We found a match
Your institution may have rights to this item. Sign in to continue.
- Title
Prediction of hepatocellular carcinoma recurrence after liver transplantation: Comparison of four explant-based prognostic models.
- Authors
Costentin, Charlotte E.; Amaddeo, Giuliana; Decaens, Thomas; Boudjema, Karim; Bachellier, Philippe; Muscari, Fabrice; Salamé, Ephrem; Bernard, Pierre ‐ Henri; Francoz, Claire; Dharancy, Sébastien; Vanlemmens, Claire; Radenne, Sylvie; Dumortier, Jérôme; Hilleret, Marie ‐ Noelle; Chazouillères, Olivier; Pageaux, Georges P.; Calderaro, Julien; Laurent, Alexis; Roudot ‐ Thoraval, Françoise; Duvoux, Christophe
- Abstract
Aim Discordance between pre- LT imaging and explanted liver findings have been reported after liver transplantation ( LT) for hepatocellular carcinoma ( HCC), suggesting the need of reassessing the risk of HCC recurrence post- LT. Our aims were to compare pre- LT imaging and explants features and to test the performances of four explant-based predictive models of recurrence in an external cohort. Methods Staging according to pre- LT imaging and explant features were compared. Four explants-based models were retrospectively tested in a cohort of 372 patients transplanted for HCC in 19 French centres between 2003 and 2005. Accuracies of the scores were compared. Results Pre- LT imaging underestimated tumour burden in 83 (22.7%) patients according to Milan criteria. The highest AUCs for prediction of 5-years recurrence were observed in the 'Up to seven' (0.7915 [95% CI: 0.7339-0.849]) and Decaens models (0.747 [95% CI: 0.6877-0.806]), with two levels of risk: low (10%) and high (>50%). Chan and Iwatsuki models identified 3 and 4 levels of risk, but had lower AUCs (0.68 and 0.70) respectively. Accuracy of the 'Up to seven' model was superior to the Decaens model ( P=.034), which was superior to the Chan model ( P=.0041) but not to the Iwatsuki model ( P=.17). Conclusion Pre- LT imaging underestimates tumour burden, and prediction of recurrence should be reassessed after LT. The explant-based 'Up to seven' and Decaens models provided the best accuracy for prediction of 5-year recurrence, identifying only two levels of risk. New models are needed to further refine the prediction of recurrence after LT.
- Subjects
CANCER risk factors; LIVER cancer; CANCER relapse; LIVER transplantation; TRANSPLANTATION of organs, tissues, etc.; TUMORS
- Publication
Liver International, 2017, Vol 37, Issue 5, p717
- ISSN
1478-3223
- Publication type
Article
- DOI
10.1111/liv.13388