Progression of Alphafetoprotein Before Liver Transplantation for Hepatocellular Carcinoma in Cirrhotic Patients: A Critical Factor

@article{Vibert2010ProgressionOA,
  title={Progression of Alphafetoprotein Before Liver Transplantation for Hepatocellular Carcinoma in Cirrhotic Patients: A Critical Factor},
  author={E. Vibert and D. Azoulay and E. Hoti and S. Iacopinelli and D. Samuel and C. Salloum and A. Lemoine and H. Bismuth and D. Castaing and R. Adam},
  journal={American Journal of Transplantation},
  year={2010},
  volume={10}
}
Liver transplantation (LT) for cirrhotic/Hepatocellular carcinoma (HCC) is associated with reduced survival in patients with poor histological features. Preoperative levels of alphafetoprotein (AFP) could predict negative biological features. AFP progression could be more relevant than static AFP levels in predicting LT outcomes. A total of 252 cirrhotic/HCC patients transplanted between 1985 and 2005 were reviewed. One hundred fifty‐three patients were analyzed, 99 excluded (for nonsecreting… Expand
Alpha-fetoprotein Level Predicts Recurrence After Transplantation in Hepatocellular Carcinoma
TLDR
Although an elevated AFP level did not correlate with survival in HCC patients undergoing orthotopic liver transplantation, a high AFP level was associated with a 3.32-folds increase in the probability of HCC recurrence. Expand
Role of Alpha-Fetoprotein in Selection of Patients with Hepatocellular Carcinoma Waiting for Liver Transplantation: Must we Reconsider it?
TLDR
AFP was the strongest predictor of HCC recurrence, stronger than tumor morphology, and could ameliorate the selection of LT candidates, as well as improve patient survival. Expand
The impact of waiting list alpha-fetoprotein changes on the outcome of liver transplant for hepatocellular carcinoma.
TLDR
Overall, downstaging HCC patients with high AFP is feasible and leads to similar intent-to-treat and post-transplant survivals to those of patients with AFP persistently low. Expand
Tumor DNA Index and α-Fetoprotein Level Define Outcome following Liver Transplantation for Advanced Hepatocellular Carcinoma
TLDR
DNA index and AFP level predict overall survival following LT in patients with advanced HCC beyond the Milan criteria, and a combined assessment of these markers during the evaluation of transplant candidates can contribute to the selection of patients with HCC who may benefit from LT independently of their tumor burden. Expand
The Postresection Alpha-Fetoprotein in Cirrhotic Patients with Hepatocellular Carcinoma. An Independent Predictor of Outcome
TLDR
The postresection AFP has an independent prognostic value and Transplantable patients resected for HCC without 90-day AFP normalization should be discussed for early liver transplantation. Expand
Alpha‐fetoprotein level > 1000 ng/mL as an exclusion criterion for liver transplantation in patients with hepatocellular carcinoma meeting the Milan criteria
TLDR
An AFP level may be a surrogate for vascular invasion and may be used to predict posttransplant HCC recurrence and Incorporating an AFP level > 1000 ng/mL as an exclusion criterion for LT within the Milan criteria may further improve posttrans transplant outcomes. Expand
Impact of locoregional therapy and alpha‐fetoprotein on outcomes in transplantation for liver cancer: a UNOS Region 6 pooled analysis
TLDR
While locoregional therapy itself did not affect DFS/recurrence, a decrease in AFP pre‐transplant appears to positively influence outcomes in those who received locoreGional therapy. Expand
Evaluation of the Alpha-Fetoprotein Model for Predicting Recurrence and Survival in Patients With Hepatitis B Virus (HBV)–Related Cirrhosis Who Received Liver Transplantation for Hepatocellular Carcinoma
TLDR
The AFP model may be used as a selection tool for Chinese HBV patients who require liver transplantation due to HCC and NRI analysis showed that the AFP model exhibited superior predictability as compared to the Milan criteria. Expand
Alpha-Fetoprotein Slope >7.5 ng/mL per Month Predicts Microvascular Invasion and Tumor Recurrence After Liver Transplantation for Hepatocellular Carcinoma
TLDR
AFP slope increasing greater than 7.5 ng/mL per month despite locoregional therapy is associated with post-LT HCC recurrence and may serve as a surrogate for microvascular invasion. Expand
Alpha‐fetoprotein and modified response evaluation criteria in Solid Tumors progression after locoregional therapy as predictors of hepatocellular cancer recurrence and death after transplantation
  • Q. Lai, A. Avolio, +7 authors J. Lerut
  • Medicine
  • Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society
  • 2013
TLDR
Both radiological and biological modifications permit documentation of the response to LRT in patients waiting for liver transplantation (LT) and, according to these 2 parameters, tumor progression significantly increases the risk of recurrence and patient death not only for MC‐OUT patients but also forMC‐IN patients. Expand
...
1
2
3
4
5
...

