Detailed Abstract
[Liver Oral Presentation 2]
[LV OP 2-2] ADV score as a quantifiable prognostic prediction model for hepatocellular carcinoma recurrence in living donor liver transplantation
Shin HWANG*, Gi-Won SONG, Yong-Kyu CHUNG, Chul-Soo AHN, Ki-Hun KIM, Deok-Bog MOON, Tae-Yong HA, Dong-Hwan JUNG, Gil-Chun PARK, Young-In YOON, Sung-Gyu LEE
Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Korea
Introduction : We aimed to assess the prognostic impact of ADV score (alpha-fetoprotein [AFP]–des-γ-carboxyprothrombin [DCP]–tumor volume score) for predicting hepatocellular carcinoma (HCC) recurrence and patient survival after living donor liver transplantation (LDLT).
Methods : This study included 843 HCC patients who underwent LDLT between January 2006 and December 2015 at Asan Medical Center. They were divided into two groups as the treatment-naïve (TN, n = 256]) and pretransplant-treated (PT, n = 587 [69.6%]) groups.
Results : In all patients, 5-year tumor recurrence, and overall and HCC-specific patient survival rates were 21.5%, 86.2% and 89.4% respectively. PT group showed higher tumor recurrence rates and lower patient survival rates than TN group. HCC recurrence, overall and HCC-specific patient survival, and post-recurrence survival rates were closely correlated with both pretransplant and explant ADV scores in both TN and PT groups. ADV score enabled further prognostic stratification of the patients within and beyond selection criteria. Both AD score (multiplication of ADP and DCP; hazard ratio = 1.53) and total tumor volume (hazard ratio = 1.84) were independent risk factors for tumor recurrence and HCC-specific patient survival. Cluster analysis reveal that the prognostic accuracy of ADV score cutoff at 5log was slightly superior to that of Metroticket 2.0 criteria, showing slightly wider patient inclusion and more accurate HCC-specific patient survival.
Conclusions : We believe that our prognostic prediction model using ADV scores is an integrated quantifiable surrogate biomarker for posttransplant prognosis in HCC patients, thus it can provide reliable information to help making decision whether to perform LDLT or not.
Methods : This study included 843 HCC patients who underwent LDLT between January 2006 and December 2015 at Asan Medical Center. They were divided into two groups as the treatment-naïve (TN, n = 256]) and pretransplant-treated (PT, n = 587 [69.6%]) groups.
Results : In all patients, 5-year tumor recurrence, and overall and HCC-specific patient survival rates were 21.5%, 86.2% and 89.4% respectively. PT group showed higher tumor recurrence rates and lower patient survival rates than TN group. HCC recurrence, overall and HCC-specific patient survival, and post-recurrence survival rates were closely correlated with both pretransplant and explant ADV scores in both TN and PT groups. ADV score enabled further prognostic stratification of the patients within and beyond selection criteria. Both AD score (multiplication of ADP and DCP; hazard ratio = 1.53) and total tumor volume (hazard ratio = 1.84) were independent risk factors for tumor recurrence and HCC-specific patient survival. Cluster analysis reveal that the prognostic accuracy of ADV score cutoff at 5log was slightly superior to that of Metroticket 2.0 criteria, showing slightly wider patient inclusion and more accurate HCC-specific patient survival.
Conclusions : We believe that our prognostic prediction model using ADV scores is an integrated quantifiable surrogate biomarker for posttransplant prognosis in HCC patients, thus it can provide reliable information to help making decision whether to perform LDLT or not.
SESSION
Liver Oral Presentation 2
Room A 7/27/2020 1:37 PM - 1:42 PM