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Risk of Recurrence of Hepatocarcinoma after Liver Transplantation: Performance of Recurrence Predictive Models in a Cohort of Transplant Patients
Liver transplantation (LT) is a curative treatment for early-stage hepatocellular carcinoma (HCC) unsuitable for surgical resection. However, tumor recurrence (TR) rates range from 8% to 20% despite strict selection criteria. The validation of new prognostic tools, such as pre-MORAL or RETREAT risks...
Autores principales: | , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10488177/ https://www.ncbi.nlm.nih.gov/pubmed/37685524 http://dx.doi.org/10.3390/jcm12175457 |
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author | Cuadrado, Antonio Fortea, José Ignacio Rodríguez-Lope, Carlos Puente, Ángela Fernández-Vilchez, Vanesa Echavarria, Victor Jose Castillo Suescun, Federico José Fernández, Roberto Echeverri, Juan Andrés Achalandabaso, Mar Toledo, Enrique Pellón, Raúl Rodríguez Sanjuan, Juan Carlos Crespo, Javier Fábrega, Emilio |
author_facet | Cuadrado, Antonio Fortea, José Ignacio Rodríguez-Lope, Carlos Puente, Ángela Fernández-Vilchez, Vanesa Echavarria, Victor Jose Castillo Suescun, Federico José Fernández, Roberto Echeverri, Juan Andrés Achalandabaso, Mar Toledo, Enrique Pellón, Raúl Rodríguez Sanjuan, Juan Carlos Crespo, Javier Fábrega, Emilio |
author_sort | Cuadrado, Antonio |
collection | PubMed |
description | Liver transplantation (LT) is a curative treatment for early-stage hepatocellular carcinoma (HCC) unsuitable for surgical resection. However, tumor recurrence (TR) rates range from 8% to 20% despite strict selection criteria. The validation of new prognostic tools, such as pre-MORAL or RETREAT risks, is necessary to improve recurrence prediction. A retrospective study was conducted at Marqués de Valdecilla University Hospital in Cantabria, Spain, between 2010 and 2019 to determine the rate of TR in LT patients and identify associated factors. Patients with liver-kidney transplantation, re-transplantation, HIV infection, survival less than 90 days, or incidental HCC were excluded. Data on demographic, liver disease-related, LT, and tumor-related variables, as well as follow-up records, including TR and death, were collected. TR was analyzed using the Log-Rank test, and a multivariate Cox regression analysis was performed. The study was approved by the IRB of Cantabria. TR occurred in 13.6% of LT patients (95% CI = 7.3–23.9), primarily as extrahepatic recurrence (67%) within the first 5 years (75%). Increased TR was significantly associated with higher Body Mass Index (BMI) (HR = 1.3 [95% CI = 1.1–1.5]), vascular micro-invasion (HR = 8.8 [1.6–48.0]), and medium (HR = 20.4 [3.0–140.4]) and high pre-MORAL risk (HR = 30.2 [1.6–568.6]). TR also showed a significant correlation with increased mortality. Conclusions: LT for HCC results in a 13.6% rate of tumor recurrence. Factors such as BMI, vascular micro-invasion, and medium/high pre-MORAL risk are strongly associated with TR following LT. |
format | Online Article Text |
id | pubmed-10488177 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-104881772023-09-09 Risk of Recurrence of Hepatocarcinoma after Liver Transplantation: Performance of Recurrence Predictive Models in a Cohort of Transplant Patients Cuadrado, Antonio Fortea, José Ignacio Rodríguez-Lope, Carlos Puente, Ángela Fernández-Vilchez, Vanesa Echavarria, Victor Jose Castillo Suescun, Federico José Fernández, Roberto Echeverri, Juan Andrés Achalandabaso, Mar Toledo, Enrique Pellón, Raúl Rodríguez Sanjuan, Juan Carlos Crespo, Javier Fábrega, Emilio J Clin Med Article Liver transplantation (LT) is a curative treatment for early-stage hepatocellular carcinoma (HCC) unsuitable for surgical resection. However, tumor recurrence (TR) rates range from 8% to 20% despite strict selection criteria. The validation of new prognostic tools, such as pre-MORAL or RETREAT risks, is necessary to improve recurrence prediction. A retrospective study was conducted at Marqués de Valdecilla University Hospital in Cantabria, Spain, between 2010 and 2019 to determine the rate of TR in LT patients and identify associated factors. Patients with liver-kidney transplantation, re-transplantation, HIV infection, survival less than 90 days, or incidental HCC were excluded. Data on demographic, liver disease-related, LT, and tumor-related variables, as well as follow-up records, including TR and death, were collected. TR was analyzed using the Log-Rank test, and a multivariate Cox regression analysis was performed. The study was approved by the IRB of Cantabria. TR occurred in 13.6% of LT patients (95% CI = 7.3–23.9), primarily as extrahepatic recurrence (67%) within the first 5 years (75%). Increased TR was significantly associated with higher Body Mass Index (BMI) (HR = 1.3 [95% CI = 1.1–1.5]), vascular micro-invasion (HR = 8.8 [1.6–48.0]), and medium (HR = 20.4 [3.0–140.4]) and high pre-MORAL risk (HR = 30.2 [1.6–568.6]). TR also showed a significant correlation with increased mortality. Conclusions: LT for HCC results in a 13.6% rate of tumor recurrence. Factors such as BMI, vascular micro-invasion, and medium/high pre-MORAL risk are strongly associated with TR following LT. MDPI 2023-08-23 /pmc/articles/PMC10488177/ /pubmed/37685524 http://dx.doi.org/10.3390/jcm12175457 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Cuadrado, Antonio Fortea, José Ignacio Rodríguez-Lope, Carlos Puente, Ángela Fernández-Vilchez, Vanesa Echavarria, Victor Jose Castillo Suescun, Federico José Fernández, Roberto Echeverri, Juan Andrés Achalandabaso, Mar Toledo, Enrique Pellón, Raúl Rodríguez Sanjuan, Juan Carlos Crespo, Javier Fábrega, Emilio Risk of Recurrence of Hepatocarcinoma after Liver Transplantation: Performance of Recurrence Predictive Models in a Cohort of Transplant Patients |
title | Risk of Recurrence of Hepatocarcinoma after Liver Transplantation: Performance of Recurrence Predictive Models in a Cohort of Transplant Patients |
title_full | Risk of Recurrence of Hepatocarcinoma after Liver Transplantation: Performance of Recurrence Predictive Models in a Cohort of Transplant Patients |
title_fullStr | Risk of Recurrence of Hepatocarcinoma after Liver Transplantation: Performance of Recurrence Predictive Models in a Cohort of Transplant Patients |
title_full_unstemmed | Risk of Recurrence of Hepatocarcinoma after Liver Transplantation: Performance of Recurrence Predictive Models in a Cohort of Transplant Patients |
title_short | Risk of Recurrence of Hepatocarcinoma after Liver Transplantation: Performance of Recurrence Predictive Models in a Cohort of Transplant Patients |
title_sort | risk of recurrence of hepatocarcinoma after liver transplantation: performance of recurrence predictive models in a cohort of transplant patients |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10488177/ https://www.ncbi.nlm.nih.gov/pubmed/37685524 http://dx.doi.org/10.3390/jcm12175457 |
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