المؤلفون: Duvoux, Christophe, Roudot-Thoraval, Françoise, Decaens, Thomas, Pessione, Fabienne, Badran, Hanaa, Piardi, Tullio, Francoz, Claire, Compagnon, Philippe, Vanlemmens, Claire, Dumortier, Jérome, Dharancy, Sébastien, Gugenheim, Jean, Bernard, Pierre-Henri, Adam, René, Radenne, Sylvie, Muscari, Fabrice, Conti, Filomena, Hardwigsen, Jean, Pageaux, Georges-Philippe, Chazouillères, Olivier, Salame, Ephrem, Hilleret, Marie-Noelle, Lebray, Pascal, Abergel, Armand, Debette-Gratien, Marilyne, Kluger, Michael, D., Mallat, Ariane, Azoulay, Daniel, Cherqui, Daniel

المساهمون: Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Pôle Recherche Clinique-Santé Publique Mondor, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor, Service de santé publique Mondor, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Pôle évaluation - biostatistique, Agence de la biomédecine Saint-Denis la Plaine, Service de Transplantation, Hôpital de Hautepierre Strasbourg, Service d'hépatologie, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7)-Hôpital Beaujon AP-HP, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de Chirurgie Hépatobiliaire et Digestive Rennes = Hepatobiliary and Digestive Surgery Rennes, Centre Hospitalier Universitaire de Rennes CHU Rennes = Rennes University Hospital Ponchaillou, Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté COMUE (UBFC)-Université Bourgogne Franche-Comté COMUE (UBFC), service d'Hépato-gastro-entérologie, Hospices Civiles de Lyon-Hôpital Edouard Heriault, Hôpital Claude Hurriez, Centre méditerranéen de médecine moléculaire (C3M), Université Nice Sophia Antipolis (1965 - 2019) (UNS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Côte d'Azur (UniCA), Service d'Hépato-Gastro-Entérologie, CHU Bordeaux-Hôpital Saint-André, Centre hépato-biliaire (CHB), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM), Hospices Civils de Lyon (HCL)-Hôpital de la Croix-Rousse CHU - HCL, Hospices Civils de Lyon (HCL), Chirurgie Générale et Digestive Rangueil, Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), CHU Saint-Antoine AP-HP, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Service de Chirurgie, Assistance Publique - Hôpitaux de Marseille (APHM)-Hospices Civiles de Marseille-Hôpital de la Conception CHU - APHM (LA CONCEPTION), Centre Hospitalier Régional Universitaire Montpellier (CHRU Montpellier)-Hôpital Saint Eloi (CHRU Montpellier), Centre Hospitalier Régional Universitaire Montpellier (CHRU Montpellier), Département de Chirurgie CHU Caen, Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Tumorothèque de Caen Basse-Normandie (TCBN), Département de Gastroentérologie et hépatologie, Université Joseph Fourier - Grenoble 1 (UJF)-Centre Hospitalier Universitaire CHU Grenoble (CHUGA)-Hôpital Michallon, CHU Pitié-Salpêtrière AP-HP, CHU Etaing, Service d'Hépato-gastro-entérologie et Nutrition CHU Dupuytren 1, Limoges, CHU Limoges-Hôpital Dupuytren CHU Limoges

المصدر: ISSN: 0016-5085.

مصطلحات موضوعية: Liver Transplantation, Hepatocellular Carcinoma, AFP, MESH: Area Under Curve, MESH: Multivariate Analysis, MESH: Neoplasm Invasiveness, MESH: Neoplasm Recurrence, Local, MESH: Patient Selection, MESH: Practice Guidelines as Topic, MESH: Predictive Value of Tests, MESH: Proportional Hazards Models, MESH: alpha-Fetoproteins, MESH: Adult, MESH: Carcinoma, Hepatocellular, MESH: Decision Support Techniques, MESH: Female, MESH: Humans, MESH: Liver Neoplasms, MESH: Liver Transplantation, MESH: Male, MESH: Middle Aged, [SDV.MHEP.HEG]Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology

