Title
Number of hepatocellular carcinoma nodules in patients listed for liver transplantation within alpha-fetoprotein score: a new prognostic risk factor
Date Issued
01 May 2021
Access level
open access
Resource Type
journal article
Author(s)
Mazzotta A.D.
Pascale A.
Rosmorduc O.
Allard M.A.
Sa Cunha A.
Adam R.
Cherqui D.
Vibert E.
Golse N.
University Rennes
Publisher(s)
John Wiley and Sons Inc
Abstract
In France, the listing for liver transplantation (LT) for hepatocellular carcinoma (HCC) requires an AFP score ≤2. This study evaluates whether the number of nodules assessed immediately before LT has a prognostic value among patients already listed within AFP score. Among 143 recipients transplanted with an AFP score ≤2 between 2013 and 2017 in our center, the number of nodules was considered at listing on the waiting list and at last imaging before LT. We compared the overall survival (OS) and disease-free survival (DFS) post-LT of patients with ≤3 and >3 nodules (current classification), and aimed to propose a new criteria to exclude patients on list at high risk of recurrence. The 3-year OS of patients with ≤3 HCC vs. >3 HCC at listing was of 90.3% vs. 67.3%, respectively (P = 0.04). At last imaging, eight listed patients presented ≥5 HCC nodules and had a significantly lower OS than <5 nodules patients (5-year OS: 24.4% vs. 78.1%; P = 0.01). Although the current AFP score offers satisfactory outcomes, we highlight the poorer outcomes when ≥5 nodules persist or appear after listing. A modification of the AFP score is mandatory to consider exclusion of high-risk patients already listed for LT program.
Start page
954
End page
963
Volume
34
Issue
5
Language
English
OCDE Knowledge area
OncologĂ­a GastroenterologĂ­a, HepatologĂ­a
Scopus EID
2-s2.0-85102465796
PubMed ID
Source
Transplant International
ISSN of the container
09340874
Sources of information: Directorio de ProducciĂ³n CientĂ­fica Scopus