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


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2017-01-06

AUTHORS

Michał Grąt, Jan Stypułkowski, Waldemar Patkowski, Emil Bik, Maciej Krasnodębski, Karolina M. Wronka, Zbigniew Lewandowski, Michał Wasilewicz, Karolina Grąt, Łukasz Masior, Joanna Ligocka, Marek Krawczyk

ABSTRACT

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) + 0.164xloge(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. More... »

PAGES

39881

Identifiers

URI

http://scigraph.springernature.com/pub.10.1038/srep39881

DOI

http://dx.doi.org/10.1038/srep39881

DIMENSIONS

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PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/28057916


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64 poor differentiation
65 positive predictions
66 pre-transplant identification
67 pre-transplant prediction
68 prediction
69 prediction model
70 prediction of MVI
71 predictors
72 rationale
73 recurrence
74 recurrence-free survival
75 retrospective analysis
76 risk factors
77 selection
78 sensitivity
79 size
80 specificity
81 study
82 surgical treatment
83 survival
84 transplantation
85 treatment
86 true positive predictions
87 tumor features
88 tumor number
89 use
90 years
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