الوصف: International audience ; BACKGROUND & AIMS: The aim of this study was to generate an improved prognostic model for predicting recurrence in liver transplant candidates with hepatocellular carcinoma (HCC). METHODS: Predictors of recurrence were tested by a Cox model analysis in a training cohort of 537 patients transplanted for HCC. A prognostic score was developed and validated in a national cohort of 435 patients followed up prospectively. RESULTS: α-Fetoprotein (AFP) independently predicted tumor recurrence and correlated with vascular invasion and differentiation. At a Cox score threshold of 0.7 (area under the receiver operating characteristic curve, 0.701; 95% confidence interval, 0.63-0.76; accuracy, 75.8%), a model combining log(10) AFP, tumor size, and number was highly predictive of tumor recurrence and death. By using a simplified version of the model, with untransformed AFP values, a cut-off value of 2 was identified. In the validation cohort, a score greater than 2 predicted a marked increase in 5-year risk of recurrence (50.6% ± 10.2% vs 8.8% ± 1.7%; P < .001) and decreased survival (47.5% ± 8.1% vs 67.8% ± 3.4%; P = .002) as compared with others. Among patients exceeding Milan criteria, a score of 2 or lower identified a subgroup of patients with AFP levels less than 100 ng/mL with a low 5-year risk of recurrence (14.4% ± 5.3% vs 47.6% ± 11.1%; P = .006). Among patients within Milan criteria, a score greater than 2 identified a subgroup of patients with AFP levels greater than 1000 ng/mL at high risk of recurrence (37.1% ± 8.9% vs 13.3% ± 2.0%; P < .001). Net reclassification improvement showed that predictability of the AFP model was superior to Milan criteria. CONCLUSIONS: Prediction of tumor recurrence is improved significantly by a model that incorporates AFP. We propose the adoption of new selection criteria for HCC transplant candidates, taking into account AFP.

العلاقة: info:eu-repo/semantics/altIdentifier/pmid/22750200; inserm-00865368; https://inserm.hal.science/inserm-00865368Test; PUBMED: 22750200

الإتاحة: https://doi.org/10.1053/j.gastro.2012.05.052Test
https://inserm.hal.science/inserm-00865368Test

المؤلفون: Duvoux, Christophe, Roudot-Thoraval, Françoise, Decaens, Thomas, Pessione, Fabienne, Badran, Hanaa, Piardi, Tullio, Francoz, Claire, Compagnon, Philippe, Vanlemmens, Claire, Dumortier, Jérome, Dharancy, Sébastien, Gugenheim, Jean, Bernard, Pierre-Henri, Adam, René, Radenne, Sylvie, Muscari, Fabrice, Conti, Filomena, Hardwigsen, Jean, Pageaux, Georges-Philippe, Chazouillères, Olivier, Salame, Ephrem, Hilleret, Marie-Noelle, Lebray, Pascal, Abergel, Armand, Debette-Gratien, Marilyne, Kluger, Michael, D., Mallat, Ariane, Azoulay, Daniel, Cherqui, Daniel

