Hepatocellular carcinoma biology predicts survival outcome after liver transplantation in the USA
PURPOSE: The aim of this study is to evaluate the clinicopathologic prognostic factors of cancer-specific survival (CSS) in hepatocellular carcinoma (HCC) patients who underwent liver transplantation (LT) stratified by tumor size.
METHODS: From the Surveillance, Epidemiology, and End Results (SEER) 18 registries (2004-2012), we retrieved data of 570 patients who underwent LT for a solitary primary HCC lesion ≤5 cm. A two multivariable Cox models were constructed to identify prognostic factors of CSS in a two different tumor sizes (2 cm cutoff).
RESULTS: Out of 570 HCC patients (median age 57 years), 16% had microvascular invasion (MVI) and 12% had a poorly differentiated tumor. Male sex (odds ratio [OR] 2.6), tumor size >2 cm (OR 1.78), elevated AFP (OR 2.31), and poor tumor differentiation (OR 2.59) are significant predictors of MVI. With a median follow up of 41.5 months (range 1-107 months), the 5-year CSS rate was 90% in the absence of MVI compared to 75% in the presence of MVI (p<0.001). Multivariate models revealed that age ≥60 years (hazard ratio [HR] 2.08), MVI (HR 2.26), and poor tumor differentiation (HR 2.42), were significant risk factors of a dismal CSS with HCC size >2 cm, but not with HCC ≤2 cm.
CONCLUSIONS: Primary HCC tumor size ≤2 cm had an excellent prognosis after LT and was not affect by the presence of MVI or poor tumor differentiation.
| Errataetall: |
CommentIn: Indian J Gastroenterol. 2017 Mar;36(2):77-80. - PMID 28357774 |
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| Medienart: |
E-Artikel |
| Erscheinungsjahr: |
2017 |
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| Erschienen: |
2017 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:36 |
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| Enthalten in: |
Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology - 36(2017), 2 vom: 28. März, Seite 117-125 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
El-Fattah, Mohamed Abd [VerfasserIn] |
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| Links: |
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| Themen: |
HCC |
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| Anmerkungen: |
Date Completed 21.09.2017 Date Revised 26.11.2019 published: Print-Electronic CommentIn: Indian J Gastroenterol. 2017 Mar;36(2):77-80. - PMID 28357774 Citation Status MEDLINE |
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| doi: |
10.1007/s12664-017-0732-x |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM268930848 |
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| 500 | |a CommentIn: Indian J Gastroenterol. 2017 Mar;36(2):77-80. - PMID 28357774 | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a PURPOSE: The aim of this study is to evaluate the clinicopathologic prognostic factors of cancer-specific survival (CSS) in hepatocellular carcinoma (HCC) patients who underwent liver transplantation (LT) stratified by tumor size | ||
| 520 | |a METHODS: From the Surveillance, Epidemiology, and End Results (SEER) 18 registries (2004-2012), we retrieved data of 570 patients who underwent LT for a solitary primary HCC lesion ≤5 cm. A two multivariable Cox models were constructed to identify prognostic factors of CSS in a two different tumor sizes (2 cm cutoff) | ||
| 520 | |a RESULTS: Out of 570 HCC patients (median age 57 years), 16% had microvascular invasion (MVI) and 12% had a poorly differentiated tumor. Male sex (odds ratio [OR] 2.6), tumor size >2 cm (OR 1.78), elevated AFP (OR 2.31), and poor tumor differentiation (OR 2.59) are significant predictors of MVI. With a median follow up of 41.5 months (range 1-107 months), the 5-year CSS rate was 90% in the absence of MVI compared to 75% in the presence of MVI (p<0.001). Multivariate models revealed that age ≥60 years (hazard ratio [HR] 2.08), MVI (HR 2.26), and poor tumor differentiation (HR 2.42), were significant risk factors of a dismal CSS with HCC size >2 cm, but not with HCC ≤2 cm | ||
| 520 | |a CONCLUSIONS: Primary HCC tumor size ≤2 cm had an excellent prognosis after LT and was not affect by the presence of MVI or poor tumor differentiation | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a HCC | |
| 650 | 4 | |a Hepatocellular carcinoma | |
| 650 | 4 | |a Liver transplantation | |
| 650 | 4 | |a Microvascular invasion | |
| 650 | 4 | |a Prognosis | |
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