Performance of pre-transplant criteria in prediction of hepatocellular carcinoma progression and waitlist dropout
Carregando...
Citações na Scopus
0
Tipo de produção
article
Data de publicação
2022
Título da Revista
ISSN da Revista
Título do Volume
Editora
WILEY
Autores
PINERO, Federico
THOMPSON, Marcos
BOIN, Ilka
QUINONEZ, Emilio
BERMUDEZ, Carla
VILATOBA, Mario
SANTOS, Luisa
ANDERS, Margarita
DUQUE, Sergio Hoyos
Citação
LIVER INTERNATIONAL, v.42, n.8, p.1879-1890, 2022
Resumo
Background & aim Liver transplantation (LT) selection models for hepatocellular carcinoma (HCC) have not been proposed to predict waitlist dropout because of tumour progression. The aim of this study was to compare the alpha-foetoprotein (AFP) model and other pre-LT models in their prediction of HCC dropout. Methods A multicentre cohort study was conducted in 20 Latin American transplant centres, including 994 listed patients for LT with HCC from 2012 to 2018. Longitudinal tumour characteristics, and patterns of progression were recorded at time of listing, after treatments and at last follow-up over the waitlist period. Competing risk regression models were performed, and model's discrimination was compared estimating Harrell's adapted c-statistics. Results HCC dropout rate was significantly higher in patients beyond (24% [95% CI 16-28]) compared to those within Milan criteria (8% [95% IC 5%-12%]; p < .0001), with a SHR of 3.01 [95% CI 2.03-4.47]), adjusted for waiting list time and bridging therapies (c-index 0.63 [95% CI 0.57; 0.69). HCC dropout rates were higher in patients with AFP scores >2 (adjusted SHR of 3.17 [CI 2.13-4.71]), c-index of 0.71 (95% CI 0.65-0.77; p = .09 vs Milan). Similar discrimination power for HCC dropout was observed between the AFP score and the Metroticket 2.0 model. In patients within Milan, an AFP score >2 points discriminated two populations with a higher risk of HCC dropout (SHR 1.68 [95% CI 1.08-2.61]). Conclusions Pre-transplant selection models similarly predicted HCC dropout. However, the AFP model can discriminate a higher risk of dropout among patients within Milan criteria.
Palavras-chave
delisting, liver cancer, outcomes, radiological progression
Referências
- Belli LS, 2016, J HEPATOL, V65, P524, DOI 10.1016/j.jhep.2016.05.010
- Berenguer M, 2020, TRANSPLANTATION, V104, P1143, DOI 10.1097/TP.0000000000003196
- Bittermann T, 2014, AM J TRANSPLANT, V14, P1657, DOI 10.1111/ajt.12774
- Cejas NG, 2013, LIVER TRANSPLANT, V19, P711, DOI 10.1002/lt.23665
- Cucchetti A, 2011, LIVER TRANSPLANT, V17, P1344, DOI 10.1002/lt.22397
- Dignam JJ, 2012, CLIN CANCER RES, V18, P2301, DOI 10.1158/1078-0432.CCR-11-2097
- Duvoux C, 2012, GASTROENTEROLOGY, V143, P986, DOI 10.1053/j.gastro.2012.05.052
- European Association for the Study of the Liver. Electronic address: easloffice@easloffice.eu, 2019, J Hepatol, V70, P817, DOI 10.1016/j.jhep.2019.01.020
- Faitot F, 2015, HEPATOLOGY, V62, P179, DOI 10.1002/hep.27864
- Ferrer-Fabrega J, 2021, J HEPATOL, V75, P1154, DOI 10.1016/j.jhep.2021.06.015
- Halazun KJ, 2014, HEPATOLOGY, V60, P1957, DOI 10.1002/hep.27272
- Heimbach JK, 2018, HEPATOLOGY, V67, P358, DOI 10.1002/hep.29086
- Lai Q, 2013, LIVER TRANSPLANT, V19, P1108, DOI 10.1002/lt.23706
- Lencioni R, 2010, SEMIN LIVER DIS, V30, P52, DOI 10.1055/s-0030-1247132
- Mazzaferro V, 1996, NEW ENGL J MED, V334, P693, DOI 10.1056/NEJM199603143341104
- Mazzaferro V, 2018, GASTROENTEROLOGY, V154, P128, DOI 10.1053/j.gastro.2017.09.025
- Mehta N, 2021, J HEPATOL, V74, P829, DOI 10.1016/j.jhep.2020.10.033
- Mehta N, 2016, LIVER TRANSPLANT, V22, P178, DOI 10.1002/lt.24360
- Mehta N, 2013, LIVER TRANSPLANT, V19, P1343, DOI 10.1002/lt.23753
- Munoz-Martinez S, 2021, JHEP REP, V3, DOI 10.1016/j.jhepr.2021.100260
- Otto G, 2006, LIVER TRANSPLANT, V12, P1260, DOI 10.1002/lt.20837
- Personeni N, 2012, J HEPATOL, V57, P101, DOI 10.1016/j.jhep.2012.02.016
- Pinero F, 2020, ANN HEPATOL, V19, P546, DOI 10.1016/j.aohep.2020.06.003
- Reig M, 2013, HEPATOLOGY, V58, P2023, DOI 10.1002/hep.26586
- Samoylova ML, 2014, LIVER TRANSPLANT, V20, P937, DOI 10.1002/lt.23902
- Schuster NA, 2020, J CLIN EPIDEMIOL, V122, P42, DOI 10.1016/j.jclinepi.2020.03.004
- Toso C, 2014, TRANSPL INT, V27, P686, DOI 10.1111/tri.12323
- Vitale A, 2010, ANN SURG ONCOL, V17, P2290, DOI 10.1245/s10434-010-0993-4
- von Elm E, 2007, PREV MED, V45, P247, DOI [10.2471/BLT.07.045120, 10.1016/S0140-6736(07)61602-X, 10.1371/journal.pmed.0040297, 10.1016/j.jclinepi.2007.11.008, 10.1371/journal.pmed.0040296]
- Wolbers M, 2014, BIOSTATISTICS, V15, P526, DOI 10.1093/biostatistics/kxt059