المساهمون: Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Pôle Recherche Clinique-Santé Publique Mondor, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor, Service de santé publique Mondor, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Pôle évaluation - biostatistique, Agence de la biomédecine Saint-Denis la Plaine, Service de Transplantation, Hôpital de Hautepierre Strasbourg, Service d'hépatologie, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7)-Hôpital Beaujon AP-HP, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de Chirurgie Hépatobiliaire et Digestive Rennes = Hepatobiliary and Digestive Surgery Rennes, Centre Hospitalier Universitaire de Rennes CHU Rennes = Rennes University Hospital Ponchaillou, Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté COMUE (UBFC)-Université Bourgogne Franche-Comté COMUE (UBFC), service d'Hépato-gastro-entérologie, Hospices Civiles de Lyon-Hôpital Edouard Heriault, Hôpital Claude Hurriez, Centre méditerranéen de médecine moléculaire (C3M), Université Nice Sophia Antipolis (1965 - 2019) (UNS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Côte d'Azur (UniCA), Service d'Hépato-Gastro-Entérologie, CHU Bordeaux-Hôpital Saint-André, Centre hépato-biliaire (CHB), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM), Hospices Civils de Lyon (HCL)-Hôpital de la Croix-Rousse CHU - HCL, Hospices Civils de Lyon (HCL), Chirurgie Générale et Digestive Rangueil, Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), CHU Saint-Antoine AP-HP, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Service de Chirurgie, Assistance Publique - Hôpitaux de Marseille (APHM)-Hospices Civiles de Marseille-Hôpital de la Conception CHU - APHM (LA CONCEPTION), Centre Hospitalier Régional Universitaire Montpellier (CHRU Montpellier)-Hôpital Saint Eloi (CHRU Montpellier), Centre Hospitalier Régional Universitaire Montpellier (CHRU Montpellier), Département de Chirurgie CHU Caen, Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Tumorothèque de Caen Basse-Normandie (TCBN), Département de Gastroentérologie et hépatologie, Université Joseph Fourier - Grenoble 1 (UJF)-Centre Hospitalier Universitaire CHU Grenoble (CHUGA)-Hôpital Michallon, CHU Pitié-Salpêtrière AP-HP, CHU Etaing, Service d'Hépato-gastro-entérologie et Nutrition CHU Dupuytren 1, Limoges, CHU Limoges-Hôpital Dupuytren CHU Limoges

المصدر: ISSN: 0016-5085.

مصطلحات موضوعية: Liver Transplantation, Hepatocellular Carcinoma, AFP, MESH: Area Under Curve, MESH: Multivariate Analysis, MESH: Neoplasm Invasiveness, MESH: Neoplasm Recurrence, Local, MESH: Patient Selection, MESH: Practice Guidelines as Topic, MESH: Predictive Value of Tests, MESH: Proportional Hazards Models, MESH: alpha-Fetoproteins, MESH: Adult, MESH: Carcinoma, Hepatocellular, MESH: Decision Support Techniques, MESH: Female, MESH: Humans, MESH: Liver Neoplasms, MESH: Liver Transplantation, MESH: Male, MESH: Middle Aged, [SDV.MHEP.HEG]Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology

الوصف: International audience ; BACKGROUND & AIMS: The aim of this study was to generate an improved prognostic model for predicting recurrence in liver transplant candidates with hepatocellular carcinoma (HCC). METHODS: Predictors of recurrence were tested by a Cox model analysis in a training cohort of 537 patients transplanted for HCC. A prognostic score was developed and validated in a national cohort of 435 patients followed up prospectively. RESULTS: α-Fetoprotein (AFP) independently predicted tumor recurrence and correlated with vascular invasion and differentiation. At a Cox score threshold of 0.7 (area under the receiver operating characteristic curve, 0.701; 95% confidence interval, 0.63-0.76; accuracy, 75.8%), a model combining log(10) AFP, tumor size, and number was highly predictive of tumor recurrence and death. By using a simplified version of the model, with untransformed AFP values, a cut-off value of 2 was identified. In the validation cohort, a score greater than 2 predicted a marked increase in 5-year risk of recurrence (50.6% ± 10.2% vs 8.8% ± 1.7%; P < .001) and decreased survival (47.5% ± 8.1% vs 67.8% ± 3.4%; P = .002) as compared with others. Among patients exceeding Milan criteria, a score of 2 or lower identified a subgroup of patients with AFP levels less than 100 ng/mL with a low 5-year risk of recurrence (14.4% ± 5.3% vs 47.6% ± 11.1%; P = .006). Among patients within Milan criteria, a score greater than 2 identified a subgroup of patients with AFP levels greater than 1000 ng/mL at high risk of recurrence (37.1% ± 8.9% vs 13.3% ± 2.0%; P < .001). Net reclassification improvement showed that predictability of the AFP model was superior to Milan criteria. CONCLUSIONS: Prediction of tumor recurrence is improved significantly by a model that incorporates AFP. We propose the adoption of new selection criteria for HCC transplant candidates, taking into account AFP.

