Liver transplantation for hepatocellular carcinoma: evaluation of the alpha-fetoprotein model in a multicenter cohort from Latin America.

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Liver transplantation for hepatocellular carcinoma: evaluation of the alpha-fetoprotein model in a multicenter cohort from Latin America.

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dc.contributor.author Piñero, Federico.
dc.contributor.author Tisi Baña, Matias.
dc.contributor.author Ataide, Elaine C.
dc.contributor.author Hoyos Duque, Sergio.
dc.contributor.author Marciano, Sebastián.
dc.contributor.author Varón, Adriana.
dc.contributor.author Anders, Margarita.
dc.contributor.author et al.
dc.date.accessioned 2020-03-06T18:10:00Z
dc.date.available 2020-03-06T18:10:00Z
dc.date.issued 2016-11-01
dc.identifier.citation Liver Int. 2016 Nov;36(11):1657-1667 en_US
dc.identifier.issn 1478-3223
dc.identifier.uri https://riu.austral.edu.ar/handle/123456789/861
dc.description.abstract BACKGROUND & AIMS: The French alpha-fetoprotein (AFP) model has recently shown superior results compared to Milan criteria (MC) for prediction of hepatocellular carcinoma (HCC) recurrence after liver transplantation (LT) in European populations. The aim of this study was to explore the predictive capacity of the AFP model for HCC recurrence in a Latin-American cohort. METHODS: Three hundred twenty-seven patients with HCC were included from a total of 2018 patients transplanted at 15 centres. Serum AFP and imaging data were both recorded at listing. Predictability was assessed by the Net Reclassification Improvement (NRI) method. RESULTS: Overall, 82 and 79% of the patients were within MC and the AFP model respectively. NRI showed a superior predictability of the AFP model against MC. Patients with an AFP score >2 points had higher risk of recurrence at 5 years Hazard Ratio (HR) of 3.15 (P = 0.0001) and lower patient survival (HR = 1.51; P = 0.03). Among patients exceeding MC, a score ≤2 points identified a subgroup of patients with lower recurrence (5% vs 42%; P = 0.013) and higher survival rates (84% vs 45%; P = 0.038). In cases treated with bridging procedures, following restaging, a score >2 points identified a higher recurrence (HR 2.2, P = 0.12) and lower survival rate (HR 2.25, P = 0.03). A comparative analysis between HBV and non-HBV patients showed that the AFP model performed better in non-HBV patients. CONCLUSIONS: The AFP model could be useful in Latin-American countries to better select patients for LT in subgroups presenting with extended criteria. However, particular attention should be focused on patients with HBV. en_US
dc.language.iso en en_US
dc.publisher Wiley en_US
dc.subject Alpha-fetoprotein en_US
dc.subject Candidate selection en_US
dc.subject Liver cancer en_US
dc.subject Prediction en_US
dc.title Liver transplantation for hepatocellular carcinoma: evaluation of the alpha-fetoprotein model in a multicenter cohort from Latin America. en_US
dc.type Article en_US


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