Comparison of survival and tumor recurrence rates in patients undergoing liver transplantation for hepatitis <scp>B</scp>‐related hepatocellular carcinoma using <scp>M</scp>ilan, <scp>S</scp>hanghai <scp>F</scp>udan and <scp>H</scp>angzhou criteria

Gao, Ting; Xia, Qiang; Qiu, De Kai; Feng, Yi; Chang, Jingjing; Wang, Si Yue; Zhi, Xi; Zhang, Jian Jun; Xu, Ning; Chen, Shi Yao; Qiu, Yu; Shen, Li; Zhou, Ting; Dong, Xiao; Li, Qi Gen; Li, Hai

doi:10.1111/1751-2980.12083

Cited by 11 publications

(6 citation statements)

References 22 publications

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“…After the introduction of the Milan Criteria (MC) in 1996, several other scores have been proposed in the last decades with the intent to refine the selection of HCC patients waiting for LT[ 5 - 8 ]. Apart from tumor morphology, also biology has been integrated into prognostic scores in the last years: Thus, the markers alpha-fetoprotein and des-gamma-carboxy-prothrombin, the radiological response after locoregional therapies or the tumor behaviour at PET scan have been largely investigated[ 9 - 13 ].…”

Section: Introductionmentioning

confidence: 99%

Platelet-to-lymphocyte ratio in the setting of liver transplantation for hepatocellular cancer: A systematic review and meta-analysis

Lai¹,

Melandro²,

Laureiro³

et al. 2018

WJG

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AIMTo perform a systematic review and meta-analysis on platelet-to-lymphocyte ratio (PLR) as a risk factor for post-transplant hepatocellular cancer (HCC) recurrence.METHODSA systematic literature search was performed using PubMed. Participants of any age and sex, who underwent liver transplantation for HCC were considered following these criteria: (1) studies comparing pre-transplant low vs high PLR values; (2) studies reporting post-transplant recurrence rates; and (3) if more than one study was reported by the same institute, only the most recent was included. The primary outcome measure was set for HCC recurrence after transplantation.RESULTSA total of 5 articles, published between 2014 and 2017, fulfilled the selection criteria. As for the quality of the reported studies, all the investigated articles presented an overall high quality. A total of 899 cases were investigated: 718 cases (80.0%) were males. Three studies coming from European countries and one from Japan presented HCV as the main cause of cirrhosis. On the opposite, one Chinese study presented a greater incidence of HBV-related cirrhotic cases. In all the studies apart one, the PLR cut-off value of 150 was reported. At meta-analysis, high PLR value was associated with a significant increase in recurrence after transplantation (OR = 3.33; 95%CI: 1.78-6.25; P < 0.001). A moderate heterogeneity was observed among the identified studies according to the Higgins I2 statistic value.CONCLUSIONPre-transplant high PLR values are connected with an increased risk of post-operative recurrence of hepatocellular cancer. More studies are needed for better clarify the biological mechanisms of this results.

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Section: Introductionmentioning

confidence: 99%

Platelet-to-lymphocyte ratio in the setting of liver transplantation for hepatocellular cancer: A systematic review and meta-analysis

Lai¹,

Melandro²,

Laureiro³

et al. 2018

WJG

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“…In addition, the Hangzhou criteria could not avoid the ‘dilute effect’ – that is, a majority of HCC patients who fulfilled the Milan criteria were included in the Hangzhou group, and a separate comparison between the newly proposed eligible patients for LT and the Milan group of patients was absent in the study. Indeed, our previous study 15 verified both the expanded criteria in patients with hepatitis B-related HCC using a prospectively collected database, and the data suggested that the 1-, 3-, and 5-year recurrence rates of the newly eligible patients selected using the Shanghai or Hangzhou criteria were significantly higher than those among patients fulfilling the Milan criteria. Thus, it is important to efficiently and accurately identify the patients with favorable prognosis from those outside the Milan criteria.…”

Section: Discussionmentioning

confidence: 83%

Serum levels of preoperative α-fetoprotein and CA19-9 predict survival of hepatic carcinoma patients after liver transplantation

