• Login
    View Item 
    •   DSpace Home
    • Centro Académico de Salud (CAS)
    • Hospital Universitario Austral -HUA-
    • Investigación Aplicada
    • View Item
    •   DSpace Home
    • Centro Académico de Salud (CAS)
    • Hospital Universitario Austral -HUA-
    • Investigación Aplicada
    • View Item
    JavaScript is disabled for your browser. Some features of this site may not work without it.

    Browse

    All of DSpaceCommunities & CollectionsBy Issue DateAuthorsTitlesSubjectsThis CollectionBy Issue DateAuthorsTitlesSubjects

    My Account

    LoginRegister

    Statistics

    View Usage Statistics

    Identifying patients at higher risk of hepatocellular carcinoma recurrence after liver transplantation in a multicenter cohort study from Argentina.

    Thumbnail
    View/Open
    IA - Piñero (276.7Kb)
    Date
    2016-04-28
    Author
    Piñero, Federico.
    Marciano, Sebastián.
    Anders, Margarita.
    et al.
    Metadata
    Show full item record
    Abstract
    BACKGROUND AND AIM: The Up-to-7 criteria on the basis of the explanted liver features categorize patients at higher risk of hepatocellular carcinoma (HCC) recurrence after liver transplantation (LT). The aim of this study was to propose a novel pretransplant scoring system to predict recurrence including pre-LT data. PATIENTS AND METHODS: From 763 consecutive adult patients who underwent transplantation in four LT centers from Argentina, 124 patients with HCC were included. A scoring system was developed in 87 patients from pre-LT risk factors for recurrence as determined by hazard ratios (HRs) from a multivariate Cox regression analysis. RESULTS: Overall survival and recurrence rates at 5 years were 63.3 and 13.7%, respectively, during a follow-up period of 3.5±2.2 years. Variables associated with HCC recurrence on multivariate analysis were α-fetoprotein more than 100 ng/ml (HR=5.6, P=0.001) and tumor beyond Up-to-7 imaging criteria (HR=6.3, P=0.001). Bootstrap validation showed that overfitting was negligible. Scoring points were assigned as follows (0-2 points): pre-LT α-fetoprotein more than 100 ng/ml (presence=1 point, absence=0 point), and tumor beyond Up-to-7 imaging criteria (presence=1 point, absence=0 point). AUROC curve indicated a c-statistic of 0.74 (0.58-0.88, P=0.003). Two distinct subgroups of patients were identified with a cut-off more than or equal to 1 point (62% sensitivity and 82% specificity): low risk (0 point) and high risk (1-2 points). The 5-year recurrence rate was 9.4 and 44.5% (P=0.0001) and the 5-year overall survival was 78.1 and 34.8% (P=0.0001) in the low-risk and high-risk groups, respectively. CONCLUSION: This scoring model may be a useful additional tool for HCC recurrence risk stratification before LT. Prospective studies are needed to evaluate our model.
    URI
    https://riu.austral.edu.ar/handle/123456789/731
    Collections
    • Investigación Aplicada

    xmlui.dri2xhtml.structural.info-link
    Licencia Creative Commons
    xmlui.dri2xhtml.structural.contact-link1 - xmlui.dri2xhtml.structural.contact-link2
    xmlui.dri2xhtml.structural.info-link2
     

     


    xmlui.dri2xhtml.structural.info-link
    Licencia Creative Commons
    xmlui.dri2xhtml.structural.contact-link1 - xmlui.dri2xhtml.structural.contact-link2
    xmlui.dri2xhtml.structural.info-link2