العلاقة: info:eu-repo/semantics/altIdentifier/pmid/22750200; inserm-00865368; https://inserm.hal.science/inserm-00865368Test; PUBMED: 22750200

الإتاحة: https://doi.org/10.1053/j.gastro.2012.05.052Test
https://inserm.hal.science/inserm-00865368Test

المؤلفون: Duvoux, Christophe, Roudot-Thoraval, Françoise, Decaens, Thomas, Pessione, Fabienne, Badran, Hanaa, Piardi, Tullio, Francoz, Claire, Compagnon, Philippe, Vanlemmens, Claire, Dumortier, Jérome, Dharancy, Sébastien, Gugenheim, Jean, Bernard, Pierre-Henri, Adam, René, Radenne, Sylvie, Muscari, Fabrice, Conti, Filomena, Hardwigsen, Jean, Pageaux, Georges-Philippe, Chazouillères, Olivier, Salame, Ephrem, Hilleret, Marie-Noelle, Lebray, Pascal, Abergel, Armand, Debette-Gratien, Marilyne, Kluger, Michael, D., Mallat, Ariane, Azoulay, Daniel, Cherqui, Daniel

المساهمون: Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Pôle Recherche Clinique-Santé Publique Mondor, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor, Service de santé publique Mondor, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Pôle évaluation - biostatistique, Agence de la biomédecine Saint-Denis la Plaine, Service de Transplantation, Hôpital de Hautepierre Strasbourg, Service d'hépatologie, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7)-Hôpital Beaujon AP-HP, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de Chirurgie Hépatobiliaire et Digestive Rennes = Hepatobiliary and Digestive Surgery Rennes, Centre Hospitalier Universitaire de Rennes CHU Rennes = Rennes University Hospital Ponchaillou, Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté COMUE (UBFC)-Université Bourgogne Franche-Comté COMUE (UBFC), service d'Hépato-gastro-entérologie, Hospices Civiles de Lyon-Hôpital Edouard Heriault, Hôpital Claude Hurriez, Centre méditerranéen de médecine moléculaire (C3M), Université Nice Sophia Antipolis (1965 - 2019) (UNS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Côte d'Azur (UniCA), Service d'Hépato-Gastro-Entérologie, CHU Bordeaux-Hôpital Saint-André, Centre hépato-biliaire (CHB), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM), Hospices Civils de Lyon (HCL)-Hôpital de la Croix-Rousse CHU - HCL, Hospices Civils de Lyon (HCL), Chirurgie Générale et Digestive Rangueil, Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), CHU Saint-Antoine AP-HP, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Service de Chirurgie, Assistance Publique - Hôpitaux de Marseille (APHM)-Hospices Civiles de Marseille-Hôpital de la Conception CHU - APHM (LA CONCEPTION), Centre Hospitalier Régional Universitaire Montpellier (CHRU Montpellier)-Hôpital Saint Eloi (CHRU Montpellier), Centre Hospitalier Régional Universitaire Montpellier (CHRU Montpellier), Département de Chirurgie CHU Caen, Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Tumorothèque de Caen Basse-Normandie (TCBN), Département de Gastroentérologie et hépatologie, Université Joseph Fourier - Grenoble 1 (UJF)-Centre Hospitalier Universitaire CHU Grenoble (CHUGA)-Hôpital Michallon, CHU Pitié-Salpêtrière AP-HP, CHU Etaing, Service d'Hépato-gastro-entérologie et Nutrition CHU Dupuytren 1, Limoges, CHU Limoges-Hôpital Dupuytren CHU Limoges

المصدر: ISSN: 0016-5085.

