Title :

Liver Transplantation for Hepatocellular Carcinoma: A Real-Life Comparison of Milan Criteria and AFP Model

Author(s) :

Brusset, Bleuenn [Auteur]
Université Grenoble Alpes - UFR Médecine [UGA UFRM]
Centre Hospitalier Universitaire [CHU Grenoble] [CHUGA]
Dumortier, Jerome [Auteur]
Hôpital Edouard Herriot [CHU - HCL]
Cherqui, Daniel [Auteur]
Centre Hépato-Biliaire [Hôpital Paul Brousse] [CHB]
Pageaux, Georges-Philippe [Auteur]
Centre Hospitalier Régional Universitaire [Montpellier] [CHRU Montpellier]
Boleslawski, Emmanuel [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Thérapies Assistées par Lasers et Immunothérapies pour l'Oncologie - U 1189 [OncoThAI]
Chapron, Ludivine [Auteur]
Centre Hospitalier Universitaire [CHU Grenoble] [CHUGA]
Quesada, Jean-Louis [Auteur]
Centre Hospitalier Universitaire [CHU Grenoble] [CHUGA]
Radenne, Sylvie [Auteur]
Hôpital de la Croix-Rousse [CHU - HCL]
Samuel, Didier [Auteur]
Centre Hépato-Biliaire [Hôpital Paul Brousse] [CHB]
Navarro, Francis [Auteur]
Centre Hospitalier Régional Universitaire [Montpellier] [CHRU Montpellier]
Dharancy, Sebastien [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Institute for Translational Research in Inflammation - U 1286 [INFINITE]
Decaens, Thomas [Auteur]
Université Grenoble Alpes - UFR Médecine - Département de Maïeutique [UGA UFRMDM]
Centre Hospitalier Universitaire [CHU Grenoble] [CHUGA]
Institute for Advanced Biosciences / Institut pour l'Avancée des Biosciences (Grenoble) [IAB]

Journal title :

Cancers

Pages :

2480

Publisher :

MDPI

Publication date :

2021

ISSN :

2072-6694

English keyword(s) :

AFP model
Milan criteria
Hepatocellular carcinoma
Liver transplantation
Post-transplant recurrence

HAL domain(s) :

Sciences du Vivant [q-bio]/Cancer
Sciences du Vivant [q-bio]/Médecine humaine et pathologie/Chirurgie
Sciences du Vivant [q-bio]/Médecine humaine et pathologie/Hépatologie et Gastroentérologie

English abstract : [en]

Purpose: To compare the agreement for the criteria on the explant and the results of liver transplantation (LT) before and after adoption of the AFP (α-fetoprotein) model.Methods: 523 patients consecutively listed in five ...
Show more >Purpose: To compare the agreement for the criteria on the explant and the results of liver transplantation (LT) before and after adoption of the AFP (α-fetoprotein) model.Methods: 523 patients consecutively listed in five French centers were reviewed to compare results of the Milan criteria period (MilanCP, n = 199) (before 2013) and the AFP score period (AFPscP, n = 324) (after 2013). (NCT03156582).Results: During AFPscP, there was a significantly longer waiting time on the list (12.3 vs. 7.7 months, p < 0.001) and higher rate of bridging therapies (84 vs. 75%, p = 0.012) compared to the MilanCP. Dropout rate was slightly higher in the AFPscP (31 vs. 24%, p = 0.073). No difference was found in the histological AFP score between groups (p = 0.838) with a global agreement in 88% of patients. Post-LT recurrence was 9.2% in MilanCP vs. 13.2% in AFPscP (p = 0.239) and predictive factors were AFP > 2 on the last imaging, downstaging policy and salvage transplantation. Post-LT survival was similar (83 vs. 87% after 2 years, p = 0.100), but after propensity score analysis, the post-listing overall survival (OS) was worse in the AFPscP (HR 1.45, p = 0.045).Conclusions: Agreement for the AFP model on explant analysis (≤2) did not significantly change. AFP score > 2 was the major prognostic factor for recurrence. Graft allocation policy has a major impact on prognosis, with a post-listing OS significantly decreased, probably due to the increase in waiting time, increase in bridging therapies, downstaging policy and salvage transplantation.Show less >

Language :

Anglais

Popular science :

Non

Collections :

• Thérapies Lasers Assistées par l'Image pour l'Oncologie (ONCO-THAI) - U1189

Source :

Harvested from HAL