[HTML][HTML] Preoperative prognostic values of α-fetoprotein (AFP) and protein induced by vitamin K absence or antagonist-II (PIVKA-II) in patients with hepatocellular …
Hepatobiliary surgery and nutrition, 2016•ncbi.nlm.nih.gov
Background Adult living donor liver transplantation (LDLT) is one of the best treatments for
hepatocellular carcinoma (HCC). However, when recurrence of HCC after LDLT occurs, the
prognosis is poor because of rapid progression. Preoperative level of α-fetoprotein (AFP)
and protein induced by vitamin K antagonist-II (PIVKA-II) reportedly correlate with recurrence
of HCC after LDLT. Methods We examined AFP and PIVKA-II preoperatively as predictors of
HCC recurrence in 461 patients who underwent LDLT using right liver graft for HCC from …
hepatocellular carcinoma (HCC). However, when recurrence of HCC after LDLT occurs, the
prognosis is poor because of rapid progression. Preoperative level of α-fetoprotein (AFP)
and protein induced by vitamin K antagonist-II (PIVKA-II) reportedly correlate with recurrence
of HCC after LDLT. Methods We examined AFP and PIVKA-II preoperatively as predictors of
HCC recurrence in 461 patients who underwent LDLT using right liver graft for HCC from …
Abstract
Background
Adult living donor liver transplantation (LDLT) is one of the best treatments for hepatocellular carcinoma (HCC). However, when recurrence of HCC after LDLT occurs, the prognosis is poor because of rapid progression. Preoperative level of α-fetoprotein (AFP) and protein induced by vitamin K antagonist-II (PIVKA-II) reportedly correlate with recurrence of HCC after LDLT.
Methods
We examined AFP and PIVKA-II preoperatively as predictors of HCC recurrence in 461 patients who underwent LDLT using right liver graft for HCC from May 2007 to December 2013.
Results
Among these, 77 patients (16.7%) who experienced recurrence were retrospectively reviewed. Multivariate analysis revealed tumor size> 5 cm, AFP> 150 nag/mol and PIVKA-II> 100 maul/mol as significant independent risk factors for recurrence. The median time to recurrence was 10 months. The median survival time after recurrence was 26 months, and the 1-, 3-and 5-year survival rates after recurrence were 80.5%, 58%, and 28.3% respectively.
Conclusions
Preoperatively, not only morphology of the tumor but also AFP and PIVKA-II levels can offers important information for the recurrence after LDLT for HCC. Thus, combination of tumor markers might be used for expansion of pre-existing strict selection criteria of liver transplantation for HCC.
ncbi.nlm.nih.gov
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