مصطلحات موضوعية: Liver Transplantation, Hepatocellular Carcinoma, AFP, MESH: Area Under Curve, MESH: Multivariate Analysis, MESH: Neoplasm Invasiveness, MESH: Neoplasm Recurrence, Local, MESH: Patient Selection, MESH: Practice Guidelines as Topic, MESH: Predictive Value of Tests, MESH: Proportional Hazards Models, MESH: alpha-Fetoproteins, MESH: Adult, MESH: Carcinoma, Hepatocellular, MESH: Decision Support Techniques, MESH: Female, MESH: Humans, MESH: Liver Neoplasms, MESH: Liver Transplantation, MESH: Male, MESH: Middle Aged, [SDV.MHEP.HEG]Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology

الوصف: International audience ; BACKGROUND & AIMS: The aim of this study was to generate an improved prognostic model for predicting recurrence in liver transplant candidates with hepatocellular carcinoma (HCC). METHODS: Predictors of recurrence were tested by a Cox model analysis in a training cohort of 537 patients transplanted for HCC. A prognostic score was developed and validated in a national cohort of 435 patients followed up prospectively. RESULTS: α-Fetoprotein (AFP) independently predicted tumor recurrence and correlated with vascular invasion and differentiation. At a Cox score threshold of 0.7 (area under the receiver operating characteristic curve, 0.701; 95% confidence interval, 0.63-0.76; accuracy, 75.8%), a model combining log(10) AFP, tumor size, and number was highly predictive of tumor recurrence and death. By using a simplified version of the model, with untransformed AFP values, a cut-off value of 2 was identified. In the validation cohort, a score greater than 2 predicted a marked increase in 5-year risk of recurrence (50.6% ± 10.2% vs 8.8% ± 1.7%; P < .001) and decreased survival (47.5% ± 8.1% vs 67.8% ± 3.4%; P = .002) as compared with others. Among patients exceeding Milan criteria, a score of 2 or lower identified a subgroup of patients with AFP levels less than 100 ng/mL with a low 5-year risk of recurrence (14.4% ± 5.3% vs 47.6% ± 11.1%; P = .006). Among patients within Milan criteria, a score greater than 2 identified a subgroup of patients with AFP levels greater than 1000 ng/mL at high risk of recurrence (37.1% ± 8.9% vs 13.3% ± 2.0%; P < .001). Net reclassification improvement showed that predictability of the AFP model was superior to Milan criteria. CONCLUSIONS: Prediction of tumor recurrence is improved significantly by a model that incorporates AFP. We propose the adoption of new selection criteria for HCC transplant candidates, taking into account AFP.

العلاقة: info:eu-repo/semantics/altIdentifier/pmid/22750200; inserm-00865368; https://inserm.hal.science/inserm-00865368Test; PUBMED: 22750200

الإتاحة: https://doi.org/10.1053/j.gastro.2012.05.052Test
https://inserm.hal.science/inserm-00865368Test

المؤلفون: Duvoux, Christophe, Roudot-Thoraval, Françoise, Decaens, Thomas, Pessione, Fabienne, Badran, Hanaa, Piardi, Tullio, Francoz, Claire, Compagnon, Philippe, Vanlemmens, Claire, Dumortier, Jérome, Dharancy, Sébastien, Gugenheim, Jean, Bernard, Pierre-Henri, Adam, René, Radenne, Sylvie, Muscari, Fabrice, Conti, Filomena, Hardwigsen, Jean, Pageaux, Georges-Philippe, Chazouillères, Olivier, Salame, Ephrem, Hilleret, Marie-Noelle, Lebray, Pascal, Abergel, Armand, Debette-Gratien, Marilyne, Kluger, Michael, D., Mallat, Ariane, Azoulay, Daniel, Cherqui, Daniel

