Usefulness of PIVKA-II After Living-donor Liver Transplantation for Hepatocellular Carcinoma

Park, M.-S.; Lee, K.-W.; Kim, H.; Choi, Young Rok; Hong, Geun; Yi, Nam‐Joon; Suh, Kyung Suk

doi:10.1016/j.transproceed.2017.03.017

Cited by 11 publications

(19 citation statements)

References 17 publications

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“…PIVKA-II has also been shown to be strongly associated with tumour biology, with higher levels significantly related to the presence of vascular invasion, larger tumour size and poorer differentiation [ 33 , 35 ]. Our results also add to the evidence base, with higher baseline PIVKA-II levels associated with increasing tumour stage, larger tumour size and poorer differentiation.…”

Section: Discussionmentioning

confidence: 99%

The potential of PIVKA-II as a treatment response biomarker in hepatocellular carcinoma: a prospective United Kingdom cohort study

et al. 2021

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Section: Discussionmentioning

confidence: 99%

The potential of PIVKA-II as a treatment response biomarker in hepatocellular carcinoma: a prospective United Kingdom cohort study

et al. 2021

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“…MVI is one of the most important predictors of post transplant recurrence in patients with HCC (Rodríguez-Perálvarez et al, 2013). Our inability to reliably detect MVI preoperatively, with imaging or biopsy, compromises ideal patient selection for transplantation (Park et al, 2017). Consequentially, tumor related factors such as tumor size and number have been used to select appropriate candidates for treatment.…”

Section: Discussionmentioning

confidence: 99%

Clinical Utility of Protein Induced by Vitamin K Absence-II in Patients with Hepatocellular Carcinoma

Bhatti

Naz

Abbas

et al. 2021

Asian Pac J Cancer Prev

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Objective: Despite moderate sensitivity, alpha fetoprotein (AFP) is widely used in screening and prognostication for hepatocellular carcinoma (HCC). The objective of the current study was to assess clinical utility of Prothrombin induced by Vitamin K absence-II (PIVKAII) in addition to AFP in patients with HCC. Methods: We retrospectively reviewed 244 patients with documented AFP, PIVKA II and dynamic imaging of the liver. Using ROC curves, cutoff values for AFP and PIVKAII for HCC detection, tumor grade and microvascular invasion (MVI) were assessed. In patients who underwent liver transplantation (LT) for HCC, survival was determined using Kaplan Meier curves. Results: The median PIVKAII in healthy living donors was 28.6mAU/ml (15.9-55). In cirrhotics, the sensitivity of an AFP cutoff of 7.6 ng/ml or PIVKAII cutoff of 250 mAU/ml for HCC detection was 91.7% (176/192) and specificity was 62.9%(68/108) (P<0.0001). In patients with HCC, PIVKAII values were significantly elevated with tumor size > 5 cm (P < 0.0001), tumor nodules > 3(P=0.01), and macrovascular invasion(P<0.0001). The high risk group (patients with AFP ≥ 40 ng/ml + PIVKAII ≥ 350 mAU/ml), had a sensitivity of (23/33) 69.6% and specificity of (22/22)100% for MVI (P <0.001). The estimated 3 year RFS after LT in the low risk group (AFP <40 ng/ml or PIVKAII< 350 mAU/ml) was 100% versus 63%(P=0.001). The estimated 3 year RFS based with and without MVI was 80% and 100% (P=0.03). Conclusion: PIVKAII in combination with AFP, appears to have a promising role in surveillance and prognostication for HCC. It also allows improved patient selection for liver transplantation.

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“…Association between post-LT HCC recurrence and level of pre-LT AFP level has been demonstrated, and AFP is incorporated as a predicting parameter in some scoring systems (such as the RETREAT 17 and MORAL 18 scores) and nomograms. 19 However, another study 20 showed that the sensitivity of AFP for recurrent HCC was just around 59%. In our center, around 20–30% of the HCC patients were nonsecretors of AFP; this fact might limit its application in patient selection.…”

Section: Patient Selection Criteria and Prediction Of Hcc Recurrencementioning

confidence: 99%

“…PIVKA-II is currently not available in many centers, including ours. Yet, many studies have demonstrated high sensitivity and specificity of PIVKA-II when used alone 20 – 22 or in combination 23 , 24 with AFP for the prediction of microvascular invasion and recurrence in HCC. Apart from biochemical markers, promising results in the prediction of microvascular invasion and HCC recurrence have been shown by using new radiological parameters, such as radiogenomic venous invasion (RVI) 25 and total tumor volume (TTV), 26 – 28 on computed tomography scan and positron emission tomography scan using different isotope tracers (i.e.…”

Section: Patient Selection Criteria and Prediction Of Hcc Recurrencementioning

confidence: 99%

Liver Transplantation for Hepatitis B Virus-related Hepatocellular Carcinoma in Hong Kong

Wing

Chok

Fung

et al. 2018

Journal of Clinical and Translational Hepatology

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Hepatocellular carcinoma (HCC) is the fifth most common cancer and the third most common cause of cancer-related deaths worldwide. Curative resection is frequently limited in Hong Kong by hepatitis B virus-related cirrhosis, and liver transplantation is the treatment of choice. Liver transplantation has been shown to produce superior oncological benefits, when compared to hepatectomy for HCC. New developments in the context of patient selection criteria, modification of organ allocation, bridging therapy, salvage liver transplantation and pharmaceutical breakthrough have improved the survival of HCC patients. In this article, we will share our experience in transplanting hepatitis B virus-related HCC patients in Hong Kong and discuss the recent progress in several areas of liver transplantation.

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Usefulness of PIVKA-II After Living-donor Liver Transplantation for Hepatocellular Carcinoma

Cited by 11 publications

References 17 publications

The potential of PIVKA-II as a treatment response biomarker in hepatocellular carcinoma: a prospective United Kingdom cohort study

The potential of PIVKA-II as a treatment response biomarker in hepatocellular carcinoma: a prospective United Kingdom cohort study

Clinical Utility of Protein Induced by Vitamin K Absence-II in Patients with Hepatocellular Carcinoma

Liver Transplantation for Hepatitis B Virus-related Hepatocellular Carcinoma in Hong Kong

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