Risk Factors of Hepatocellular Carcinoma Recurrence After Liver Transplantation: Accuracy of the Alpha-Fetoprotein Model in a Single-Center Experience

Varona, M.A.; Soriano, Arturo; Aguirre‐Jaime, Armando; Garrido, S.; Oton, E.; Díaz, Dácil; Portero, Julián; Bravo, Pilar; Barrera, Manuel; Perera, A.

doi:10.1016/j.transproceed.2014.12.013

Cited by 43 publications

(31 citation statements)

References 20 publications

(12 reference statements)

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“…This form of HCC spreads between multiple organs, commonly seen in the lungs and in bone (Roberts, 2005). The studies produced by Vagefi et al (2015), Felga et al(2012), and Varona et al (2015) had similar findings, with recorded incidence of 6.5%, 6.9%, and 7%, respectively. Research performed by Fisher et al (2007), Bonadio et al (2015), and Kornberg et al (2015) identified higher incidence, reported at 18%, 22%, and 23.3%, respectively.…”

Section: Incidencementioning

confidence: 59%

“…Research by Varona et al (2015) supplements the argument made by Chaiteerakij et al (2015), in terms of the AFP biomarker. These two studies agree that biomarkers should be used in addition to criteria methods, but the studies propose different levels of AFP as the indicator of recurrence.…”

Section: Patientsmentioning

confidence: 81%

“…A study by Berry and Ioannou (2013) suggest an AFP lower limit of ≥ 15 ng/mL, while Varona et al (2015) suggests a larger lower limit of ≥ 100 ng/mL. These studies argue that AFP levels are accurate indicators of recurrence when combined with Milan criteria, but scholars cannot agree upon the level of concern.…”

Section: Non-significant Risk Factorsmentioning

confidence: 99%

“…These two studies agree that biomarkers should be used in addition to criteria methods, but the studies propose different levels of AFP as the indicator of recurrence. Chaiteerakij et al (2015) proposed a level ≥ 250 ng/mL, while Varona et al (2015) proposed a lower level of ≥ 100 ng/mL. A study by Berry and Ioannou (2013) proposed an even lower level of ≥ 15ng/mL.…”

Section: Patientsmentioning

confidence: 99%

“…Three studies analyzed in the literature review followed this rule, with Vagefi et al (2015) having an incidence of 6.5% for 324 patients, Varona et al (2015) with an incidence of 7% for 480 patients, and Felga et al (2012) with an incidence of 6.9% for 603 patients. These studies were larger in scope and sample size compared to the data collected from OHSU.…”

Section: Incidencementioning

confidence: 99%

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Hepatocellular Carcinoma Recurrence After Liver Transplantation: An Analysis of Risk Factors and Incidence from Oregon Health Science University

Hubsky

2016

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Section: Incidencementioning

confidence: 59%

Section: Patientsmentioning

confidence: 81%

Section: Non-significant Risk Factorsmentioning

confidence: 99%

Section: Patientsmentioning

confidence: 99%

Section: Incidencementioning

confidence: 99%

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Hepatocellular Carcinoma Recurrence After Liver Transplantation: An Analysis of Risk Factors and Incidence from Oregon Health Science University

Hubsky

2016

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Tumor Stiffness Measurements on MR Elastography for Single Nodular Hepatocellular Carcinomas Can Predict Tumor Recurrence After Hepatic Resection

