Significance of preoperative fluorodeoxyglucose-positron emission tomography in prediction of tumor recurrence after liver transplantation for hepatocellular carcinoma patients: a Japanese multicenter study

the LTx-PET study group of the Japanese Society of Hepato-Biliary-Pancreatic Surgery and the Japanese Liver Transplantation Society

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Abstract

Background: In the present study, we conducted a multicenter nationwide survey to investigate the effects of preoperative fluorine-18-fluorodeoxyglucose (FDG) positron emission tomography (PET) on the prediction of hepatocellular carcinoma (HCC) recurrence after liver transplantation (LT). Methods: From 16 Japanese LT centers, data were collected on 182 recipients with HCC who underwent living donor liver transplantation (LDLT) between February 2005 and November 2013. PET-positive status was defined as increased uptake of FDG in the tumor compared to the surrounding non-tumor liver tissue. The median follow-up after LDLT was 54.5 months (range 1–125 months). Results: Postoperative HCC recurrence occurred in 23 patients. Multivariate analysis revealed that exceeding the Milan criteria (MC), alpha-fetoprotein (AFP) level ≥115 ng/ml, and PET-positive status were significant and independent risk factors for recurrence. In the over-MC group, a subgroup of patients with AFP level <115 ng/ml and PET-negative status (n = 22) had a significantly lower 5-year recurrence rate than the other patients (n = 27, 19% vs. 53%, P = 0.019). Conclusions: These results suggest that preoperative FDG-PET status offers additional information on HCC recurrence risk after LT. Over-MC patients with PET-negative status and lower AFP level may achieve successful outcome comparable to that of within-MC patients.

Original languageEnglish
Pages (from-to)49-57
Number of pages9
JournalJournal of Hepato-Biliary-Pancreatic Sciences
Volume24
Issue number1
DOIs
Publication statusPublished - Jan 1 2017

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Positron-Emission Tomography
Liver Transplantation
Multicenter Studies
Hepatocellular Carcinoma
Recurrence
alpha-Fetoproteins
Neoplasms
Living Donors
Fluorodeoxyglucose F18
Multivariate Analysis
Liver

All Science Journal Classification (ASJC) codes

  • Medicine(all)

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Significance of preoperative fluorodeoxyglucose-positron emission tomography in prediction of tumor recurrence after liver transplantation for hepatocellular carcinoma patients : a Japanese multicenter study. / the LTx-PET study group of the Japanese Society of Hepato-Biliary-Pancreatic Surgery and the Japanese Liver Transplantation Society.

In: Journal of Hepato-Biliary-Pancreatic Sciences, Vol. 24, No. 1, 01.01.2017, p. 49-57.

Research output: Contribution to journalArticle

the LTx-PET study group of the Japanese Society of Hepato-Biliary-Pancreatic Surgery and the Japanese Liver Transplantation Society. / Significance of preoperative fluorodeoxyglucose-positron emission tomography in prediction of tumor recurrence after liver transplantation for hepatocellular carcinoma patients : a Japanese multicenter study. In: Journal of Hepato-Biliary-Pancreatic Sciences. 2017 ; Vol. 24, No. 1. pp. 49-57.
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title = "Significance of preoperative fluorodeoxyglucose-positron emission tomography in prediction of tumor recurrence after liver transplantation for hepatocellular carcinoma patients: a Japanese multicenter study",
abstract = "Background: In the present study, we conducted a multicenter nationwide survey to investigate the effects of preoperative fluorine-18-fluorodeoxyglucose (FDG) positron emission tomography (PET) on the prediction of hepatocellular carcinoma (HCC) recurrence after liver transplantation (LT). Methods: From 16 Japanese LT centers, data were collected on 182 recipients with HCC who underwent living donor liver transplantation (LDLT) between February 2005 and November 2013. PET-positive status was defined as increased uptake of FDG in the tumor compared to the surrounding non-tumor liver tissue. The median follow-up after LDLT was 54.5 months (range 1–125 months). Results: Postoperative HCC recurrence occurred in 23 patients. Multivariate analysis revealed that exceeding the Milan criteria (MC), alpha-fetoprotein (AFP) level ≥115 ng/ml, and PET-positive status were significant and independent risk factors for recurrence. In the over-MC group, a subgroup of patients with AFP level <115 ng/ml and PET-negative status (n = 22) had a significantly lower 5-year recurrence rate than the other patients (n = 27, 19{\%} vs. 53{\%}, P = 0.019). Conclusions: These results suggest that preoperative FDG-PET status offers additional information on HCC recurrence risk after LT. Over-MC patients with PET-negative status and lower AFP level may achieve successful outcome comparable to that of within-MC patients.",
author = "{the LTx-PET study group of the Japanese Society of Hepato-Biliary-Pancreatic Surgery and the Japanese Liver Transplantation Society} and Yasutsugu Takada and Toshimi Kaido and Ken Shirabe and Hiroaki Nagano and Hiroto Egawa and Yasuhiko Sugawara and Akinobu Taketomi and Takeshi Takahara and Go Wakabayashi and Chikashi Nakanishi and Naoki Kawagishi and Akira Kenjo and Mitsukazu Gotoh and Yoshikazu Toyoki and Kenichi Hakamada and Masayuki Ohtsuka and Nobuhisa Akamatsu and Norihiro Kokudo and Kazuhisa Takeda and Itaru Endo and Hiroyuki Takamura and Hideaki Okajima and Hiroshi Wada and Shoji Kubo and Kaoru Kuramitsu and Yonson Ku and Kohei Ishiyama and Hideki Ohdan and Eitaro Ito and Yoshihiko Maehara and Masaki Honda and Yukihiro Inomata and Hiroyuki Furukawa and Shinji Uemoto and Hiroki Yamaue and Masaru Miyazaki and Yoshihiko Maehara",
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T1 - Significance of preoperative fluorodeoxyglucose-positron emission tomography in prediction of tumor recurrence after liver transplantation for hepatocellular carcinoma patients

