The prediction of risk of recurrence and time to recurrence of hepatocellular carcinoma after orthotopic liver transplantation

A pilot study

J. Wallis Marsh, Igor Dvorchik, Michael Subotin, Vijayan Balan, Jorge Rakela, E. P. Popechitelev, Vladimir Subbotin, Adrian Casavilla, Brian I. Carr, John J. Fung, Shunzaburo Iwatsuki

Research output: Contribution to journalArticle

171 Citations (Scopus)

Abstract

Orthotopic liver transplantation (OLTx) in the presence of hepatocellular carcinoma (HCC) has been complicated by high recurrence rates. The ability to determine the risk and timing of HCC recurrence on an individual basis would greatly aid in the candidate selection process resulting in a more efficient use of donated organs and allow the individualization and better evaluation of adjuvant chemotherapy. The 214 patients who underwent OLTx in the presence of HCC were analyzed. From the 178 patients who survived more than 150 days, 71 (40%) have suffered HCC recurrence. Based on five risk factors, that is, gender, tumor number, lobar tumor distribution, tumor size, grade of vascular invasion, artificial neural network models predicting the likelihood of HCC recurrence within 1, 2, and 3 consecutive years after transplantation were developed. Based on model predictions, those combinations of risk factors that should/should not lead to recurrence were generated, allowing stratification of patients into the following three groups: 1) patients who should not suffer HCC recurrence and who should not need adjuvant therapy, 2) patients who will suffer recurrence and for whom postoperative chemotherapy significantly prolonged survival (but did not prevent recurrence), and 3) patients who may or may not suffer HCC recurrence and whose recurrence may be prevented by adjuvant chemotherapy. The outcome of OLTx for patients with HCC can be prognosticated based on a number of clinical variables. If verified through multicenter trials, these models could be made available to transplantation programs performing OLTx in the presence of HCC.

Original languageEnglish
Pages (from-to)444-450
Number of pages7
JournalHepatology
Volume26
Issue number2
DOIs
Publication statusPublished - 1997

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Liver Transplantation
Hepatocellular Carcinoma
Recurrence
Adjuvant Chemotherapy
Transplantation
Neoplasms
Neural Networks (Computer)
Multicenter Studies
Blood Vessels
Drug Therapy
Survival

ASJC Scopus subject areas

  • Hepatology

Cite this

Marsh, J. W., Dvorchik, I., Subotin, M., Balan, V., Rakela, J., Popechitelev, E. P., ... Iwatsuki, S. (1997). The prediction of risk of recurrence and time to recurrence of hepatocellular carcinoma after orthotopic liver transplantation: A pilot study. Hepatology, 26(2), 444-450. https://doi.org/10.1002/hep.510260227

The prediction of risk of recurrence and time to recurrence of hepatocellular carcinoma after orthotopic liver transplantation : A pilot study. / Marsh, J. Wallis; Dvorchik, Igor; Subotin, Michael; Balan, Vijayan; Rakela, Jorge; Popechitelev, E. P.; Subbotin, Vladimir; Casavilla, Adrian; Carr, Brian I.; Fung, John J.; Iwatsuki, Shunzaburo.

In: Hepatology, Vol. 26, No. 2, 1997, p. 444-450.

Research output: Contribution to journalArticle

Marsh, JW, Dvorchik, I, Subotin, M, Balan, V, Rakela, J, Popechitelev, EP, Subbotin, V, Casavilla, A, Carr, BI, Fung, JJ & Iwatsuki, S 1997, 'The prediction of risk of recurrence and time to recurrence of hepatocellular carcinoma after orthotopic liver transplantation: A pilot study', Hepatology, vol. 26, no. 2, pp. 444-450. https://doi.org/10.1002/hep.510260227
Marsh, J. Wallis ; Dvorchik, Igor ; Subotin, Michael ; Balan, Vijayan ; Rakela, Jorge ; Popechitelev, E. P. ; Subbotin, Vladimir ; Casavilla, Adrian ; Carr, Brian I. ; Fung, John J. ; Iwatsuki, Shunzaburo. / The prediction of risk of recurrence and time to recurrence of hepatocellular carcinoma after orthotopic liver transplantation : A pilot study. In: Hepatology. 1997 ; Vol. 26, No. 2. pp. 444-450.
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