Liver Transplantation for Hepatocellular Carcinoma: Malatya Experience and Proposals for Expanded Criteria

Ince, Volkan; Akbulut, Sami; Otan, Emrah; Ersan, Veysel; Karakas, Serdar; Sahin, Tevfik Tolga; Carr, Brian I.; Başkıran, Adil; Şamdancı, Emine; Bag, Harika Gozukara; Koç, Cemalettin; Usta, Sertaç; Özdemir, Fatih; Barut, Bora; Gönültaş, Fatih; Sarıcı, Barış; Kutlutürk, Koray; Doğan, Murat; Özgör, Dinçer; Dikilitaş, Mustafa; Harputluoğlu, Murat; Aladağ, Murat; Kutlu, Ramazan; Varol, Fatma İlknur; Dirican, Abuzer; Aydın, Cemalettin; Işık, Burak; Ara, Cengiz; Kayaalp, Cüneyt; Emre, Sükrü; Yilmaz, Sezai

doi:10.1007/s12029-020-00424-w

Cited by 38 publications

(27 citation statements)

References 25 publications

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“…In addition, recent studies have demonstrated that the ALBI grade is associated with higher levels of AFP and more advanced tumor stage, which is correlated with malignant biological behavior and poor prognosis [32], similar to the association of AAPR in HCC. Moreover, HCC patients without cirrhosis, in whom HCC is presumably attributed to the direct carcinogenic effect of HBV infection, tend to harbor larger-sized or poorly differentiated tumors, contributing to the unfavorable prognosis of early-stage HCC [33,34]. In our series, since the presence of liver cirrhosis or the CP grade was not associated with the prognosis of earlystage HCC, we speculated that patients in the low-AAPR group might exhibit more aggressive tumor behaviors, indicated by AAPR or the ALBI grade, due to the direct development of HCC in the absence of liver cirrhosis.…”

Section: Discussionmentioning

confidence: 99%

Albumin-to-alkaline phosphatase ratio as a predictor of tumor recurrence and prognosis in patients with early-stage hepatocellular carcinoma undergoing radiofrequency ablation as initial therapy

Zhang

et al. 2021

International Journal of Hyperthermia

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Section: Discussionmentioning

confidence: 99%

Albumin-to-alkaline phosphatase ratio as a predictor of tumor recurrence and prognosis in patients with early-stage hepatocellular carcinoma undergoing radiofrequency ablation as initial therapy

Zhang

et al. 2021

International Journal of Hyperthermia

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“…Tumor size and number are commonly used in various HCC staging systems [ 47 – 49 ]. Larger tumor size and more tumors indicate a higher probability of intrahepatic metastasis and a poorer prognosis [ 50 – 54 ]. Serum AFP level is not only a significant prognostic predictor for HCC [ 54 – 57 ], but is also associated with many metastatic characteristics of HCC, such as MVI [ 58 ], an incomplete tumor capsule [ 59 , 60 ], and satellite lesions [ 61 ].…”

Section: Discussionmentioning

confidence: 99%

Preoperative and postoperative nomograms for predicting early recurrence of hepatocellular carcinoma without macrovascular invasion after curative resection

Zhang

Lei

et al. 2022

BMC Surg

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Background Postoperative early recurrence (ER) is a major obstacle to long-term survival after curative liver resection (LR) in patients with hepatocellular carcinoma (HCC). This study aimed to establish preoperative and postoperative nomograms to predict ER in HCC without macrovascular invasion. Methods Patients who underwent curative LR for HCC between January 2012 and December 2016 were divided into training and internal prospective validation cohorts. Nomograms were constructed based on independent risk factors derived from the multivariate logistic regression analyses in the training cohort. The predictive performances of the nomograms were validated using the internal prospective validation cohort. Results In total, 698 patients fulfilled the eligibility criteria. Among them, 265 of 482 patients (55.0%) in the training cohort and 120 of 216 (55.6%) patients in the validation cohort developed ER. The preoperative risk factors associated with ER were age, alpha-fetoprotein, tumor diameter, and tumor number, and the postoperative risk factors associated with ER were age, tumor diameter, tumor number, microvascular invasion, and differentiation. The pre- and postoperative nomograms based on these factors showed good accuracy, with concordance indices of 0.712 and 0.850 in the training cohort, respectively, and 0.754 and 0.857 in the validation cohort, respectively. The calibration curves showed optimal agreement between the predictions by the nomograms and actual observations. The area under the receiver operating characteristic curves of the pre- and postoperative nomograms were 0.721 and 0.848 in the training cohort, respectively, and 0.754 and 0.844 in the validation cohort, respectively. Conclusions The nomograms constructed in this study showed good performance in predicting ER for HCC without macrovascular invasion before and after surgery. These nomograms would be helpful for doctors when determining treatments and selecting patients for regular surveillance or administration of adjuvant therapies.