المساهمون: Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Pôle Recherche Clinique-Santé Publique Mondor, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor, Service de santé publique Mondor, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Pôle évaluation - biostatistique, Agence de la biomédecine Saint-Denis la Plaine, Service de Transplantation, Hôpital de Hautepierre Strasbourg, Service d'hépatologie, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7)-Hôpital Beaujon AP-HP, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de Chirurgie Hépatobiliaire et Digestive Rennes = Hepatobiliary and Digestive Surgery Rennes, Centre Hospitalier Universitaire de Rennes CHU Rennes = Rennes University Hospital Ponchaillou, Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté COMUE (UBFC)-Université Bourgogne Franche-Comté COMUE (UBFC), service d'Hépato-gastro-entérologie, Hospices Civiles de Lyon-Hôpital Edouard Heriault, Hôpital Claude Hurriez, Centre méditerranéen de médecine moléculaire (C3M), Université Nice Sophia Antipolis (1965 - 2019) (UNS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Côte d'Azur (UniCA), Service d'Hépato-Gastro-Entérologie, CHU Bordeaux-Hôpital Saint-André, Centre hépato-biliaire (CHB), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM), Hospices Civils de Lyon (HCL)-Hôpital de la Croix-Rousse CHU - HCL, Hospices Civils de Lyon (HCL), Chirurgie Générale et Digestive Rangueil, Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), CHU Saint-Antoine AP-HP, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Service de Chirurgie, Assistance Publique - Hôpitaux de Marseille (APHM)-Hospices Civiles de Marseille-Hôpital de la Conception CHU - APHM (LA CONCEPTION), Centre Hospitalier Régional Universitaire Montpellier (CHRU Montpellier)-Hôpital Saint Eloi (CHRU Montpellier), Centre Hospitalier Régional Universitaire Montpellier (CHRU Montpellier), Département de Chirurgie CHU Caen, Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Tumorothèque de Caen Basse-Normandie (TCBN), Département de Gastroentérologie et hépatologie, Université Joseph Fourier - Grenoble 1 (UJF)-Centre Hospitalier Universitaire CHU Grenoble (CHUGA)-Hôpital Michallon, CHU Pitié-Salpêtrière AP-HP, CHU Etaing, Service d'Hépato-gastro-entérologie et Nutrition CHU Dupuytren 1, Limoges, CHU Limoges-Hôpital Dupuytren CHU Limoges

المصدر: ISSN: 0016-5085.

مصطلحات موضوعية: Liver Transplantation, Hepatocellular Carcinoma, AFP, MESH: Area Under Curve, MESH: Multivariate Analysis, MESH: Neoplasm Invasiveness, MESH: Neoplasm Recurrence, Local, MESH: Patient Selection, MESH: Practice Guidelines as Topic, MESH: Predictive Value of Tests, MESH: Proportional Hazards Models, MESH: alpha-Fetoproteins, MESH: Adult, MESH: Carcinoma, Hepatocellular, MESH: Decision Support Techniques, MESH: Female, MESH: Humans, MESH: Liver Neoplasms, MESH: Liver Transplantation, MESH: Male, MESH: Middle Aged, [SDV.MHEP.HEG]Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology

الوصف: International audience ; BACKGROUND & AIMS: The aim of this study was to generate an improved prognostic model for predicting recurrence in liver transplant candidates with hepatocellular carcinoma (HCC). METHODS: Predictors of recurrence were tested by a Cox model analysis in a training cohort of 537 patients transplanted for HCC. A prognostic score was developed and validated in a national cohort of 435 patients followed up prospectively. RESULTS: α-Fetoprotein (AFP) independently predicted tumor recurrence and correlated with vascular invasion and differentiation. At a Cox score threshold of 0.7 (area under the receiver operating characteristic curve, 0.701; 95% confidence interval, 0.63-0.76; accuracy, 75.8%), a model combining log(10) AFP, tumor size, and number was highly predictive of tumor recurrence and death. By using a simplified version of the model, with untransformed AFP values, a cut-off value of 2 was identified. In the validation cohort, a score greater than 2 predicted a marked increase in 5-year risk of recurrence (50.6% ± 10.2% vs 8.8% ± 1.7%; P < .001) and decreased survival (47.5% ± 8.1% vs 67.8% ± 3.4%; P = .002) as compared with others. Among patients exceeding Milan criteria, a score of 2 or lower identified a subgroup of patients with AFP levels less than 100 ng/mL with a low 5-year risk of recurrence (14.4% ± 5.3% vs 47.6% ± 11.1%; P = .006). Among patients within Milan criteria, a score greater than 2 identified a subgroup of patients with AFP levels greater than 1000 ng/mL at high risk of recurrence (37.1% ± 8.9% vs 13.3% ± 2.0%; P < .001). Net reclassification improvement showed that predictability of the AFP model was superior to Milan criteria. CONCLUSIONS: Prediction of tumor recurrence is improved significantly by a model that incorporates AFP. We propose the adoption of new selection criteria for HCC transplant candidates, taking into account AFP.

