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Limitations of predicting microvascular invasion in patients with hepatocellular cancer prior to liver transplantation

Microvascular invasion (MVI) is well known to negatively influence outcomes following surgical treatment of hepatocellular cancer (HCC) patients. The aim of this study was to evaluate the rationale for prediction of MVI before liver transplantation (LT). Data of 200 HCC patients after LT were subjec...

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Autores principales: Grąt, Michał, Stypułkowski, Jan, Patkowski, Waldemar, Bik, Emil, Krasnodębski, Maciej, Wronka, Karolina M., Lewandowski, Zbigniew, Wasilewicz, Michał, Grąt, Karolina, Masior, Łukasz, Ligocka, Joanna, Krawczyk, Marek
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5216407/
https://www.ncbi.nlm.nih.gov/pubmed/28057916
http://dx.doi.org/10.1038/srep39881
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author Grąt, Michał
Stypułkowski, Jan
Patkowski, Waldemar
Bik, Emil
Krasnodębski, Maciej
Wronka, Karolina M.
Lewandowski, Zbigniew
Wasilewicz, Michał
Grąt, Karolina
Masior, Łukasz
Ligocka, Joanna
Krawczyk, Marek
author_facet Grąt, Michał
Stypułkowski, Jan
Patkowski, Waldemar
Bik, Emil
Krasnodębski, Maciej
Wronka, Karolina M.
Lewandowski, Zbigniew
Wasilewicz, Michał
Grąt, Karolina
Masior, Łukasz
Ligocka, Joanna
Krawczyk, Marek
author_sort Grąt, Michał
collection PubMed
description Microvascular invasion (MVI) is well known to negatively influence outcomes following surgical treatment of hepatocellular cancer (HCC) patients. The aim of this study was to evaluate the rationale for prediction of MVI before liver transplantation (LT). Data of 200 HCC patients after LT were subject to retrospective analysis. MVI was present in 57 patients (28.5%). Tumor number (p = 0.001) and size (p = 0.009), and alpha-fetoprotein (p = 0.049) were independent predictors of MVI used to create a prediction model, defined as: 0.293x(tumor number) + 0.283x(tumor size in cm) + 0.164xlog(e)(alpha-fetoprotein in ng/ml) (c statistic  =  0.743). The established cut-off (≥2.24) was associated with sensitivity and specificity of 72%. MVI was not an independent risk factor for recurrence (p = 0.307), in contrast to tumor number (p = 0.047) and size (p < 0.001), alpha-fetoprotein (p < 0.001) and poor differentiation (p = 0.039). Recurrence-free survival at 5 years for patients without MVI was 85.9% as compared to 83.3% (p = 0.546) and 55.3% (p = 0.001) for patients with false negative and true positive prediction of MVI, respectively. The use of both morphological and biological tumor features enables effective pre-transplant prediction of high-risk MVI. Provided that these parameters are combined in selection of HCC patients for LT, pre-transplant identification of all patients with MVI does not appear necessary.
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spelling pubmed-52164072017-01-10 Limitations of predicting microvascular invasion in patients with hepatocellular cancer prior to liver transplantation Grąt, Michał Stypułkowski, Jan Patkowski, Waldemar Bik, Emil Krasnodębski, Maciej Wronka, Karolina M. Lewandowski, Zbigniew Wasilewicz, Michał Grąt, Karolina Masior, Łukasz Ligocka, Joanna Krawczyk, Marek Sci Rep Article Microvascular invasion (MVI) is well known to negatively influence outcomes following surgical treatment of hepatocellular cancer (HCC) patients. The aim of this study was to evaluate the rationale for prediction of MVI before liver transplantation (LT). Data of 200 HCC patients after LT were subject to retrospective analysis. MVI was present in 57 patients (28.5%). Tumor number (p = 0.001) and size (p = 0.009), and alpha-fetoprotein (p = 0.049) were independent predictors of MVI used to create a prediction model, defined as: 0.293x(tumor number) + 0.283x(tumor size in cm) + 0.164xlog(e)(alpha-fetoprotein in ng/ml) (c statistic  =  0.743). The established cut-off (≥2.24) was associated with sensitivity and specificity of 72%. MVI was not an independent risk factor for recurrence (p = 0.307), in contrast to tumor number (p = 0.047) and size (p < 0.001), alpha-fetoprotein (p < 0.001) and poor differentiation (p = 0.039). Recurrence-free survival at 5 years for patients without MVI was 85.9% as compared to 83.3% (p = 0.546) and 55.3% (p = 0.001) for patients with false negative and true positive prediction of MVI, respectively. The use of both morphological and biological tumor features enables effective pre-transplant prediction of high-risk MVI. Provided that these parameters are combined in selection of HCC patients for LT, pre-transplant identification of all patients with MVI does not appear necessary. Nature Publishing Group 2017-01-06 /pmc/articles/PMC5216407/ /pubmed/28057916 http://dx.doi.org/10.1038/srep39881 Text en Copyright © 2017, The Author(s) http://creativecommons.org/licenses/by/4.0/ This work is licensed under a Creative Commons Attribution 4.0 International License. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in the credit line; if the material is not included under the Creative Commons license, users will need to obtain permission from the license holder to reproduce the material. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/
spellingShingle Article
Grąt, Michał
Stypułkowski, Jan
Patkowski, Waldemar
Bik, Emil
Krasnodębski, Maciej
Wronka, Karolina M.
Lewandowski, Zbigniew
Wasilewicz, Michał
Grąt, Karolina
Masior, Łukasz
Ligocka, Joanna
Krawczyk, Marek
Limitations of predicting microvascular invasion in patients with hepatocellular cancer prior to liver transplantation
title Limitations of predicting microvascular invasion in patients with hepatocellular cancer prior to liver transplantation
title_full Limitations of predicting microvascular invasion in patients with hepatocellular cancer prior to liver transplantation
title_fullStr Limitations of predicting microvascular invasion in patients with hepatocellular cancer prior to liver transplantation
title_full_unstemmed Limitations of predicting microvascular invasion in patients with hepatocellular cancer prior to liver transplantation
title_short Limitations of predicting microvascular invasion in patients with hepatocellular cancer prior to liver transplantation
title_sort limitations of predicting microvascular invasion in patients with hepatocellular cancer prior to liver transplantation
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5216407/
https://www.ncbi.nlm.nih.gov/pubmed/28057916
http://dx.doi.org/10.1038/srep39881
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