Liver Transplantation For Hepatocellular Carcinoma: Evaluation Of The Alpha-fetoprotein Model In A Multicenter Cohort From Latin America

dc.creatorPinero
dc.creatorFederico; Tisi Bana
dc.creatorMatias; de Ataide
dc.creatorElaine Cristina; Hoyos Duque
dc.creatorSergio; Marciano
dc.creatorSebastian; Varon
dc.creatorAdriana; Anders
dc.creatorMargarita; Zerega
dc.creatorAlina; Menendez
dc.creatorJosemaria; Zapata
dc.creatorRodrigo; Munoz
dc.creatorLinda; Padilla Machaca
dc.creatorMartin; Soza
dc.creatorAlejandro; McCormack
dc.creatorLucas; Poniachik
dc.creatorJaime; Podesta
dc.creatorLuis G.; Gadano
dc.creatorAdrian; Fatima Boin
dc.creatorIlka S. F.; Duvoux
dc.creatorChristophe; Silva
dc.creatorMarcelo
dc.date2016
dc.datenov
dc.date2017-11-13T13:21:28Z
dc.date2017-11-13T13:21:28Z
dc.date.accessioned2018-03-29T05:54:41Z
dc.date.available2018-03-29T05:54:41Z
dc.identifierLiver International. Wiley-blackwell, v. 36, p. 1657 - 1667, 2016.
dc.identifier1478-3223
dc.identifier1478-3231
dc.identifierWOS:000385863400013
dc.identifier10.1111/liv.13159
dc.identifierhttp://onlinelibrary.wiley.com/doi/10.1111/liv.13159/abstract;jsessionid=2B29E476981B73A22619E77B21C857F8.f04t04?systemMessage=Wiley+Online+Library+will+be+unavailable+on+Saturday+12th+August+at+3%3A00+EDT+%2F+8%3A00+BST+%2F+12%3A30+IST+%2F+15%3A00+SGT+for+4+hours+for+essential+maintenance.+Apologies+for+the+inconvenience.
dc.identifierhttp://repositorio.unicamp.br/jspui/handle/REPOSIP/327761
dc.identifier.urihttp://repositorioslatinoamericanos.uchile.cl/handle/2250/1364786
dc.descriptionThe French alpha-fetoprotein (AFP) model has recently shown superior results compared to Milan criteria (MC) for prediction of hepatocellular carcinoma (HCC) recurrence after liver transplantation (LT) in European populations. The aim of this study was to explore the predictive capacity of the AFP model for HCC recurrence in a Latin-American cohort. MethodsThree hundred twenty-seven patients with HCC were included from a total of 2018 patients transplanted at 15 centres. Serum AFP and imaging data were both recorded at listing. Predictability was assessed by the Net Reclassification Improvement (NRI) method. ResultsOverall, 82 and 79% of the patients were within MC and the AFP model respectively. NRI showed a superior predictability of the AFP model against MC. Patients with an AFP score >2 points had higher risk of recurrence at 5 years Hazard Ratio (HR) of 3.15 (P = 0.0001) and lower patient survival (HR = 1.51; P = 0.03). Among patients exceeding MC, a score 2 points identified a subgroup of patients with lower recurrence (5% vs 42%; P = 0.013) and higher survival rates (84% vs 45%; P = 0.038). In cases treated with bridging procedures, following restaging, a score >2 points identified a higher recurrence (HR 2.2, P = 0.12) and lower survival rate (HR 2.25, P = 0.03). A comparative analysis between HBV and non-HBV patients showed that the AFP model performed better in non-HBV patients. ConclusionsThe AFP model could be useful in Latin-American countries to better select patients for LT in subgroups presenting with extended criteria. However, particular attention should be focused on patients with HBV.
dc.description36
dc.description11
dc.description1657
dc.description1667
dc.languageEnglish
dc.publisherWiley-Blackwell
dc.publisherHoboken
dc.relationLiver International
dc.rightsfechado
dc.sourceWOS
dc.subjectAlpha-fetoprotein
dc.subjectCandidate Selection
dc.subjectLiver Cancer
dc.subjectPrediction
dc.titleLiver Transplantation For Hepatocellular Carcinoma: Evaluation Of The Alpha-fetoprotein Model In A Multicenter Cohort From Latin America
dc.typeArtículos de revistas


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