العلاقة: info:eu-repo/semantics/altIdentifier/pmid/22750200; inserm-00865368; https://inserm.hal.science/inserm-00865368Test; PUBMED: 22750200

الإتاحة: https://doi.org/10.1053/j.gastro.2012.05.052Test
https://inserm.hal.science/inserm-00865368Test

المؤلفون: Duvoux, Christophe, Roudot-Thoraval, Françoise, Decaens, Thomas, Pessione, Fabienne, Badran, Hanaa, Piardi, Tullio, Francoz, Claire, Compagnon, Philippe, Vanlemmens, Claire, Dumortier, Jérome, Dharancy, Sébastien, Gugenheim, Jean, Bernard, Pierre-Henri, Adam, René, Radenne, Sylvie, Muscari, Fabrice, Conti, Filomena, Hardwigsen, Jean, Pageaux, Georges-Philippe, Chazouillères, Olivier, Salame, Ephrem, Hilleret, Marie-Noelle, Lebray, Pascal, Abergel, Armand, Debette-Gratien, Marilyne, Kluger, Michael, D., Mallat, Ariane, Azoulay, Daniel, Cherqui, Daniel

المساهمون: Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Pôle Recherche Clinique-Santé Publique Mondor, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor, Service de santé publique Mondor, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Pôle évaluation - biostatistique, Agence de la biomédecine Saint-Denis la Plaine, Service de Transplantation, Hôpital de Hautepierre Strasbourg, Service d'hépatologie, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7)-Hôpital Beaujon AP-HP, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de Chirurgie Hépatobiliaire et Digestive Rennes = Hepatobiliary and Digestive Surgery Rennes, Centre Hospitalier Universitaire de Rennes CHU Rennes = Rennes University Hospital Ponchaillou, Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté COMUE (UBFC)-Université Bourgogne Franche-Comté COMUE (UBFC), service d'Hépato-gastro-entérologie, Hospices Civiles de Lyon-Hôpital Edouard Heriault, Hôpital Claude Hurriez, Centre méditerranéen de médecine moléculaire (C3M), Université Nice Sophia Antipolis (1965 - 2019) (UNS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Côte d'Azur (UniCA), Service d'Hépato-Gastro-Entérologie, CHU Bordeaux-Hôpital Saint-André, Centre hépato-biliaire (CHB), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM), Hospices Civils de Lyon (HCL)-Hôpital de la Croix-Rousse CHU - HCL, Hospices Civils de Lyon (HCL), Chirurgie Générale et Digestive Rangueil, Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), CHU Saint-Antoine AP-HP, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Service de Chirurgie, Assistance Publique - Hôpitaux de Marseille (APHM)-Hospices Civiles de Marseille-Hôpital de la Conception CHU - APHM (LA CONCEPTION), Centre Hospitalier Régional Universitaire Montpellier (CHRU Montpellier)-Hôpital Saint Eloi (CHRU Montpellier), Centre Hospitalier Régional Universitaire Montpellier (CHRU Montpellier), Département de Chirurgie CHU Caen, Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Tumorothèque de Caen Basse-Normandie (TCBN), Département de Gastroentérologie et hépatologie, Université Joseph Fourier - Grenoble 1 (UJF)-Centre Hospitalier Universitaire CHU Grenoble (CHUGA)-Hôpital Michallon, CHU Pitié-Salpêtrière AP-HP, CHU Etaing, Service d'Hépato-gastro-entérologie et Nutrition CHU Dupuytren 1, Limoges, CHU Limoges-Hôpital Dupuytren CHU Limoges

المصدر: ISSN: 0016-5085.

