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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
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
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ANTONIO CUADRADO LAVIN
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
JUAN CARLOS RODRIGUEZ SANJUAN
JAVIER CRESPO GARCIA
EMILIO FABREGA GARCIA
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