References

SHOWING 1-10 OF 34 REFERENCES
Selection criteria for liver transplantation in early‐stage hepatocellular carcinoma with cirrhosis: Results of a multicenter study
  • J. Figueras, L. Ibáñez, +8 authors J. Santoyo
  • Medicine
  • Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society
  • 2001
TLDR
A large multicenter study to assess survival and related factors of recurrence after OLT in patients with small HCCs who have low AFP levels and no macroscopic vascular invasion or extrahepatic disease concludes that better selection of patients with HCC before OLT is achieved. Expand
Liver Transplantation for Malignant Diseases: Selection andPattern of Recurrence
TLDR
Patients with early HCC in cirrhosis are good candidates for LT and results are similar when compared with those of cirrhotic patients without tumor, according to univariate analysis and multivariate analysis. Expand
Liver transplantation for hepatocellular carcinoma: Expansion of the tumor size limits does not adversely impact survival
TLDR
The current criteria for OLT based on tumor size may be modestly expanded while still preserving excellent survival after OLT, and only pT4 stage and total tumor diameter remained statistically significant in multivariate analysis. Expand
Recurrent hepatocellular carcinoma after transplantation: Use of a pathological score on explanted livers to predict recurrence
  • J. Parfitt, P. Marotta, +11 authors D. Driman
  • Medicine
  • Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society
  • 2007
TLDR
Compared to patients meeting Milan criteria, patients who meet only UCSF criteria have a worse survival and an increased rate of recurrent HCC with long‐term follow‐up, as well as more frequent occurrence of adverse histopathological features, such as microvascular invasion. Expand
Competing Risks Analysis of Predictors of Delisting Owing to Tumor Progression in Liver Transplant Candidates with Hepatocellular Carcinoma
  • N. Yamashiki, J. Gaynor, +8 authors A. Tzakis
  • Medicine
  • American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons
  • 2004
TLDR
The initial AFP level may be useful along with tumor stage in defining an urgency score for liver transplant candidates with HCC. Expand
Surgical treatment of hepatocellular cancer in the era of hepatic transplantation.
TLDR
LTx offers better recurrence freedom than LR, but longterm survival is not significantly different in the two series, but a strict selection should be made to optimize graft allocation. Expand
Liver transplantation for hepatocellular carcinoma validation of present selection criteria in predicting outcome
  • K. Shetty, K. Timmins, +8 authors K. Olthoff
  • Medicine
  • Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society
  • 2004
TLDR
Tumor size appears to be a surrogate marker for negative pathobiological predictors of outcome, i.e., vascular invasion and multifocality in present UNOS selection criteria for HCC. Expand
LIVER TRANSPLANTATION FOR THE TREATMENT OF SMALL HEPATOCELLULAR CARCINOMAS IN PATIENTS WITH CIRRHOSIS
Background. The role of orthotopic liver transplantation in the treatment of patients with cirrhosis and hepatocellular carcinoma is controversial, and determining which patients are likely to have aExpand
Liver Resection Versus Transplantation for Hepatocellular Carcinoma in Cirrhotic Patients
TLDR
The best indication for transplantation seems to be patients with small and uninodular or binodular tumors; until now, these patients were considered to be the best candidates for resection. Expand
Vascular invasion and histopathologic grading determine outcome after liver transplantation for hepatocellular carcinoma in cirrhosis
TLDR
Tumor diameter and number of nodules in correlation with the histopathologic grading were predictive of a vascular invasion only in HCC larger than 5 cm, which is a safe and effective long‐term treatment for small HCC in cirrhosis. Expand
...
1
2
3
4
...