title: Impact of preoperative α-fetoprotein level on disease-free survival after liver transplantation for hepatocellular carcinoma.
abstract: BACKGROUND
  Preoperative α-fetoprotein (AFP) levels may have an influence on disease-free survival (DFS) of patients after liver transplantation for hepatocellular carcinoma (HCC) located on a cirrhotic liver.
  
  
  METHODS
  Between 2000 and 2009, two groups were distinguished according to preoperative AFP level: normal-level group (<10 ng/ml) and increased-level group (>10 ng/ml). The increased-level group was further divided into three levels of preoperative AFP: 10-150, 150-500, and ≥ 500 ng/ml. DFS and recurrence rates were compared. All patients underwent transplantation using the preoperative 5/5 criteria.
  
  
  RESULTS
  Of the 122 patients in this study, 63 had normal and 59 had increased preoperative AFP. There were no differences between the two groups concerning perioperative or pathologic data. Those with an increased preoperative AFP level had a significantly shorter 5-year DFS, and their recurrence rate was higher than that of the normal AFP group. The 5-year DFS and recurrence rates were 71 and 4 %, respectively, for those with normal AFP; 57 and 10 %, respectively, for those with AFP 10-150 ng/ml; 46 and 24 %, respectively, for those with AFP 150-500 ng/ml; and 28 and 62 %, respectively, for those with AFP ≥ 500 ng/ml.
  
  
  CONCLUSIONS
  This study shows the prognostic value of preoperative AFP levels on DFS after a liver transplant for HCC in a population of patients undergoing transplantation with the same preoperative criteria.
authors.affiliation: Department of Digestive Surgery and Liver Transplantation, CHU Rangueil, 1 Avenue Jean Poulhès, 31059, Toulouse Cedex, France. muscari.f@chu-toulouse.fr
authors.forename: Fabrice
authors.initials: F
authors.lastname: Muscari
authors.forename: Jean-Pascal
authors.initials: JP
authors.lastname: Guinard
authors.forename: Nassim
authors.initials: N
authors.lastname: Kamar
authors.forename: Jean-Marie
authors.initials: JM
authors.lastname: Peron
authors.forename: Philippe
authors.initials: P
authors.lastname: Otal
authors.forename: Bertrand
authors.initials: B
authors.lastname: Suc
mesh_terms: D014408:Biomarkers, Tumor / Q000378:metabolism; D001706:Biopsy; D006528:Carcinoma, Hepatocellular / Q000097:blood* / Q000473:pathology / Q000601:surgery*; D016009:Chi-Square Distribution; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D008113:Liver Neoplasms / Q000097:blood* / Q000473:pathology / Q000601:surgery*; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011446:Prospective Studies; D016896:Treatment Outcome; D000509:alpha-Fetoproteins / Q000378:metabolism*
chemical_list: D014408:Biomarkers, Tumor; D007166:Immunosuppressive Agents; D000509:alpha-Fetoproteins