title: Prognostic Value of Pre-transplantation Serum Alpha-Fetoprotein Levels in Hepatocellular Carcinoma Recurrence.
abstract: Serum alpha-fetoprotein (AFP) value is still not included in the consensus guidelines to make decisions referring to liver transplantation (LT) for hepatocellular carcinoma (HCC). Many studies demonstrated the influence of high AFP level in poor prognosis after LT for HCC. We studied 301 consecutive recipients transplanted for HCC from January 2002 to December 2011. The median follow-up was 64.3 months (interquartile range, 41.6-90.8). HCC recurrence was 31.6% when AFP was >400 ng/mL and 50% when AFP was >1,000 ng/mL. Specificity to predict HCC recurrence was 95.1% (95% confidence interval [CI], 91.9-97.1) when AFP was >400 ng/mL and 98.9% (95% CI, 96.8-99.6) when AFP was >1,000 ng/mL. The overall survival (P = .008) and disease-free survival (P = .004) differed between patients groups when an AFP cutoff level of 1,000 ng/mL was used. The predictive accuracy of high pre-transplantation serum AFP level for HCC post-transplantation recurrence should be used in decision algorithms for LT.
authors.affiliation: Unit of Hepato-Biliary-Pancreatic Surgery and Transplantation, La Fe University Hospital, Valencia, Spain. Electronic address: montalva.oron@gmail.com.
authors.forename: E M
authors.initials: EM
authors.lastname: Montalvá
authors.affiliation: Unit of Hepato-Biliary-Pancreatic Surgery and Transplantation, La Fe University Hospital, Valencia, Spain; General Surgery Department, General University Hospital, Valencia, Spain.
authors.forename: M
authors.initials: M
authors.lastname: Cantos
authors.affiliation: Unit of Hepato-Biliary-Pancreatic Surgery and Transplantation, La Fe University Hospital, Valencia, Spain; General Surgery Department, Lluís Alcanyís Hospital, Xàtiva, Valencia, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Boscà
authors.affiliation: Unit of Hepatology and Liver Transplantation, La Fe University Hospital, Valencia, Spain.
authors.forename: A
authors.initials: A
authors.lastname: Rubín
authors.affiliation: Unit of Hepatology and Liver Transplantation, La Fe University Hospital, Valencia, Spain.
authors.forename: C
authors.initials: C
authors.lastname: Vinaixa
authors.affiliation: Unit of Hepato-Biliary-Pancreatic Surgery and Transplantation, La Fe University Hospital, Valencia, Spain.
authors.forename: P
authors.initials: P
authors.lastname: Granero
authors.affiliation: Unit of Hepato-Biliary-Pancreatic Surgery and Transplantation, La Fe University Hospital, Valencia, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Maupoey
authors.affiliation: Unit of Hepato-Biliary-Pancreatic Surgery and Transplantation, La Fe University Hospital, Valencia, Spain.
authors.forename: R
authors.initials: R
authors.lastname: López-Andújar
mesh_terms: D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000097:blood* / Q000473:pathology; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008113:Liver Neoplasms / Q000097:blood* / Q000473:pathology; D016031:Liver Transplantation / Q000401:mortality*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000097:blood / Q000401:mortality*; D011183:Postoperative Complications / Q000097:blood / Q000401:mortality*; D057234:Preoperative Period; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D012680:Sensitivity and Specificity; D000509:alpha-Fetoproteins / Q000032:analysis*
chemical_list: D000509:alpha-Fetoproteins