Predictive Models of Hepatocellular Carcinoma Recurrence After Liver Transplantation
Copyright © 2020 Elsevier Inc. All rights reserved..
BACKGROUND: Liver transplantation (LT) is a curative treatment for patients with hepatocellular carcinoma who are not candidates for resection. Despite the generalized use of the Milan criteria and up-to-seven criteria, new markers have been proposed to predict recurrence after LT. Biomarkers such as neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR), and scores such as the Model of Recurrence After Liver transplantation (MORAL) are used as predictors of post-LT recurrence.
OBJECTIVE: We aim to compare NLR, PLR, and MORAL score with Milan criteria and up-to-seven criteria.
METHODS: A descriptive study of 99 patients who underwent LT for hepatocellular carcinoma in our hospital between April 2010 and April 2016. The 5 prognostic models were applied to the patients to stratify them into risk groups. We used a Kaplan-Meier survival plot to measure recurrence-free survival in each model. Receiver operative curves were used to compare the models.
RESULTS: Three-year recurrence-free survival in MORAL was 91.1% for the low-risk group, 89.8% for the moderate-risk group, 60% for the high-risk group, and 75% for the very high-risk group (P = .003). The combined MORAL score was superior in predicting 1- and 3-year recurrence with the area under the curve 0.684 (95% confidence interval [CI]: 0.52-0.85) compared with Milan (0.536 [95% CI: 0.37-0.70]), up-to-seven (0.601 [95% CI: 0.43-0.77]), PLR (0.452 [95% CI: 0.30-0.61]), and NLR (0.542 [95% CI: 0.37-0.71]).
CONCLUSIONS: A model based only on pre-LT radiological signs leads to underdiagnosis of tumor load; therefore, the risk of recurrence must be recalculated after LT. The combined MORAL score was the best prognostic model of 1- and 3-year recurrence after LT in our study.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2020 |
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| Erschienen: |
2020 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:52 |
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| Enthalten in: |
Transplantation proceedings - 52(2020), 2 vom: 04. März, Seite 546-548 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Sánchez Segura, José [VerfasserIn] |
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| Anmerkungen: |
Date Completed 31.08.2020 Date Revised 31.08.2020 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1016/j.transproceed.2019.11.048 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM306316331 |
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| 245 | 1 | 0 | |a Predictive Models of Hepatocellular Carcinoma Recurrence After Liver Transplantation |
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| 500 | |a Date Revised 31.08.2020 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Copyright © 2020 Elsevier Inc. All rights reserved. | ||
| 520 | |a BACKGROUND: Liver transplantation (LT) is a curative treatment for patients with hepatocellular carcinoma who are not candidates for resection. Despite the generalized use of the Milan criteria and up-to-seven criteria, new markers have been proposed to predict recurrence after LT. Biomarkers such as neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR), and scores such as the Model of Recurrence After Liver transplantation (MORAL) are used as predictors of post-LT recurrence | ||
| 520 | |a OBJECTIVE: We aim to compare NLR, PLR, and MORAL score with Milan criteria and up-to-seven criteria | ||
| 520 | |a METHODS: A descriptive study of 99 patients who underwent LT for hepatocellular carcinoma in our hospital between April 2010 and April 2016. The 5 prognostic models were applied to the patients to stratify them into risk groups. We used a Kaplan-Meier survival plot to measure recurrence-free survival in each model. Receiver operative curves were used to compare the models | ||
| 520 | |a RESULTS: Three-year recurrence-free survival in MORAL was 91.1% for the low-risk group, 89.8% for the moderate-risk group, 60% for the high-risk group, and 75% for the very high-risk group (P = .003). The combined MORAL score was superior in predicting 1- and 3-year recurrence with the area under the curve 0.684 (95% confidence interval [CI]: 0.52-0.85) compared with Milan (0.536 [95% CI: 0.37-0.70]), up-to-seven (0.601 [95% CI: 0.43-0.77]), PLR (0.452 [95% CI: 0.30-0.61]), and NLR (0.542 [95% CI: 0.37-0.71]) | ||
| 520 | |a CONCLUSIONS: A model based only on pre-LT radiological signs leads to underdiagnosis of tumor load; therefore, the risk of recurrence must be recalculated after LT. The combined MORAL score was the best prognostic model of 1- and 3-year recurrence after LT in our study | ||
| 650 | 4 | |a Comparative Study | |
| 650 | 4 | |a Journal Article | |
| 650 | 7 | |a Biomarkers, Tumor |2 NLM | |
| 700 | 1 | |a León Díaz, Francisco Javier |e verfasserin |4 aut | |
| 700 | 1 | |a Pérez Reyes, María |e verfasserin |4 aut | |
| 700 | 1 | |a Cabañó Muñoz, Daniel |e verfasserin |4 aut | |
| 700 | 1 | |a Sánchez Pérez, Belinda |e verfasserin |4 aut | |
| 700 | 1 | |a Pérez Daga, Jose Antonio |e verfasserin |4 aut | |
| 700 | 1 | |a Montiel Casado, Custodia |e verfasserin |4 aut | |
| 700 | 1 | |a Santoyo Santoyo, Julio |e verfasserin |4 aut | |
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