Prognostic impact of Des-γ-carboxyl prothrombin in living-donor liver transplantation for recurrent hepatocellular carcinoma

Norifumi Harimoto, Y. Yoshida, T. Kurihara, kazuki takeishi, shinji itoh, Noboru Harada, E. Tsujita, Y. I. Yamashita, H. Uchiyama, Yuji Soejima, Toru Ikegami, Tomoharu Yoshizumi, H. Kawanaka, Tetsuo Ikeda, K. Shirabe, Hiroshi Saeki, Eiji Oki, Yasue Kimura, Yoshihiko Maehara

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Abstract

Background Although the Milan criteria are widely accepted for liver transplantation (LT) in patients for hepatocellular carcinoma (HCC), they have not been fully evaluated for salvage LT in patients with recurrent HCC. We have previously reported outcomes of living-donor LT (LDLT) for HCC and identified 2 risk factors affecting recurrence-free survival (RFS): tumor size >5 cm and des-γ-carboxyl prothrombin (DCP) concentration >300 mAU/mL (Kyushu University criteria). This study was designed to clarify risk factors for tumor recurrence after LDLT in patients with recurrent HCC. Methods Outcomes in 114 patients who underwent LDLT for recurrent HCC were analyzed retrospectively. RFS rates after LDLT were calculated, and risk factors for tumor recurrence were identified. Results The 1-, 3-, and 5-year RFS rates after LDLT were 90.6%, 80.4%, and 78.8%, respectively. Univariate analysis showed that tumor recurrence was associated with alpha-fetoprotein concentration ≥300 ng/mL, DCP concentration ≥300 mAU/mL, tumor number ≥4, tumor size ≥5 cm, transarterial chemotherapy before LDLT, duration of last treatment of HCC to LDLT <3 months, bilobar distribution, exceeding Milan criteria, exceeding Kyushu University criteria, poor differentiation, and histologic vascular invasion. Multivariate analysis showed that DCP ≥300 mAU/mL (P =.03) and duration from last treatment to LDLT <3 months (P =.01) were independent predictors of RFS. Conclusions DCP concentration and time between last treatment and LDLT are prognostic of RFS in patients undergoing LDLT for HCC.

Original languageEnglish
Pages (from-to)703-704
Number of pages2
JournalTransplantation Proceedings
Volume47
Issue number3
DOIs
Publication statusPublished - Jan 1 2015

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Living Donors
Prothrombin
Liver Transplantation
Hepatocellular Carcinoma
Recurrence
Neoplasms
Survival
Survival Rate
Prothrombin Time
alpha-Fetoproteins
Blood Vessels
Therapeutics
Multivariate Analysis
Drug Therapy

All Science Journal Classification (ASJC) codes

  • Surgery
  • Transplantation

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Prognostic impact of Des-γ-carboxyl prothrombin in living-donor liver transplantation for recurrent hepatocellular carcinoma. / Harimoto, Norifumi; Yoshida, Y.; Kurihara, T.; takeishi, kazuki; itoh, shinji; Harada, Noboru; Tsujita, E.; Yamashita, Y. I.; Uchiyama, H.; Soejima, Yuji; Ikegami, Toru; Yoshizumi, Tomoharu; Kawanaka, H.; Ikeda, Tetsuo; Shirabe, K.; Saeki, Hiroshi; Oki, Eiji; Kimura, Yasue; Maehara, Yoshihiko.

In: Transplantation Proceedings, Vol. 47, No. 3, 01.01.2015, p. 703-704.

Research output: Contribution to journalArticle

Harimoto, Norifumi ; Yoshida, Y. ; Kurihara, T. ; takeishi, kazuki ; itoh, shinji ; Harada, Noboru ; Tsujita, E. ; Yamashita, Y. I. ; Uchiyama, H. ; Soejima, Yuji ; Ikegami, Toru ; Yoshizumi, Tomoharu ; Kawanaka, H. ; Ikeda, Tetsuo ; Shirabe, K. ; Saeki, Hiroshi ; Oki, Eiji ; Kimura, Yasue ; Maehara, Yoshihiko. / Prognostic impact of Des-γ-carboxyl prothrombin in living-donor liver transplantation for recurrent hepatocellular carcinoma. In: Transplantation Proceedings. 2015 ; Vol. 47, No. 3. pp. 703-704.
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abstract = "Background Although the Milan criteria are widely accepted for liver transplantation (LT) in patients for hepatocellular carcinoma (HCC), they have not been fully evaluated for salvage LT in patients with recurrent HCC. We have previously reported outcomes of living-donor LT (LDLT) for HCC and identified 2 risk factors affecting recurrence-free survival (RFS): tumor size >5 cm and des-γ-carboxyl prothrombin (DCP) concentration >300 mAU/mL (Kyushu University criteria). This study was designed to clarify risk factors for tumor recurrence after LDLT in patients with recurrent HCC. Methods Outcomes in 114 patients who underwent LDLT for recurrent HCC were analyzed retrospectively. RFS rates after LDLT were calculated, and risk factors for tumor recurrence were identified. Results The 1-, 3-, and 5-year RFS rates after LDLT were 90.6{\%}, 80.4{\%}, and 78.8{\%}, respectively. Univariate analysis showed that tumor recurrence was associated with alpha-fetoprotein concentration ≥300 ng/mL, DCP concentration ≥300 mAU/mL, tumor number ≥4, tumor size ≥5 cm, transarterial chemotherapy before LDLT, duration of last treatment of HCC to LDLT <3 months, bilobar distribution, exceeding Milan criteria, exceeding Kyushu University criteria, poor differentiation, and histologic vascular invasion. Multivariate analysis showed that DCP ≥300 mAU/mL (P =.03) and duration from last treatment to LDLT <3 months (P =.01) were independent predictors of RFS. Conclusions DCP concentration and time between last treatment and LDLT are prognostic of RFS in patients undergoing LDLT for HCC.",
author = "Norifumi Harimoto and Y. Yoshida and T. Kurihara and kazuki takeishi and shinji itoh and Noboru Harada and E. Tsujita and Yamashita, {Y. I.} and H. Uchiyama and Yuji Soejima and Toru Ikegami and Tomoharu Yoshizumi and H. Kawanaka and Tetsuo Ikeda and K. Shirabe and Hiroshi Saeki and Eiji Oki and Yasue Kimura and Yoshihiko Maehara",
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T1 - Prognostic impact of Des-γ-carboxyl prothrombin in living-donor liver transplantation for recurrent hepatocellular carcinoma

