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Tumor micronecrosis predicts poor prognosis of patients with hepatocellular carcinoma after liver transplantation
BACKGROUND: Tumor micronecrosis is a histopathological feature predicting poor prognosis in patients with hepatocellular carcinoma (HCC) who underwent liver resection. However, the role of tumor micronecrosis in liver transplantation remains unclear. METHODS: We retrospectively reviewed patients wit...
Autores principales: | , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9875414/ https://www.ncbi.nlm.nih.gov/pubmed/36698095 http://dx.doi.org/10.1186/s12885-023-10550-w |
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author | Wang, Yangyang Zhang, Wei Ge, Hongbin Han, Xu Wu, Jiangchao Sun, Xuqi Sun, Ke Cao, Wanyue Huang, Chao Li, Jingsong Zhang, Qi Liang, Tingbo |
author_facet | Wang, Yangyang Zhang, Wei Ge, Hongbin Han, Xu Wu, Jiangchao Sun, Xuqi Sun, Ke Cao, Wanyue Huang, Chao Li, Jingsong Zhang, Qi Liang, Tingbo |
author_sort | Wang, Yangyang |
collection | PubMed |
description | BACKGROUND: Tumor micronecrosis is a histopathological feature predicting poor prognosis in patients with hepatocellular carcinoma (HCC) who underwent liver resection. However, the role of tumor micronecrosis in liver transplantation remains unclear. METHODS: We retrospectively reviewed patients with HCC who underwent liver transplantation between January 2015 and December 2021 at our center. We then classified them into micronecrosis(−) and micronecrosis(+) groups and compared their recurrence-free survival (RFS) and overall survival (OS). We identified independent prognostic factors using Cox regression analysis and calculated the area under the receiver operating characteristic curve (AUC) to evaluate the predictive value of RFS for patients with HCC after liver transplantation. RESULTS: A total of 370 cases with evaluable histological sections were included. Patients of the micronecrosis(+) group had a significantly shorter RFS than those of the micronecrosis(−) group (P = 0.037). Shorter RFS and OS were observed in micronecrosis(+) patients without bridging treatments before liver transplantation (P = 0.002 and P = 0.007), while no differences were detected in those with preoperative antitumor therapies that could cause iatrogenic tumor necrosis. Tumor micronecrosis improved the AUC of Milan criteria (0.77–0.79), the model for end-stage liver disease score (0.70–0.76), and serum alpha-fetoprotein (0.63–0.71) for the prediction of prognosis after liver transplantation. CONCLUSION: Patients with HCC with tumor micronecrosis suffer from a worse prognosis than those without this feature. Tumor micronecrosis can help predict RFS after liver transplantation. Therefore, patients with HCC with tumor micronecrosis should be treated with adjuvant therapy and closely followed after liver transplantation. CLINICAL TRIALS REGISTRATION: Not Applicable. |
format | Online Article Text |
id | pubmed-9875414 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-98754142023-01-26 Tumor micronecrosis predicts poor prognosis of patients with hepatocellular carcinoma after liver transplantation Wang, Yangyang Zhang, Wei Ge, Hongbin Han, Xu Wu, Jiangchao Sun, Xuqi Sun, Ke Cao, Wanyue Huang, Chao Li, Jingsong Zhang, Qi Liang, Tingbo BMC Cancer Research BACKGROUND: Tumor micronecrosis is a histopathological feature predicting poor prognosis in patients with hepatocellular carcinoma (HCC) who underwent liver resection. However, the role of tumor micronecrosis in liver transplantation remains unclear. METHODS: We retrospectively reviewed patients with HCC who underwent liver transplantation between January 2015 and December 2021 at our center. We then classified them into micronecrosis(−) and micronecrosis(+) groups and compared their recurrence-free survival (RFS) and overall survival (OS). We identified independent prognostic factors using Cox regression analysis and calculated the area under the receiver operating characteristic curve (AUC) to evaluate the predictive value of RFS for patients with HCC after liver transplantation. RESULTS: A total of 370 cases with evaluable histological sections were included. Patients of the micronecrosis(+) group had a significantly shorter RFS than those of the micronecrosis(−) group (P = 0.037). Shorter RFS and OS were observed in micronecrosis(+) patients without bridging treatments before liver transplantation (P = 0.002 and P = 0.007), while no differences were detected in those with preoperative antitumor therapies that could cause iatrogenic tumor necrosis. Tumor micronecrosis improved the AUC of Milan criteria (0.77–0.79), the model for end-stage liver disease score (0.70–0.76), and serum alpha-fetoprotein (0.63–0.71) for the prediction of prognosis after liver transplantation. CONCLUSION: Patients with HCC with tumor micronecrosis suffer from a worse prognosis than those without this feature. Tumor micronecrosis can help predict RFS after liver transplantation. Therefore, patients with HCC with tumor micronecrosis should be treated with adjuvant therapy and closely followed after liver transplantation. CLINICAL TRIALS REGISTRATION: Not Applicable. BioMed Central 2023-01-25 /pmc/articles/PMC9875414/ /pubmed/36698095 http://dx.doi.org/10.1186/s12885-023-10550-w Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Wang, Yangyang Zhang, Wei Ge, Hongbin Han, Xu Wu, Jiangchao Sun, Xuqi Sun, Ke Cao, Wanyue Huang, Chao Li, Jingsong Zhang, Qi Liang, Tingbo Tumor micronecrosis predicts poor prognosis of patients with hepatocellular carcinoma after liver transplantation |
title | Tumor micronecrosis predicts poor prognosis of patients with hepatocellular carcinoma after liver transplantation |
title_full | Tumor micronecrosis predicts poor prognosis of patients with hepatocellular carcinoma after liver transplantation |
title_fullStr | Tumor micronecrosis predicts poor prognosis of patients with hepatocellular carcinoma after liver transplantation |
title_full_unstemmed | Tumor micronecrosis predicts poor prognosis of patients with hepatocellular carcinoma after liver transplantation |
title_short | Tumor micronecrosis predicts poor prognosis of patients with hepatocellular carcinoma after liver transplantation |
title_sort | tumor micronecrosis predicts poor prognosis of patients with hepatocellular carcinoma after liver transplantation |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9875414/ https://www.ncbi.nlm.nih.gov/pubmed/36698095 http://dx.doi.org/10.1186/s12885-023-10550-w |
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