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Changes in Tumor Markers and Their Implications in Selecting Liver Transplantation for Patients With Hepatocellular Carcinoma.

Abstract：

BACKGROUND AND AIM:It has been suggested that tumor markers can provide additional information over tumor size and number-based liver transplantation (LT) criteria. We aimed to assess if changes in tumor markers are associated with the risk of tumor recurrence after LT for hepatocellular carcinoma (HCC) who received loco-regional therapies (LRTs). METHODS:A total of 129 patients who received LT with pre-LT LRTs for HCC were analyzed. Milan criteria and tumor markers, alpha-fetoprotein, and protein induced by vitamin K antagonist II, at diagnosis and at transplant were assessed. The primary outcome was tumor recurrence. RESULTS:When patients were stratified by radiologic criteria, cumulative recurrence rates at 3 years for patients who were not down-staged (outside Milan to outside Milan), progressed (within Milan to outside Milan), down-staged (outside Milan to within Milan), and bridged (within Milan to within Milan) were 66.7%, 58.3%, 18.7%, and 8.5%, respectively (P < .001). Among patients who were transplanted within Milan criteria at transplant (n = 113), cumulative recurrence rates at 3 years were highest for those with persistently high tumor markers (high to high, 21.7%), followed by those with increase in tumor markers (low to high, 11.1%), those with normalization of tumor markers (high to low, 5.6%), and those with persistently low tumor markers (low to low, 0%), respectively, after LRTs (P = .035). CONCLUSIONS:Changes of tumor markers can provide additional information on the risk of recurrence after LT among HCC patients who received LRTs, indicating that they could be used to refine current LT selection criteria.

journal_name

Transplant Proc

journal_title

Transplantation proceedings

authors

Song BG,Sinn DH,Kang W,Gwak GY,Paik YH,Choi MS,Lee JH,Koh KC,Paik SW,Kim JM,Joh JW,Choi GS

doi

10.1016/j.transproceed.2020.01.037

subject

Has Abstract

pub_date

2020-04-01 00:00:00

pages

881-888

issue

3

eissn

0041-1345

issn

1873-2623

pii

S0041-1345(20)30016-6

journal_volume

52

pub_type

杂志文章

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