Abstract
Context: Liver transplantation (LT) is considered the ideal therapy for patients with hepatocellular carcinoma (HCC) having cirrhosis but the shortage of liver donors and the risk of dropout from the wait list due to tumor progression severely limit transplantation. A new prognostic score, the HCC-model for end-stage liver disease (HCC-MELD), was developed by combining a-fetoprotein (AFP), MELD, and tumor size, to improve risk stratification of dropout in patients with HCC. Objectives: In this study, we investigated the ability of the HCC-MELD score in predicting the posttransplant for patients fulfilling Milan criteria (MC). Design: Two hundred patients with stage II tumor were retrospectively reviewed from a total of 1290 transplants performed at our institution from October 1997 through April 2015. Cox regression analysis was performed to identify the prognostic factors impacting the posttransplant survival. Results: Overall survival at 1, 5, and 10 years was 89.3%, 71.1%, and 67.2%, whereas disease-free survival was 86.4%, 66.5%, and 52.4%, respectively. Multivariate analysis showed HCC-MELD score (hazard ratio [HR] 39.6, P < .001) and microvascular invasion (HR 2.41, P = .002) to be independent risk factors for recurrence, whereas HCC diameter (HR 1.15, P = .041), HCC-MELD (HR 15.611, P = .006), and grading (HR 2.17, P = .03) proved to be predictive factors of poor overall survival. Conclusion: Our study showed the validity of the HCC-MELD equation in the evaluation of patients undergoing LT for HCC. This score offers a reliable method to assess the risk of waiting list dropout and predict posttransplantation outcomes.
| Original language | English |
|---|---|
| Pages (from-to) | 63-69 |
| Number of pages | 7 |
| Journal | Progress in Transplantation |
| Volume | 28 |
| Issue number | 1 |
| DOIs | |
| Publication status | Published - Mar 1 2018 |
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Keywords
- HCC-MELD
- Hepatocellular carcinoma
- Liver transplantation
- Liver tumor
- MELD
- Milan criteria
ASJC Scopus subject areas
- Transplantation
Cite this
Value of HCC-MELD score in patients with hepatocellular carcinoma undergoing liver transplantation. / Guerrini, Gian Piero; Pinelli, Domenico; Marini, Elena; Corno, Vittorio; Guizzetti, Michela; Zambelli, Marco; Aluffi, Alessandro; Lincini, Lisa; Fagiuoli, Stefano; Lucianetti, Alessandro; Colledan, Michele.
In: Progress in Transplantation, Vol. 28, No. 1, 01.03.2018, p. 63-69.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Value of HCC-MELD score in patients with hepatocellular carcinoma undergoing liver transplantation
AU - Guerrini, Gian Piero
AU - Pinelli, Domenico
AU - Marini, Elena
AU - Corno, Vittorio
AU - Guizzetti, Michela
AU - Zambelli, Marco
AU - Aluffi, Alessandro
AU - Lincini, Lisa
AU - Fagiuoli, Stefano
AU - Lucianetti, Alessandro
AU - Colledan, Michele
PY - 2018/3/1
Y1 - 2018/3/1
N2 - Context: Liver transplantation (LT) is considered the ideal therapy for patients with hepatocellular carcinoma (HCC) having cirrhosis but the shortage of liver donors and the risk of dropout from the wait list due to tumor progression severely limit transplantation. A new prognostic score, the HCC-model for end-stage liver disease (HCC-MELD), was developed by combining a-fetoprotein (AFP), MELD, and tumor size, to improve risk stratification of dropout in patients with HCC. Objectives: In this study, we investigated the ability of the HCC-MELD score in predicting the posttransplant for patients fulfilling Milan criteria (MC). Design: Two hundred patients with stage II tumor were retrospectively reviewed from a total of 1290 transplants performed at our institution from October 1997 through April 2015. Cox regression analysis was performed to identify the prognostic factors impacting the posttransplant survival. Results: Overall survival at 1, 5, and 10 years was 89.3%, 71.1%, and 67.2%, whereas disease-free survival was 86.4%, 66.5%, and 52.4%, respectively. Multivariate analysis showed HCC-MELD score (hazard ratio [HR] 39.6, P < .001) and microvascular invasion (HR 2.41, P = .002) to be independent risk factors for recurrence, whereas HCC diameter (HR 1.15, P = .041), HCC-MELD (HR 15.611, P = .006), and grading (HR 2.17, P = .03) proved to be predictive factors of poor overall survival. Conclusion: Our study showed the validity of the HCC-MELD equation in the evaluation of patients undergoing LT for HCC. This score offers a reliable method to assess the risk of waiting list dropout and predict posttransplantation outcomes.
AB - Context: Liver transplantation (LT) is considered the ideal therapy for patients with hepatocellular carcinoma (HCC) having cirrhosis but the shortage of liver donors and the risk of dropout from the wait list due to tumor progression severely limit transplantation. A new prognostic score, the HCC-model for end-stage liver disease (HCC-MELD), was developed by combining a-fetoprotein (AFP), MELD, and tumor size, to improve risk stratification of dropout in patients with HCC. Objectives: In this study, we investigated the ability of the HCC-MELD score in predicting the posttransplant for patients fulfilling Milan criteria (MC). Design: Two hundred patients with stage II tumor were retrospectively reviewed from a total of 1290 transplants performed at our institution from October 1997 through April 2015. Cox regression analysis was performed to identify the prognostic factors impacting the posttransplant survival. Results: Overall survival at 1, 5, and 10 years was 89.3%, 71.1%, and 67.2%, whereas disease-free survival was 86.4%, 66.5%, and 52.4%, respectively. Multivariate analysis showed HCC-MELD score (hazard ratio [HR] 39.6, P < .001) and microvascular invasion (HR 2.41, P = .002) to be independent risk factors for recurrence, whereas HCC diameter (HR 1.15, P = .041), HCC-MELD (HR 15.611, P = .006), and grading (HR 2.17, P = .03) proved to be predictive factors of poor overall survival. Conclusion: Our study showed the validity of the HCC-MELD equation in the evaluation of patients undergoing LT for HCC. This score offers a reliable method to assess the risk of waiting list dropout and predict posttransplantation outcomes.
KW - HCC-MELD
KW - Hepatocellular carcinoma
KW - Liver transplantation
KW - Liver tumor
KW - MELD
KW - Milan criteria
UR - http://www.scopus.com/inward/record.url?scp=85044928764&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85044928764&partnerID=8YFLogxK
U2 - 10.1177/1526924817746686
DO - 10.1177/1526924817746686
M3 - Article
AN - SCOPUS:85044928764
VL - 28
SP - 63
EP - 69
JO - Progress in Transplantation
JF - Progress in Transplantation
SN - 1526-9248
IS - 1
ER -