Evaluation of absolute serum α-fetoprotein levels in liver transplant for hepatocellular cancer.
Arch Surg
; 146(1): 26-33, 2011 Jan.
Article
en En
| MEDLINE
| ID: mdl-21242442
ABSTRACT
HYPOTHESIS:
An elevated serum α-fetoprotein (AFP) level before orthotopic liver transplant (OLT) is predictive of mortality after OLT for hepatocellular carcinoma (HCC).DESIGN:
Retrospective analysis of a population-based cohort.SETTING:
United Network for Organ Sharing registry (2003-2008). PATIENTS We identified 2253 patients who underwent OLT for HCC with available pre-OLT serum AFP values.METHODS:
Patients were stratified by AFP levels into low (<20 ng/mL), medium (20-399 ng/mL), or high (≥400 ng/mL) groups. Clinical and pathological characteristics were compared among groups. Survival curves were constructed by the Kaplan-Meier method, and univariate and multivariate Cox-regression analysis was performed.RESULTS:
Of the 2253 patients, 1210 (53.7%), 805 (35.7%), and 238 (10.6%) were in the low, medium, and high AFP groups, respectively. On univariate analysis, the low AFP group demonstrated the best 4-year survival (76%) compared with the medium (65%; P = .001) and high (57%; P < .001) AFP groups. When AFP levels in patients with only stage II HCC underwent assessment, improved survival in the low AFP group was still observed (P < .001). On multivariate analysis, the medium and high AFP groups were associated with higher mortality (hazard ratios, 1.50 [95% confidence interval, 1.19-1.89; P = .001] and 2.11 [1.55-2.88; P < .001], respectively).CONCLUSIONS:
Serum AFP level is an independent prognostic predictor of outcome after OLT for HCC. The association between serum AFP value and post-OLT survival warrants further investigation to potentially better allocate donor allografts for HCC.
Texto completo:
1
Colección:
01-internacional
Asunto principal:
Alfa-Fetoproteínas
/
Trasplante de Hígado
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Carcinoma Hepatocelular
/
Neoplasias Hepáticas
Tipo de estudio:
Prognostic_studies
Límite:
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Idioma:
En
Revista:
Arch Surg
Año:
2011
Tipo del documento:
Article
País de afiliación:
Estados Unidos