Value of HCC-MELD Score in Patients With Hepatocellular Carcinoma Undergoing Liver Transplantation

Guerrini, Gian Piero; Pinelli, D.; Marini, Elena; Corno, V.; Guizzetti, M.; Zambelli, M.; Aluffi, A.; Lincini, Lisa; Fagiuoli, Stefano; Lucianetti, A.; Colledan, M.

doi:10.1177/1526924817746686

Cited by 16 publications

(11 citation statements)

References 38 publications

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“…Also, as expected, age and functional status were major factors associated with survival. In addition, and consistent with the prior literature, 1,2,23,24 we found that persons who underwent transplant in more recent years, all else being equal, had better survival, and those with diabetes, ascites, and hepatic encephalopathy had worse survival.…”

Section: Discussionsupporting

confidence: 90%

Life Expectancy After Liver Transplantation for Hepatocellular Carcinoma With Cirrhosis

Kwak¹,

Shavelle²,

Brooks³

2021

Prog Transpl

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Background: Hepatocelluar carcinoma, the most common primary liver cancer, has a historically dire prognosis. For hepatic cancer patients with cirrhosis who underwent liver transplantation, we sought to calculate life expectancies both at time of transplant and several years later, stratified by some key variables, and to determine if survival has improved in recent years. Methods: Data on 13,797 hepatic cancer patients with cirrhosis who underwent liver transplantation in the MELD era (2002-2018) from the US Organ Procurement and Transplantation Network database were analyzed using the Cox proportional hazards regression model and life table methods. Results: The major factors related to survival were age, donor age, transplant year, diabetes, functional status, and the presence of severe hepatic encephalopathy. Survival was significantly worse with increasing age and decreasing functional status level. There was no significant difference in survival between males and females. Survival improved over the study period, at 5% per calendar year during the first 5 years post transplant, and 1% per year thereafter. Conclusions: Life expectancies were markedly reduced from normal, even among 5-year survivors with the most favorable characteristics. Survival improved modestly over the years 2002-2018.

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Section: Discussionsupporting

confidence: 90%

Life Expectancy After Liver Transplantation for Hepatocellular Carcinoma With Cirrhosis

Kwak¹,

Shavelle²,

Brooks³

2021

Prog Transpl

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“…Generally, TAE is reserved for non-surgical candidates with liver-dominant disease. Patient selection for all locoregional therapies including TAE involves clinical and serologic evaluation of the patient including functional status, liver function tests, and clinical indices such as the ALBI (Albumin-Bilirubin), CP (Child-Pugh), MELD (Model for End-stage Liver Disease), and ECOG (Eastern Cooperative Oncology Group) performance status scores for patient stratification and assessment [34][35][36]. In addition to its role in the diagnosis of HCC, preprocedural imaging is paramount for evaluation of the vascular anatomy, access site patency, and ensuring patency of the portal vein [37].…”

Section: Patient Selectionmentioning

confidence: 99%

Locoregional Therapy Approaches for Hepatocellular Carcinoma: Recent Advances and Management Strategies

Makary

Khandpur

Cloyd

et al. 2020

Cancers

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Hepatocellular carcinoma (HCC) is the most common primary liver malignancy and third leading cause of cancer-related mortality worldwide. While surgical resection and transplantation are the standard first-line treatments for early-stage HCC, most patients do not fulfill criteria for surgery. Fortunately, catheter-directed and percutaneous locoregional approaches have evolved as major treatment modalities for unresectable HCC. Improved outcomes have been achieved with novel techniques which can be employed for diverse applications ranging from curative-intent for small localized tumors, to downstaging or bridging to resection and transplantation for early and intermediate disease, and locoregional control and palliation for advanced disease. This review explores recent advances in liver-directed techniques for HCC including bland transarterial embolization, chemoembolization, radioembolization, and ablative therapies, with a focus on patient selection, procedural technique, periprocedural management, and outcomes.

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“…In addition, the inability to discriminate liver function and clinical outcomes among patients with HCC and well-preserved liver function is a major drawback of the CTP class system, as the majority of patients with HCC are of CTP class A [8, 9]. The MELD score is reliable for stratification of the risk of dropout in patients with HCC [10]. However, this score has limitations when applied to patients with less-severe HCC, and has been evaluated only with those awaiting liver transplantation (LT) with “exception” points [4, 9, 11].…”

Section: Introductionmentioning

confidence: 99%

Comparing various scoring system for predicting overall survival according to treatment modalities in hepatocellular carcinoma focused on Platelet-albumin-bilirubin (PALBI) and albumin-bilirubin (ALBI) grade: A nationwide cohort study

et al. 2019

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Background We evaluated the ability of various grading scales including platelet-albumin-bilirubin (PALBI) and albumin-bilirubin (ALBI) grades to predict overall survival (OS) according to treatment modality in patients with hepatocellular carcinoma (HCC). Methods The cohort of 6,669 patients with HCC was selected randomly from the 2008–2012 national cohort of the Korean Central Cancer Registry. The OS of 6,507 of these patients was evaluated using the Child-Turcotte-Pugh (CTP) class, Model for End-stage Liver Disease (MELD) score, and ALBI and PALBI grades. Results The patient’s mean age was 59.7 years. The most patients were hepatitis B virus (63.4%) and CTP class A (71.8%). The median OS durations of PALBI grade1 (38.4%), grade2 (33.2%), and grade3 (28.4%) patients were 81, 30, and 5 months, respectively ( P <0.001). The PALBI grade had a larger area under the receiver operator characteristic curve (AUC) than did the CTP class, MELD score, and ALBI grade (overall AUC: 0.675 vs. 0.633, 0.645, and 0.642, respectively; P < 0.001). Moreover, the PALBI and ALBI grades enabled sub-classification of CTP A patients ( P < 0.001). In a multivariate analysis, the PALBI and ALBI grades were significant risk factors for OS (P < 0.05). According to treatment modality, the PALBI grade was predictive of OS in patients receiving transarterial chemoembolization or supportive care. The ALBI grade was predictive of OS in patients undergoing surgical resection or radiofrequency ablation. Conclusion The PALBI and ALBI grades are more reliable for accessing liver function and predicting OS in patients with HCC. Moreover, according to treatment modality, appropriate use of the ALBI and PALBI grades will enable accurate determination of the prognosis of patients with HCC.

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Value of HCC-MELD Score in Patients With Hepatocellular Carcinoma Undergoing Liver Transplantation

Abstract: Our study showed the validity of the HCC-MELD equation in the evaluation of patients undergoing LT for HCC. This score offers a reliable method to assess the risk of waiting list dropout and predict posttransplantation outcomes.

Cited by 16 publications

References 38 publications

Life Expectancy After Liver Transplantation for Hepatocellular Carcinoma With Cirrhosis

Life Expectancy After Liver Transplantation for Hepatocellular Carcinoma With Cirrhosis

Locoregional Therapy Approaches for Hepatocellular Carcinoma: Recent Advances and Management Strategies

Comparing various scoring system for predicting overall survival according to treatment modalities in hepatocellular carcinoma focused on Platelet-albumin-bilirubin (PALBI) and albumin-bilirubin (ALBI) grade: A nationwide cohort study

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