Combination of Morphologic Criteria and α‐Fetoprotein in Selection of Patients With Hepatocellular Carcinoma for Liver Transplantation Minimizes the Problem of Posttransplant Tumor Recurrence

Grąt, Michał; Kornasiewicz, Oskar; Lewandowski, Zbigniew; Hołówko, Wacław; Grąt, Karolina; Kobryń, Konrad; Patkowski, Waldemar; Zieniewicz, Krzysztof; Krawczyk, Marek

doi:10.1007/s00268-014-2647-3

Cited by 41 publications

(41 citation statements)

References 47 publications

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“…However, it seems difficult to use the cut-off value of 400 ng/mL to directly exclude patients from a waiting list, because this value has been mostly studied as part of algorithms that include tumor volume, tumor size, the MC, and/or the UCSFcriteria. Moreover, many other cutoff values have been suggested, such as 100 ng/mL [47,57,67] and 200 ng/ mL [10,68] . The level of evidence to define an optimal value is very weak and thus calls for further studies.…”

Section: Defining a Cut-off Value For Afpmentioning

confidence: 99%

Contribution of alpha-fetoprotein in liver transplantation for hepatocellular carcinoma

Charrière¹,

Maulat²,

Suc³

et al. 2016

WJH

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Alpha-fetoprotein (AFP) is the main tumor biomarker available for the management of hepatocellular carcinoma (HCC). Although it is neither a good screening test nor an accurate diagnostic tool for HCC, it seems to be a possible prognostic marker. However, its contribution in liver transplantation for HCC has not been fully determined, although its use to predict recurrence after liver transplantation has been underlined by international societies. In an era of organ shortages, it could also have a key role in the selection of patients eligible for liver transplantation. Yet unanswered questions remain. First, the cut-off value of serum AFP above which liver transplantation should not be performed is still a subject of debate. We show that a concentration of 1000 ng/mL could be an exclusion criterion, whereas values of < 15 ng/mL indicate patients with an excellent prognosis whatever the size and number of tumors. Monitoring the dynamics of AFP could also prove useful. However, evidence is lacking regarding the values that should be used. Today, the real input of AFP seems to be its integration into new criteria to select patients eligible for a liver transplantation. These recent tools have associated AFP values with morphological criteria, thus refining pre-existing criteria, such as Milan, University of California, San Francisco, or "up-to-seven". We provide a review of the different criteria submitted within the past years. Finally, AFP can be used to monitor recurrence after transplantation, although there is little evidence to support this claim. Future challenges will be to draft new international guidelines to implement the use of AFP as a selection tool, and to determine a clear cut-off value above which liver transplantation should not be performed.

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Section: Defining a Cut-off Value For Afpmentioning

confidence: 99%

Contribution of alpha-fetoprotein in liver transplantation for hepatocellular carcinoma

Charrière¹,

Maulat²,

Suc³

et al. 2016

WJH

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“…Another Polish study including 121 HCC patients confirmed the validity of 100 ng/mL as cut-off value in predicting the risk of post-LT recurrence in patients meeting San Francisco criteria or up-to-seven criteria [13] . An Egyptian study identified AFP value > 200 ng/mL as a predictive tool for HCC recurrence in 170 living donor LT (LDLT) [14] .…”

Section: Recurrence: Role Of Static Valuesmentioning

confidence: 90%

“…The San Francisco transplant center underlined the recent implementation in their inclusion policy for LT to include patients with AFP levels > 1000 ng/mL only if LRT enabled to decrease this level beneath 500 ng/mL [21] . A Canadian study including 48 patients showed by 1901 July 28, 2015|Volume 7|Issue 15| WJH|www.wjgnet.com McHugh et al [12] 2010 101 United States 100 Grąt et al [13] 2014 121 Poland 100 Abdel-Wahab et al [14] 2013 170 (LDLT) Egypt 200 Lai et al [15] 2011 153 Italy 210 Harimoto et al [16] 2013 167 (LDLT) Japan 300 Merani et al [6] 2011 6817 United States 400 Toso et al [7] 2009 6478 United States 400 Zheng et al [8] 2008…”

Section: From Static To Dynamicmentioning

confidence: 99%

Selection tool alpha-fetoprotein for patients waiting for liver transplantation: How to easily manage a fractal algorithm

