title: Pretransplant serum levels of C-reactive protein predict prognoses in patients undergoing liver transplantation for hepatocellular carcinoma.
abstract: BACKGROUND
  Preoperative absolute C-reactive protein (CRP) has been shown to correlate with prognoses in various malignancies, including hepatocellular carcinoma (HCC).
  
  
  METHODS
  The aim of this study was to investigate whether pretransplant CRP levels predict prognoses in patients undergoing liver transplantation (LT) for HCC. We retrospectively analyzed clinicopathological factors in 211 patients with available pretransplant serum CRP levels who underwent LT for HCC between January 2005 and April 2012.
  
  
  RESULTS
  By means of receiver operating characteristic curve analysis, a CRP level of >0.3 mg/dL was considered to be elevated. By multivariate analysis, the high CRP level, the maximal tumor size >5 cm, the presence of intrahepatic metastasis, and positive findings in pretransplant (18)fluoro-2-deoxy-D-glucose positron emission tomography/computed tomography ((18)F-FDG PET/CT) were related to tumor recurrence, whereas the high CRP level, the presence of intrahepatic metastasis, and positive findings in pretransplant (18)F-FDG PET/CT were related to poor overall survival. When subgroup analysis was conducted according to the Milan criteria, the high CRP level was an independent factor for predicting poor outcomes in patients with HCC beyond the Milan criteria (P = .001 for recurrence-free survival and P = .010 for overall survival), and not for patients within the criteria.
  
  
  CONCLUSIONS
  Pretransplant serum CRP levels can predict prognoses in patients undergoing LT for HCC, especially in patients with HCC exceeding the Milan criteria.
authors.affiliation: Department of Surgery, School of Medicine, Jeju National University, Jeju-si, Republic of Korea; Department of Surgery, Graduate School of Medicine, Kangwon National University, Chuncheon-si, Republic of Korea.
authors.forename: Y-K
authors.initials: YK
authors.lastname: Kim
authors.affiliation: Center for Liver Cancer, National Cancer Center, Goyang-si, Republic of Korea. Electronic address: kshlj@hanmail.net.
authors.forename: S H
authors.initials: SH
authors.lastname: Kim
authors.affiliation: Center for Liver Cancer, National Cancer Center, Goyang-si, Republic of Korea.
authors.forename: S D
authors.initials: SD
authors.lastname: Lee
authors.affiliation: Department of Surgery, Graduate School of Medicine, Kangwon National University, Chuncheon-si, Republic of Korea.
authors.forename: S K
authors.initials: SK
authors.lastname: Hong
authors.affiliation: Center for Liver Cancer, National Cancer Center, Goyang-si, Republic of Korea.
authors.forename: S-J
authors.initials: SJ
authors.lastname: Park
mesh_terms: D000328:Adult; D000368:Aged; D002097:C-Reactive Protein / Q000032:analysis*; D006528:Carcinoma, Hepatocellular / Q000097:blood* / Q000401:mortality* / Q000601:surgery; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D008113:Liver Neoplasms / Q000097:blood* / Q000401:mortality* / Q000601:surgery; D016031:Liver Transplantation / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D049268:Positron-Emission Tomography / Q000379:methods; D011379:Prognosis; D019275:Radiopharmaceuticals; D012189:Retrospective Studies; D012307:Risk Factors; D014057:Tomography, X-Ray Computed
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18; D002097:C-Reactive Protein