Analysis of factors affecting recurrence of hepatocellular carcinoma after liver transplantation with a special focus on inflammation markers.

Abstract:

BACKGROUND:Systemic inflammation markers, such as neutrophil-to-lymphocyte ratio (NLR), have recently emerged as the prognostic factors for recurrence of liver tumors. METHODS:We assessed the ability of NLR and of other variables to predict the outcomes of orthotopic liver transplantation (OLT) for hepatocellular carcinoma (HCC). A retrospective analysis was performed in 219 patients with HCC who underwent OLT between 1997 and 2009, with a median follow-up of 40 months. RESULTS:Overall 3- and 5-year patient survival rates were 76.6% and 70.7%, respectively. Overall 3- and 5-year recurrence-free survival (RFS) rates were 83.8% and 82.1%, respectively. On univariate analysis, the factors affecting overall survival were α-fetoprotein more than 30 ng/mL (P=0.006), NLR more than or equal to 5 (P<0.0001), hepatitis C infection (P=0.043), and presence of microvascular invasion (MVI; P=0.006). Preoperative treatments (P=0.006), α-fetoprotein more than 30 ng/mL (P=0.003), NLR more than or equal to 5 (P<0.0001), exceeding Milan criteria at final histology (P=0.001), poor tumor differentiation (P=0.02), and presence of MVI (P<0.0001) predicted a lower RFS. Cox's proportional hazard model showed that only increased NLR and presence of MVI independently predicted overall survival and RFS. CONCLUSIONS:NLR is an important predictor of outcome after OLT for HCC and should be used to identify OLT candidates at high risk of recurrence.

journal_name

Transplantation

journal_title

Transplantation

authors

Bertuzzo VR,Cescon M,Ravaioli M,Grazi GL,Ercolani G,Del Gaudio M,Cucchetti A,D'Errico-Grigioni A,Golfieri R,Pinna AD

doi

10.1097/TP.0b013e3182187cf0

subject

Has Abstract

pub_date

2011-06-15 00:00:00

pages

1279-85

issue

11

eissn

0041-1337

issn

1534-6080

pii

00007890-201106150-00021

journal_volume

91

pub_type

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