Lai

Sandri

Lerut

2015

WJH

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Alpha-fetoprotein (AFP) behavior in patients with hepatocellular carcinoma (HCC) waiting for liver transplant (LT) represents a perfect biological example of a fractal model in which its progressive modification and possible future prediction of its values are very hard to capture. As a consequence, AFP represents a useful but poorly manageable tool to increase the ability to better select HCC patients waiting for LT. Trying to find a "filrouge" in the recent literature, no definitive answers can be done to several open questions: (1) the best AFP value to adopt; (2) the best cut-off measurement; and (3) the best way to comfortably capture the effective, time-related, fluctuations of this biological marker. More, structured and prospective, studies using serial determination of AFP values within and without the context of locoregional therapies are needed in order to find the "ideal" (static and dynamic) cut-off values allowing to respond to all the still open questions in this field of transplant oncology. Core tip: Alpha-fetoprotein (AFP) behavior in patients with hepatocellular carcinoma waiting for liver transplant (LT) represents a perfect example of a fractal model. Consequently, AFP represents a useful but poorly manageable selection tool for patients waiting for LT. Looking at the recent literature, we can assume that: (1) last AFP value seem to be the best values to adopt; (2) different cut-offs may be adopted in the two different scenarios of Milan Criteria (MC) IN and MC OUT status; (3) AFP cut-off of 1000 ng/mL represent EDITORIAL Submit a

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“…Therefore, serum AFP levels are useful for the early detection and differential diagnosis of HCC (18). For patients who undergo curative hepatectomy for localized HCC, AFP levels are also useful for the detection of recurrence, and are associated with prognosis (19)(20)(21). Based on the data of the present study, GTSF1 mRNA was expressed in 87.5% of AFP-positive samples, but only in 50% of AFP-negative samples.…”

Section: Discussionmentioning

confidence: 99%

GTSF1 gene may serve as a novel potential diagnostic biomarker for liver cancer

et al. 2017

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Abstract. The gametocyte-specific factor 1 (GTSF1) gene participates in DNA methylation and retrotransposon activation in germ cells, particularly during cell proliferation. The present study aimed to assess the level of GTSF1 gene expression in liver cancer tumor tissues, and its role in human hepatoma cell lines in vitro and in a nude mouse model in vivo. GTSF1 gene expression was detected in liver cancer tumor tissues, compared with in healthy controls, via reverse transcription quantitative polymerase chain reaction. An adeno-associated virus vector was used to study tumor stem cell proliferation in vivo. A plasmid expressing GTSF1 was constructed and transfected into various human hepatoma cell lines, in order to analyze the cellular proliferation and apoptosis of liver cancer cells using small interfering (si)RNAs in vitro. In the present study, GTSF1 gene expression was detected in 18/24 (75.0%) liver cancer tumor tissues from patients with hepatocellular carcinoma (HCC), and elevated GTSF1 expression was identified in the tissue of one of 32 healthy control samples (3.13%; P<0.05). Notably, the GTSF1 gene was expressed at a higher frequency in AFP-positive HCC samples (14/16, 87.50%) compared with in AFP-negative HCC samples (4/8, 50.0%; P=0.129). In addition, there was no statistical significance between GTSF1 expression in non-HBV-infected (71.42%) and HBV-infected HCC specimens (76.47%), as determined by a χ 2 test (P=0.921). It was demonstrated that GTSF1 significantly increased the tumorigenicity of Ad-shNC-transfected (GTSF1-positive) HepG2 cells in the nude mouse xenograft model, whereas the sizes and weights of the tumors in the GTSF1-negative group were dercreased in comparison with the GTSF1-positive group (P<0.05). Reduced levels of GTSF1 mRNA, along with fewer and smaller colonies, were identified in two groups of human liver cancer cells treated with with GTSF1-targeting siRNA, when compared with cells without GTSF1 mRNA interference (P<0.05). In summary, the present study elucidated the GTSF1 mRNA expression pattern in liver cancer, and investigated the potential role of GTSF1 in tumorigenesis. The data suggest an important role for the GTSF1 gene in the molecular etiology of hepatocarcinogenesis, and indicate a potential application of GTSF1 mRNA expression in liver cancer diagnosis and therapy.

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Combination of Morphologic Criteria and α‐Fetoprotein in Selection of Patients With Hepatocellular Carcinoma for Liver Transplantation Minimizes the Problem of Posttransplant Tumor Recurrence

Cited by 41 publications

References 47 publications

Contribution of alpha-fetoprotein in liver transplantation for hepatocellular carcinoma

Contribution of alpha-fetoprotein in liver transplantation for hepatocellular carcinoma

Selection tool alpha-fetoprotein for patients waiting for liver transplantation: How to easily manage a fractal algorithm

GTSF1 gene may serve as a novel potential diagnostic biomarker for liver cancer

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