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Risk of recurrence of hepatocarcinoma after liver transplantation: performance of recurrence predictive models in a cohort of transplant patients

Abstract: Liver transplantation (LT) is a curative treatment for early-stage hepatocellular carcinoma (HCC) unsuitable for surgical resection. However, tumor recurrence (TR) rates range from 8% to 20% despite strict selection criteria. The validation of new prognostic tools, such as pre-MORAL or RETREAT risks, is necessary to improve recurrence prediction. A retrospective study was conducted at Marqués de Valdecilla University Hospital in Cantabria, Spain, between 2010 and 2019 to determine the rate of TR in LT patients and identify associated factors. Patients with liver-kidney transplantation, re-transplantation, HIV infection, survival less than 90 days, or incidental HCC were excluded. Data on demographic, liver disease-related, LT, and tumor-related variables, as well as follow-up records, including TR and death, were collected. TR was analyzed using the Log-Rank test, and a multivariate Cox regression analysis was performed. The study was approved by the IRB of Cantabria. TR occurred in 13.6% of LT patients (95% CI = 7.3-23.9), primarily as extrahepatic recurrence (67%) within the first 5 years (75%). Increased TR was significantly associated with higher Body Mass Index (BMI) (HR = 1.3 [95% CI = 1.1-1.5]), vascular micro-invasion (HR = 8.8 [1.6-48.0]), and medium (HR = 20.4 [3.0-140.4]) and high pre-MORAL risk (HR = 30.2 [1.6-568.6]). TR also showed a significant correlation with increased mortality. Conclusions: LT for HCC results in a 13.6% rate of tumor recurrence. Factors such as BMI, vascular micro-invasion, and medium/high pre-MORAL risk are strongly associated with TR following LT

Otras publicaciones de la misma revista o congreso con autores/as de la Universidad de Cantabria

 Fuente: Journal of Clinical Medicine, 2023, 12(17), 5457

Editorial: MDPI

 Año de publicación: 2023

Nº de páginas: 12

Tipo de publicación: Artículo de Revista

 DOI: 10.3390/jcm12175457

ISSN: 2077-0383

Url de la publicación: https://doi.org/10.3390/jcm12175457

Autoría

JOSE IGNACIO FORTEA ORMAECHEA

RODRÍGUEZ-LOPE, CARLOS

PUENTES, ÁNGELA

FERNÁNDEZ-VILCHEZ, VANESA

ECHEBARRÍA, VICTOR JOSE

CASTILLO SUESCUN, FEDERICO JOSÉ

FERNÁNDEZ, ROBERTO

ECHEVERRI, JUAN ANDRÉS

ACHALANDABASO, MAR

TOLEDO, ENRIQUE

PELLÓN, RAÚL