AU - Harimoto, Norifumi

AU - Yoshida, Y.

AU - Kurihara, T.

AU - takeishi, kazuki

AU - itoh, shinji

AU - Harada, Noboru

AU - Tsujita, E.

AU - Yamashita, Y. I.

AU - Uchiyama, H.

AU - Soejima, Yuji

AU - Ikegami, Toru

AU - Yoshizumi, Tomoharu

AU - Kawanaka, H.

AU - Ikeda, Tetsuo

AU - Shirabe, K.

AU - Saeki, Hiroshi

AU - Oki, Eiji

AU - Kimura, Yasue

AU - Maehara, Yoshihiko

PY - 2015/1/1

Y1 - 2015/1/1

N2 - Background Although the Milan criteria are widely accepted for liver transplantation (LT) in patients for hepatocellular carcinoma (HCC), they have not been fully evaluated for salvage LT in patients with recurrent HCC. We have previously reported outcomes of living-donor LT (LDLT) for HCC and identified 2 risk factors affecting recurrence-free survival (RFS): tumor size >5 cm and des-γ-carboxyl prothrombin (DCP) concentration >300 mAU/mL (Kyushu University criteria). This study was designed to clarify risk factors for tumor recurrence after LDLT in patients with recurrent HCC. Methods Outcomes in 114 patients who underwent LDLT for recurrent HCC were analyzed retrospectively. RFS rates after LDLT were calculated, and risk factors for tumor recurrence were identified. Results The 1-, 3-, and 5-year RFS rates after LDLT were 90.6%, 80.4%, and 78.8%, respectively. Univariate analysis showed that tumor recurrence was associated with alpha-fetoprotein concentration ≥300 ng/mL, DCP concentration ≥300 mAU/mL, tumor number ≥4, tumor size ≥5 cm, transarterial chemotherapy before LDLT, duration of last treatment of HCC to LDLT <3 months, bilobar distribution, exceeding Milan criteria, exceeding Kyushu University criteria, poor differentiation, and histologic vascular invasion. Multivariate analysis showed that DCP ≥300 mAU/mL (P =.03) and duration from last treatment to LDLT <3 months (P =.01) were independent predictors of RFS. Conclusions DCP concentration and time between last treatment and LDLT are prognostic of RFS in patients undergoing LDLT for HCC.

AB - Background Although the Milan criteria are widely accepted for liver transplantation (LT) in patients for hepatocellular carcinoma (HCC), they have not been fully evaluated for salvage LT in patients with recurrent HCC. We have previously reported outcomes of living-donor LT (LDLT) for HCC and identified 2 risk factors affecting recurrence-free survival (RFS): tumor size >5 cm and des-γ-carboxyl prothrombin (DCP) concentration >300 mAU/mL (Kyushu University criteria). This study was designed to clarify risk factors for tumor recurrence after LDLT in patients with recurrent HCC. Methods Outcomes in 114 patients who underwent LDLT for recurrent HCC were analyzed retrospectively. RFS rates after LDLT were calculated, and risk factors for tumor recurrence were identified. Results The 1-, 3-, and 5-year RFS rates after LDLT were 90.6%, 80.4%, and 78.8%, respectively. Univariate analysis showed that tumor recurrence was associated with alpha-fetoprotein concentration ≥300 ng/mL, DCP concentration ≥300 mAU/mL, tumor number ≥4, tumor size ≥5 cm, transarterial chemotherapy before LDLT, duration of last treatment of HCC to LDLT <3 months, bilobar distribution, exceeding Milan criteria, exceeding Kyushu University criteria, poor differentiation, and histologic vascular invasion. Multivariate analysis showed that DCP ≥300 mAU/mL (P =.03) and duration from last treatment to LDLT <3 months (P =.01) were independent predictors of RFS. Conclusions DCP concentration and time between last treatment and LDLT are prognostic of RFS in patients undergoing LDLT for HCC.

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