T2 - a Japanese multicenter study

AU - the LTx-PET study group of the Japanese Society of Hepato-Biliary-Pancreatic Surgery and the Japanese Liver Transplantation Society

AU - Takada, Yasutsugu

AU - Kaido, Toshimi

AU - Shirabe, Ken

AU - Nagano, Hiroaki

AU - Egawa, Hiroto

AU - Sugawara, Yasuhiko

AU - Taketomi, Akinobu

AU - Takahara, Takeshi

AU - Wakabayashi, Go

AU - Nakanishi, Chikashi

AU - Kawagishi, Naoki

AU - Kenjo, Akira

AU - Gotoh, Mitsukazu

AU - Toyoki, Yoshikazu

AU - Hakamada, Kenichi

AU - Ohtsuka, Masayuki

AU - Akamatsu, Nobuhisa

AU - Kokudo, Norihiro

AU - Takeda, Kazuhisa

AU - Endo, Itaru

AU - Takamura, Hiroyuki

AU - Okajima, Hideaki

AU - Wada, Hiroshi

AU - Kubo, Shoji

AU - Kuramitsu, Kaoru

AU - Ku, Yonson

AU - Ishiyama, Kohei

AU - Ohdan, Hideki

AU - Ito, Eitaro

AU - Maehara, Yoshihiko

AU - Honda, Masaki

AU - Inomata, Yukihiro

AU - Furukawa, Hiroyuki

AU - Uemoto, Shinji

AU - Yamaue, Hiroki

AU - Miyazaki, Masaru

AU - Maehara, Yoshihiko

PY - 2017/1/1

Y1 - 2017/1/1

N2 - Background: In the present study, we conducted a multicenter nationwide survey to investigate the effects of preoperative fluorine-18-fluorodeoxyglucose (FDG) positron emission tomography (PET) on the prediction of hepatocellular carcinoma (HCC) recurrence after liver transplantation (LT). Methods: From 16 Japanese LT centers, data were collected on 182 recipients with HCC who underwent living donor liver transplantation (LDLT) between February 2005 and November 2013. PET-positive status was defined as increased uptake of FDG in the tumor compared to the surrounding non-tumor liver tissue. The median follow-up after LDLT was 54.5 months (range 1–125 months). Results: Postoperative HCC recurrence occurred in 23 patients. Multivariate analysis revealed that exceeding the Milan criteria (MC), alpha-fetoprotein (AFP) level ≥115 ng/ml, and PET-positive status were significant and independent risk factors for recurrence. In the over-MC group, a subgroup of patients with AFP level <115 ng/ml and PET-negative status (n = 22) had a significantly lower 5-year recurrence rate than the other patients (n = 27, 19% vs. 53%, P = 0.019). Conclusions: These results suggest that preoperative FDG-PET status offers additional information on HCC recurrence risk after LT. Over-MC patients with PET-negative status and lower AFP level may achieve successful outcome comparable to that of within-MC patients.

AB - Background: In the present study, we conducted a multicenter nationwide survey to investigate the effects of preoperative fluorine-18-fluorodeoxyglucose (FDG) positron emission tomography (PET) on the prediction of hepatocellular carcinoma (HCC) recurrence after liver transplantation (LT). Methods: From 16 Japanese LT centers, data were collected on 182 recipients with HCC who underwent living donor liver transplantation (LDLT) between February 2005 and November 2013. PET-positive status was defined as increased uptake of FDG in the tumor compared to the surrounding non-tumor liver tissue. The median follow-up after LDLT was 54.5 months (range 1–125 months). Results: Postoperative HCC recurrence occurred in 23 patients. Multivariate analysis revealed that exceeding the Milan criteria (MC), alpha-fetoprotein (AFP) level ≥115 ng/ml, and PET-positive status were significant and independent risk factors for recurrence. In the over-MC group, a subgroup of patients with AFP level <115 ng/ml and PET-negative status (n = 22) had a significantly lower 5-year recurrence rate than the other patients (n = 27, 19% vs. 53%, P = 0.019). Conclusions: These results suggest that preoperative FDG-PET status offers additional information on HCC recurrence risk after LT. Over-MC patients with PET-negative status and lower AFP level may achieve successful outcome comparable to that of within-MC patients.

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U2 - 10.1002/jhbp.412

DO - 10.1002/jhbp.412

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C2 - 27806426

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EP - 57

JO - Journal of Hepato-Biliary-Pancreatic Sciences

JF - Journal of Hepato-Biliary-Pancreatic Sciences

SN - 1868-6974

IS - 1

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