Wan¹,

Zhang²,

Long³

et al. 2014

European Journal of Gastroenterology &Amp; Hepatology

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ObjectiveThe aim of this study was to assess serum levels of presurgical α-fetoprotein (AFP) and carbohydrate antigen 19-9 (CA19-9) as prognostic markers in patients with hepatic carcinoma after liver transplantation (LT).MethodsA total of 226 patients were recruited for the analysis of serum AFP and CA19-9 levels, on the basis of which the tumor marker type (TMT) was defined and evaluated for prognostic prediction. Overall survival (OS) and relapse-free survival (RFS) were analyzed using Kaplan–Meier curves, and univariate and multivariate Cox models.ResultsOne-year and 5-year OS were 79.0 and 58.0%, respectively, whereas RFS were 70.3 and 62.2%, respectively, in this cohort of patients. There were six variables predicting both OS and RFS, including TMT, tumor size, number of tumor lesions, extrahepatic or vascular invasion, and histopathological grade. Among these, TMT, tumor size, and extrahepatic invasion were all independent predictors of OS and RFS among these patients. Further, on the basis of TMT, novel LT selection criteria for patients with hepatic carcinoma, which supplemented the Milan criteria, were adopted, because the patients within the Milan criteria (n=107) and those exceeding Milan but fulfilling the proposed criteria (n=30) had similar 5-year OS (77.8 vs. 79.3%, P=0.862) and RFS (85.5 vs. 75.1%, P=0.210) rates.ConclusionThe data from this study showed that serum levels of preoperative AFP and CA19-9 were able to predict survival of patients with hepatic carcinoma after LT. This study included novel criteria, adding serum AFP and CA19-9 levels to the selection criteria for LT eligibility of patients, in addition to the Milan criteria.

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“…Previous studies have pointed out that chronic HBV exposure, fatty liver, cigarette and alcohol use, and liver cirrhosis could help tumor cells escape immune surveillance and promote tumor proliferation and metastasis[ 19 , 20 , 11 ]. Additionally, the prognosis of PLC is impacted by tumor size, number, the presence of vascular invasion, and lymph node metastasis[ 21 ]. In clinical practice, these high-risk factors are mixed in with the different criteria we analyzed; however, there is no good model featuring the different phases of PLC, meaning it is essential to treat the factors distinctively.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of high-risk factors and the diagnostic value of alpha-fetoprotein in the stratification of primary liver cancer

Jiao¹,

Wang²,

Guo³

et al. 2022

WJCC

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BACKGROUND Alpha-fetoprotein (AFP) is one of the diagnostic standards for primary liver cancer (PLC); however, AFP exhibits insufficient sensitivity and specificity for diagnosing PLC. AIM To evaluate the effects of high-risk factors and the diagnostic value of AFP in stratified PLC. METHODS In total, 289 PLC cases from 2013 to 2019 were selected for analysis. First, the contributions of high-risk factors in stratifying PLC were compared according to the following criteria: Child–Pugh score, clinical stage of liver cirrhosis, tumor size, and Barcelona Clinic Liver Cancer (BCLC) stage. Then, the diagnostic value of AFP was evaluated in different stratifications of PLC by receiver operating characteristic curves. For PLC cases in which AFP played little role, the diagnostic values of carcinoembryonic antigen (CEA), carbohydrate antigen 19-9 (CA 19-9), gamma-glutamyl transferase (GGT), and AFP were analyzed. RESULTS The roles of high-risk factors differed in stratified PLC. The incidence of smoking and drinking history was higher in PLC with Child–Pugh scores of C ( P < 0.0167). The hepatitis B virus (HBV) infection rate in PLC with cirrhosis was more than in PLC without cirrhosis ( P < 0.0167). Small tumors were more prone to cirrhosis than large tumors ( P < 0.005). BCLC stage D PLC was more likely to be associated with HBV infection and cirrhosis ( P < 0.0083). AFP levels were higher in PLC with cirrhosis, diffuse tumors, and BCLC stage D disease. In diagnosing PLC defined as Child–Pugh A, B, and C, massive hepatoma, diffuse hepatoma, BCLC stage B, C, and D, and AFP showed significant diagnostic value [all area under the curve (AUC) > 0.700]. However, these measures were meaningless (AUC < 0.600) in small hepatomas and BCLC A stage PLC, but could be replaced by the combined detection of CEA, CA 19-9, GGT, and AFP (AUC = 0.810 and 0.846, respectively). CONCLUSION Stratification of PLC was essential for precise diagnoses and benefited from evaluating AFP levels.

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Comparison of survival and tumor recurrence rates in patients undergoing liver transplantation for hepatitis B‐related hepatocellular carcinoma using Milan, Shanghai Fudan and Hangzhou criteria

Cited by 11 publications

References 22 publications

Platelet-to-lymphocyte ratio in the setting of liver transplantation for hepatocellular cancer: A systematic review and meta-analysis

Platelet-to-lymphocyte ratio in the setting of liver transplantation for hepatocellular cancer: A systematic review and meta-analysis

Serum levels of preoperative α-fetoprotein and CA19-9 predict survival of hepatic carcinoma patients after liver transplantation

Evaluation of high-risk factors and the diagnostic value of alpha-fetoprotein in the stratification of primary liver cancer

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