title: Recurrence after liver transplantation for hepatocellular carcinoma according to up-to-seven criteria.
abstract: OBJECTIVE
  The Up7 criteria for HCC have recently emerged to identify potential candidates for OLT. The aim of this study was to assess the validity of the Up7 criteria according to the pathological analysis of the explanted livers.
  
  
  METHODS
  For recurrence risk calculation 669 HCC transplanted patients were classified according to both the pathological Milan and Up7 criteria. In order to identify potential predictors of recurrence, selected biological tumor markers and morphological features were then tested by Cox regression.
  
  
  RESULTS
  The 5-year HCC recurrence rate for the Milan out/Up7 in subgroup (n=87), was significantly higher than patients meeting Milan criteria (n=299), 15.8% vs. 9.4% (p=0.0290). For patients within the Up7 criteria (n=383), only pre-OLT AFP level >1000ng/mL and microvascular invasion were significant predictors for recurrence, and for those beyond the Up7 criteria (n=286), pre-OLT AFP level >1000ng/mL, poor differentiation grade and microvascular invasion remained significant.
  
  
  CONCLUSIONS
  Compared to the current Milan staging system, HCC patients within the pathological Up7 criteria were associated with a higher, but acceptable risk of recurrence after OLT, and along with tumor burden, other parameters can potentially be used for further refinement of HCC staging, such as AFP levels and microvascular invasion.
authors.forename: Jean
authors.initials: J
authors.lastname: Gugenheim
authors.forename: Luis César
authors.initials: LC
authors.lastname: Bredt
authors.forename: Antonio
authors.initials: A
authors.lastname: Iannelli
authors.forename: Thomas
authors.initials: T
authors.lastname: Decaens
authors.forename: Francoise
authors.initials: F
authors.lastname: Roudot-Thoraval
authors.forename: Carole
authors.initials: C
authors.lastname: Meyer
authors.forename: Francois
authors.initials: F
authors.lastname: Durand
authors.forename: Pierre-Henri
authors.initials: PH
authors.lastname: Bernard
authors.forename: Olivier
authors.initials: O
authors.lastname: Boillot
authors.forename: Laurent
authors.initials: L
authors.lastname: Sulpice
authors.forename: Yvon
authors.initials: Y
authors.lastname: Calmus
authors.forename: Jean
authors.initials: J
authors.lastname: Hardwigsen
authors.forename: Christian
authors.initials: C
authors.lastname: Ducerf
authors.forename: Georges-Philippe
authors.initials: GP
authors.lastname: Pageaux
authors.forename: Sebastien
authors.initials: S
authors.lastname: Dharancy
authors.forename: Olivier
authors.initials: O
authors.lastname: Chazouilleres
authors.forename: Daniel
authors.initials: D
authors.lastname: Cherqui
authors.forename: Christophe
authors.initials: C
authors.lastname: Duvoux
authors.forename: Solange
authors.initials: S
authors.lastname: Hadni-Bresson
mesh_terms: D006528:Carcinoma, Hepatocellular / Q000473:pathology*; D005260:Female; D005602:France; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology*; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology*; D018579:Patient Selection; D012189:Retrospective Studies; D018570:Risk Assessment; D015996:Survival Rate