Living donor liver transplantation for hepatocellular carcinoma: A special reference to a preoperative des-gamma-carboxy prothrombin value

M. Shimada, Y. Yonemura, H. Ijichi, Noboru Harada, S. Shiotani, M. Ninomiya, T. Terashi, Tomoharu Yoshizumi, Yuji Soejima, Yoshihiko Maehara

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Abstract

Background. Des-gamma-carboxy prothrombin (DCP) is a sensitive marker related to vascular invasion of hepatocellular carcinoma (HCC). The aim of this study was to clarify the risk factors of HCC recurrence in living donor liver transplantation (LDLT) with special reference to preoperative DCP values. Methods. Forty consecutive adult HCC patients who underwent LDLT were examined for a correlation between the DCP value and vascular invasion. Risk factors for recurrence were also investigated using clinicopathological variables including preoperative DCP levels. Results. The incidence of positive histological vascular invasion in patients with DCP values above 300 mAU/mL was higher than that with those with DCP value below 300 mAU/mL. Other significant risk factors for recurrence were over 5 cm tumor diameter, not meeting the Milan criteria, AFP value >400 ng/mL, histological vascular invasion, poorly differentiated histology, and male gender. Among the patients who did not meet the Milan criteria, those with both no more than 5 cm of tumor diameter and no more than 300 mAU/mL DCP exhibited a good prognosis. Conclusions. A high DCP value, namely >300 mAU/mL correlated with histological vascular invasion and was one of the strongest prognostic variables. Therefore, special attention should be paid to HCC patients with high DCP values. No correlation between the number of tumor nodules and recurrence was found; therefore, the Milan criteria may require revision regarding the number of tumor nodules.

Original languageEnglish
Pages (from-to)1177-1179
Number of pages3
JournalTransplantation Proceedings
Volume37
Issue number2
DOIs
Publication statusPublished - Jan 1 2005

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Living Donors
Liver Transplantation
Hepatocellular Carcinoma
Blood Vessels
Recurrence
Neoplasms
acarboxyprothrombin
Histology
Incidence

All Science Journal Classification (ASJC) codes

  • Surgery
  • Transplantation

Cite this

Living donor liver transplantation for hepatocellular carcinoma : A special reference to a preoperative des-gamma-carboxy prothrombin value. / Shimada, M.; Yonemura, Y.; Ijichi, H.; Harada, Noboru; Shiotani, S.; Ninomiya, M.; Terashi, T.; Yoshizumi, Tomoharu; Soejima, Yuji; Maehara, Yoshihiko.

In: Transplantation Proceedings, Vol. 37, No. 2, 01.01.2005, p. 1177-1179.

Research output: Contribution to journalArticle

Shimada, M. ; Yonemura, Y. ; Ijichi, H. ; Harada, Noboru ; Shiotani, S. ; Ninomiya, M. ; Terashi, T. ; Yoshizumi, Tomoharu ; Soejima, Yuji ; Maehara, Yoshihiko. / Living donor liver transplantation for hepatocellular carcinoma : A special reference to a preoperative des-gamma-carboxy prothrombin value. In: Transplantation Proceedings. 2005 ; Vol. 37, No. 2. pp. 1177-1179.
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abstract = "Background. Des-gamma-carboxy prothrombin (DCP) is a sensitive marker related to vascular invasion of hepatocellular carcinoma (HCC). The aim of this study was to clarify the risk factors of HCC recurrence in living donor liver transplantation (LDLT) with special reference to preoperative DCP values. Methods. Forty consecutive adult HCC patients who underwent LDLT were examined for a correlation between the DCP value and vascular invasion. Risk factors for recurrence were also investigated using clinicopathological variables including preoperative DCP levels. Results. The incidence of positive histological vascular invasion in patients with DCP values above 300 mAU/mL was higher than that with those with DCP value below 300 mAU/mL. Other significant risk factors for recurrence were over 5 cm tumor diameter, not meeting the Milan criteria, AFP value >400 ng/mL, histological vascular invasion, poorly differentiated histology, and male gender. Among the patients who did not meet the Milan criteria, those with both no more than 5 cm of tumor diameter and no more than 300 mAU/mL DCP exhibited a good prognosis. Conclusions. A high DCP value, namely >300 mAU/mL correlated with histological vascular invasion and was one of the strongest prognostic variables. Therefore, special attention should be paid to HCC patients with high DCP values. No correlation between the number of tumor nodules and recurrence was found; therefore, the Milan criteria may require revision regarding the number of tumor nodules.",
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AU - Shiotani, S.

AU - Ninomiya, M.

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AB - Background. Des-gamma-carboxy prothrombin (DCP) is a sensitive marker related to vascular invasion of hepatocellular carcinoma (HCC). The aim of this study was to clarify the risk factors of HCC recurrence in living donor liver transplantation (LDLT) with special reference to preoperative DCP values. Methods. Forty consecutive adult HCC patients who underwent LDLT were examined for a correlation between the DCP value and vascular invasion. Risk factors for recurrence were also investigated using clinicopathological variables including preoperative DCP levels. Results. The incidence of positive histological vascular invasion in patients with DCP values above 300 mAU/mL was higher than that with those with DCP value below 300 mAU/mL. Other significant risk factors for recurrence were over 5 cm tumor diameter, not meeting the Milan criteria, AFP value >400 ng/mL, histological vascular invasion, poorly differentiated histology, and male gender. Among the patients who did not meet the Milan criteria, those with both no more than 5 cm of tumor diameter and no more than 300 mAU/mL DCP exhibited a good prognosis. Conclusions. A high DCP value, namely >300 mAU/mL correlated with histological vascular invasion and was one of the strongest prognostic variables. Therefore, special attention should be paid to HCC patients with high DCP values. No correlation between the number of tumor nodules and recurrence was found; therefore, the Milan criteria may require revision regarding the number of tumor nodules.

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