Progression of AFP SCORE is a Preoperative Predictive Factor of Microvascular Invasion in Selected Patients Meeting Liver Transplantation Criteria for Hepatocellular Carcinoma

Microvascular invasion (MVI) is one of the main prognostic factors of hepatocellular carcinoma (HCC) after liver transplantation (LT), but its occurrence is unpredictable before surgery. The alpha fetoprotein (AFP) model (composite score including size, number, AFP), currently used in France, define...

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Published in:Transplant international 2022-03, Vol.35, p.10412-10412
Main Authors: Herrero, Astrid, Boivineau, Lucile, Cassese, Gianluca, Assenat, Eric, Riviere, Benjamin, Faure, Stéphanie, Bedoya, José Ursic, Panaro, Fabrizio, Guiu, Boris, Navarro, Francis, Pageaux, Georges-Philippe
Format: Article
Language:English
Subjects:
alpha-Fetoproteins
Carcinoma, Hepatocellular
Health Archive
Human health and pathology
Humans
Hépatology and Gastroenterology
Life Sciences
Liver Neoplasms
Liver Neoplasms - diagnosis
Liver Transplantation
Liver Transplantation - adverse effects
Neoplasm Invasiveness
Neoplasm Recurrence, Local
Retrospective Studies
Risk Factors
Surgery
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Summary:Microvascular invasion (MVI) is one of the main prognostic factors of hepatocellular carcinoma (HCC) after liver transplantation (LT), but its occurrence is unpredictable before surgery. The alpha fetoprotein (AFP) model (composite score including size, number, AFP), currently used in France, defines the selection criteria for LT. This study's aim was to evaluate the preoperative predictive value of AFP SCORE progression on MVI and overall survival during the waiting period for LT. Data regarding LT recipients for HCC from 2007 to 2015 were retrospectively collected from a single institutional database. Among 159 collected cases, 34 patients progressed according to AFP SCORE from diagnosis until LT. MVI was shown to be an independent histopathological prognostic factor according to Cox regression and competing risk analysis in our cohort. AFP SCORE progression was the only preoperative predictive factor of MVI (OR = 10.79 [2.35-49.4]; 0.002). The 5-year overall survival in the progression and no progression groups was 63.9% vs. 86.3%, respectively ( = 0.001). Cumulative incidence of HCC recurrence was significantly different between the progression and no progression groups (Sub-HR = 4.89 [CI 2-11.98]). In selected patients, the progression of AFP SCORE during the waiting period can be a useful preoperative tool to predict MVI.
ISSN:1432-2277
0934-0874
1432-2277
DOI:10.3389/ti.2022.10412