The Warsaw Proposal for the Use of Extended Selection Criteria in Liver Transplantation for Hepatocellular Cancer View Full Text


Ontology type: schema:ScholarlyArticle      Open Access: True


Article Info

DATE

2016-08-16

AUTHORS

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

ABSTRACT

BACKGROUND: Combination of the University of California, San Francisco (UCSF) and the up-to-7 criteria with alpha-fetoprotein (AFP) cutoff of 100 ng/ml was proposed as the Warsaw expansion of the Milan criteria in selection of hepatocellular cancer (HCC) patients for liver transplantation. The purpose of this retrospective study was to validate this proposal. METHODS: A total of 240 HCC patients after liver transplantation were included. Recurrence-free survival and overall survival at 5 years were set as the primary and secondary outcome measures, respectively. RESULTS: The Warsaw expansion increased transplant eligibility rate by 20.3 %. AFP >100 ng/ml significantly increased the recurrence risk in patients within the Milan criteria (p = 0.025) and in those beyond, yet within either the UCSF or the up-to-7 criteria (p < 0.001). Recurrence-free survival at 5 years was 90.8 % for patients within the Milan criteria, 100.0 % in patients within the Warsaw expansion, 54.9 % in patients beyond the Warsaw expansion but within either the UCSF or the up-to-7 criteria, and 45.1 % in patients beyond both the UCSF and the up-to-7 criteria (p < 0.001). The corresponding overall survival rates were 71.6, 82.4, 64.3, and 55.3 %, respectively (p = 0.027). CONCLUSIONS: The Warsaw expansion of the Milan criteria substantially increases the recipient pool without compromising outcomes. More... »

PAGES

526-534

Identifiers

URI

http://scigraph.springernature.com/pub.10.1245/s10434-016-5500-0

DOI

http://dx.doi.org/10.1245/s10434-016-5500-0

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1046901370

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/27531306


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