, uptake-volume product according the SUV mean of mediastinum (UVP-M), Milan criteria, lymph node metastasis, and the number of tumors were significant prognostic factors for RFS (P<0.05) in both univariate and multivariate survival analyses. Additionally, the MVI was a significant prognostic factor based on univariate survival analyses. Overall, the present study demonstrated the metabolic burden indices measured by PET/CT, Deauville-like score, MTV, TLG and UVP as significant prognostic factors in patients with HCC following OLT. The combination of metabolic indices measured by PET/CT and the existing criteria, such as the Milan criteria, may play an important role in evaluating the suitability of OLT in specific patients.

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Transplantation pathology

Hübscher¹,

Clouston²

2012

MacSween's Pathology of the Liver

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A comparative study of pathological staging systems in predicting recurrent hepatocellular carcinoma after liver transplantation

Abstract: The current AJCC tumor-node-metastasis staging and the LCSGJ system are superior in predicting HCC recurrence after LT.

Cited by 3 publications

References 15 publications

What is the best staging system for hepatocellular carcinoma in the setting of liver transplantation?

What is the best staging system for hepatocellular carcinoma in the setting of liver transplantation?

Predicting tumor recurrence using metabolic indices of 18F‑FDG PET/CT prior to orthotopic liver transplantationfor hepatocellular carcinoma

Transplantation pathology

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