TY - JOUR
T1 - Role of alfa-fetoprotein in selection of patients with hepatocellular carcinoma waiting for liver transplantation.
AU - Lai, Quirino
AU - Avolio, Alfonso Wolfango
AU - Manzia, Tommaso Maria
AU - Agnes, Salvatore
AU - Tisone, Giuseppe
AU - Berloco, Pasquale
AU - Rossi, Massimo
PY - 2011
Y1 - 2011
N2 - Background: Milan criteria (MC) represent the most commonly adopted criteria for the selection of patients with hepatocellular carcinoma (HCC) waiting for liver transplantation (LT). However, MC are exclusively based on morphological aspects. The aim of the present study was to evaluate pre-LT–detectable biological parameters,
to compare them with morphological ones in terms of tumor recurrence prediction and patient survival.
Methods: A cohort of 153 consecutive adult patients who underwent LT for HCC on cirrhosis from January 1999 to March 2009 was retrospectively analyzed.
Results: HCC recurrence was observed in 12 patients (7.8%). At multivariate logistic regression analysis, serum alpha-fetoprotein (AFP) was the unique independent negative risk factor for the development of HCC recurrence (odds ratio 2.0, p=0.03). Adopting a cutoff value of 210 ng/mL, patients who presented serum AFP ≥210 ng/mL showed a 5-year survival rate of 23.3% versus 76.2% observed in patients with pre-LT serum AFP <210 ng/mL (log-rank test: <0.0001).
Conclusions: In our experience, AFP was the strongest predictor of HCC recurrence, stronger than tumor morphology. AFP could ameliorate the selection of LT candidates. Further studies to evaluate the combination of morphological and biological criteria are needed.
AB - Background: Milan criteria (MC) represent the most commonly adopted criteria for the selection of patients with hepatocellular carcinoma (HCC) waiting for liver transplantation (LT). However, MC are exclusively based on morphological aspects. The aim of the present study was to evaluate pre-LT–detectable biological parameters,
to compare them with morphological ones in terms of tumor recurrence prediction and patient survival.
Methods: A cohort of 153 consecutive adult patients who underwent LT for HCC on cirrhosis from January 1999 to March 2009 was retrospectively analyzed.
Results: HCC recurrence was observed in 12 patients (7.8%). At multivariate logistic regression analysis, serum alpha-fetoprotein (AFP) was the unique independent negative risk factor for the development of HCC recurrence (odds ratio 2.0, p=0.03). Adopting a cutoff value of 210 ng/mL, patients who presented serum AFP ≥210 ng/mL showed a 5-year survival rate of 23.3% versus 76.2% observed in patients with pre-LT serum AFP <210 ng/mL (log-rank test: <0.0001).
Conclusions: In our experience, AFP was the strongest predictor of HCC recurrence, stronger than tumor morphology. AFP could ameliorate the selection of LT candidates. Further studies to evaluate the combination of morphological and biological criteria are needed.
KW - ALFA-FETOPROTEIN
KW - HEPATOCELLULAR CARCINOMA
KW - LIVER TRANSPLANTATION
KW - MILAN CRITERIA
KW - OUTCOME
KW - RECURRENCE
KW - ALFA-FETOPROTEIN
KW - HEPATOCELLULAR CARCINOMA
KW - LIVER TRANSPLANTATION
KW - MILAN CRITERIA
KW - OUTCOME
KW - RECURRENCE
UR - http://hdl.handle.net/10807/18268
UR - http://www.biological-markers.com/public/jbm/default.aspx
U2 - 10.5301/JBM.2011.8557
DO - 10.5301/JBM.2011.8557
M3 - Article
SN - 1724-6008
VL - 2011
SP - 153
EP - 159
JO - THE INTERNATIONAL JOURNAL OF BIOLOGICAL MARKERS
JF - THE INTERNATIONAL JOURNAL OF BIOLOGICAL MARKERS
ER -