Park

Yoon

Lee

et al. 2020

Magnetic Resonance Imaging

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BackgroundTumor stiffness (TS), measured by magnetic resonance elastography (MRE), could be associated with tumor mechanical properties and tumor grade.PurposeTo determine whether TS obtained using MRE is associated with survival in patients with single nodular hepatocellular carcinoma (HCC) after hepatic resection (HR).Study TypeRetrospective.PopulationIn all, 95 patients with pathologically confirmed HCCs.Field Strength/Sequence1.5T/3D spin‐echo echo‐planar imaging MRE.AssessmentTS values of the whole tumor (TS‐WT) and of a solid portion of the tumor (TS‐SP) after excluding the necrotic area were measured on stiffness maps. Known imaging prognostic factors of HCC were also analyzed. After surgery, pathologic findings were evaluated from resected pathology specimens.Statistical TestsFisher's exact test and the Mann–Whitney U‐test were performed to determine the significance of differences according to the tumor grade. Overall survival (OS) / recurrence‐free survival (RFS) analyses were performed using Kaplan–Meier analyses and Cox multivariable models.ResultsThe average TS‐WT was 2.14 ± 0.74 kPa, and the average TS‐SP was 2.51 ± 1.07 kPa. The cumulative incidence of RFS was 73.1%, 63.1%, and 57.3% at 1, 3, and 5 years, respectively. The TS‐WT, TS‐SP, and tumor size (≥5 cm) were significant prognostic factors for RFS (P < 0.001; P < 0.001; P = 0.017, respectively). The estimated overall 1‐, 3‐, and 5‐year survival rates were 95.7%, 86.9%, and 80.8%, respectively. The alpha‐fetoprotein changes, platelets, tumor size (≥5 cm), and vascular invasion in pathology were significant predictive factors for overall survival (all P < 0.05). Tumor necrosis, TS‐WT, TS‐SP, and vascular invasion in pathology were significantly correlated with poorly differentiated HCC (all P < 0.05).Data ConclusionThe TS‐WT, TW‐SP, and tumor size (≥5 cm) were significant predictive factors of RFS after HR in patients with HCC.Level of EvidenceTechnical Efficacy Stage 5J. MAGN. RESON. IMAGING 2021;53:587–596.

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Utility‐based criteria for selecting patients with hepatocellular carcinoma for liver transplantation: A multicenter cohort study using the alpha‐fetoprotein model as a survival predictor

et al. 2015

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The lifetime utility of liver transplantation (LT) in patients with hepatocellular carcinoma (HCC) is still controversial. The aim of this study was to ascertain when LT is cost-effective for HCC patients, with a view to proposing new transplant selection criteria. The study involved a real cohort of potentially transplantable Italian HCC patients (n = 2419 selected from the Italian Liver Cancer group database) who received nontransplant therapies. A non-LT survival analysis was conducted, the direct costs of therapies were calculated, and a Markov model was used to compute the cost utility of LT over non-LT therapies in Italian and US cost scenarios. Post-LT survival was calculated using the alpha-fetoprotein (AFP) model on the basis of AFP values and radiological size and number of nodules. The primary endpoint was the net health benefit (NHB), defined as LT survival benefit in quality-adjusted life years minus incremental costs (US $)/willingness to pay. The calculated median cost of non-LT therapies per patient was US $53,042 in Italy and US $62,827 in the United States. On Monte Carlo simulation, the NHB of LT was always positive for AFP model values ≤ 3 and always negative for values > 7 in both countries. A multivariate model showed that nontumor variables (patient's age, Child-Turcotte-Pugh [CTP] class, and alternative therapies) had the potential to shift the AFP model threshold of LT cost-ineffectiveness from 3 to 7. LT proved always cost-effective for HCC patients with AFP model values ≤ 3, whereas the cost-ineffectiveness threshold ranged between 3 and 7 using nontumor variables. Liver Transpl 21:1250-1258, 2015. © 2015 AASLD

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Risk Factors of Hepatocellular Carcinoma Recurrence After Liver Transplantation: Accuracy of the Alpha-Fetoprotein Model in a Single-Center Experience

Cited by 43 publications

References 20 publications

Hepatocellular Carcinoma Recurrence After Liver Transplantation: An Analysis of Risk Factors and Incidence from Oregon Health Science University

Hepatocellular Carcinoma Recurrence After Liver Transplantation: An Analysis of Risk Factors and Incidence from Oregon Health Science University

Tumor Stiffness Measurements on MR Elastography for Single Nodular Hepatocellular Carcinomas Can Predict Tumor Recurrence After Hepatic Resection

Utility‐based criteria for selecting patients with hepatocellular carcinoma for liver transplantation: A multicenter cohort study using the alpha‐fetoprotein model as a survival predictor

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