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“…At the first surgery, clinicopathological variables including age, sex, underlying liver disease, and preoperative laboratory results such as alpha-fetoprotein (AFP), tumor number, largest tumor diameter, tumor differentiation, microvascular invasion (MVI), satellite lesions, and liver cirrhosis were recorded. At the second surgery, clinicopathological variables including preoperative laboratory results such as AFP; and levels of aminotransferase (ALT), aspartate transaminase (AST), and total bilirubin (TBIL); tumor number; and largest tumor diameter were collected [ 15 , 16 ]. At the initial hepatectomy, 95 patients were within the Milan criteria (a single tumor < 5 cm or with up to three nodules < 3 cm) and 76 patients were beyond the Milan criteria.…”

Section: Methodsmentioning

confidence: 99%

The impact of tumor burden at the initial hepatectomy on the recurrence-to-death survival after repeat surgical resection/radiofrequency ablation: a retrospective study

Peng

Shen

et al. 2022

BMC Surg

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Background Previous studies have reported the surgical resection (SR) and radiofrequency ablation (RFA) could achieve comparable recurrence-to-death survival (RTDS). However, the impact of primary tumor burden on RTDS of patients with recurrent hepatocellular carcinoma (HCC) following SR or RFA has not been clarified. Methods From January 2009 to March 2015, 171 patients who underwent initial hepatectomy and second curative treatments in West China Hospital were retrospectively analyzed. Survival analysis was performed by the Kaplan–Meier method. Risk factors were identified using the Cox proportional hazard model. Results At initial hepatectomy, 96 patients (56.1%) were diagnosed with HCC within the Milan criteria (MC), and 75 patients (43.9%) were HCC beyond the MC. The clinicopathological features and re-treatment methods of recurrent HCC were similar between patients with primary HCC within or beyond the MC. Patients with primary HCC within the MC had longer recurrence time (31.4 ± 24.2 months vs. 20.2 ± 16 months, P < 0.001). The 1- and 3- year RTDS within and beyond the MC group were 88.8%, 57.6% and 79.0%, 46.3%, respectively (P = 0.093). In multivariate analysis, the recurrence time, tumor size and AFP > 400 ng/mL at the time of recurrence were associated with RTDS. Conclusions The primary tumor burden had no impact on RTDS, but had an impact on recurrence time. The recurrence time had an impact on RTDS and might be a good index to reflect the biology of recurrent HCC.

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Liver Transplantation for Hepatocellular Carcinoma: Malatya Experience and Proposals for Expanded Criteria

Cited by 38 publications

References 25 publications

Albumin-to-alkaline phosphatase ratio as a predictor of tumor recurrence and prognosis in patients with early-stage hepatocellular carcinoma undergoing radiofrequency ablation as initial therapy

Albumin-to-alkaline phosphatase ratio as a predictor of tumor recurrence and prognosis in patients with early-stage hepatocellular carcinoma undergoing radiofrequency ablation as initial therapy

Preoperative and postoperative nomograms for predicting early recurrence of hepatocellular carcinoma without macrovascular invasion after curative resection

The impact of tumor burden at the initial hepatectomy on the recurrence-to-death survival after repeat surgical resection/radiofrequency ablation: a retrospective study

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