مصطلحات موضوعية: Liver Transplantation, Hepatocellular Carcinoma, AFP, MESH: Area Under Curve, MESH: Multivariate Analysis, MESH: Neoplasm Invasiveness, MESH: Neoplasm Recurrence, Local, MESH: Patient Selection, MESH: Practice Guidelines as Topic, MESH: Predictive Value of Tests, MESH: Proportional Hazards Models, MESH: alpha-Fetoproteins, MESH: Adult, MESH: Carcinoma, Hepatocellular, MESH: Decision Support Techniques, MESH: Female, MESH: Humans, MESH: Liver Neoplasms, MESH: Liver Transplantation, MESH: Male, MESH: Middle Aged, [SDV.MHEP.HEG]Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology

الوصف: International audience ; BACKGROUND & AIMS: The aim of this study was to generate an improved prognostic model for predicting recurrence in liver transplant candidates with hepatocellular carcinoma (HCC). METHODS: Predictors of recurrence were tested by a Cox model analysis in a training cohort of 537 patients transplanted for HCC. A prognostic score was developed and validated in a national cohort of 435 patients followed up prospectively. RESULTS: α-Fetoprotein (AFP) independently predicted tumor recurrence and correlated with vascular invasion and differentiation. At a Cox score threshold of 0.7 (area under the receiver operating characteristic curve, 0.701; 95% confidence interval, 0.63-0.76; accuracy, 75.8%), a model combining log(10) AFP, tumor size, and number was highly predictive of tumor recurrence and death. By using a simplified version of the model, with untransformed AFP values, a cut-off value of 2 was identified. In the validation cohort, a score greater than 2 predicted a marked increase in 5-year risk of recurrence (50.6% ± 10.2% vs 8.8% ± 1.7%; P < .001) and decreased survival (47.5% ± 8.1% vs 67.8% ± 3.4%; P = .002) as compared with others. Among patients exceeding Milan criteria, a score of 2 or lower identified a subgroup of patients with AFP levels less than 100 ng/mL with a low 5-year risk of recurrence (14.4% ± 5.3% vs 47.6% ± 11.1%; P = .006). Among patients within Milan criteria, a score greater than 2 identified a subgroup of patients with AFP levels greater than 1000 ng/mL at high risk of recurrence (37.1% ± 8.9% vs 13.3% ± 2.0%; P < .001). Net reclassification improvement showed that predictability of the AFP model was superior to Milan criteria. CONCLUSIONS: Prediction of tumor recurrence is improved significantly by a model that incorporates AFP. We propose the adoption of new selection criteria for HCC transplant candidates, taking into account AFP.

العلاقة: info:eu-repo/semantics/altIdentifier/pmid/22750200; inserm-00865368; https://inserm.hal.science/inserm-00865368Test; PUBMED: 22750200

الإتاحة: https://doi.org/10.1053/j.gastro.2012.05.052Test
https://inserm.hal.science/inserm-00865368Test

المؤلفون: Duvoux, Christophe, Roudot-Thoraval, Françoise, Decaens, Thomas, Pessione, Fabienne, Badran, Hanaa, Piardi, Tullio, Francoz, Claire, Compagnon, Philippe, Vanlemmens, Claire, Dumortier, Jérome, Dharancy, Sébastien, Gugenheim, Jean, Bernard, Pierre-Henri, Adam, René, Radenne, Sylvie, Muscari, Fabrice, Conti, Filomena, Hardwigsen, Jean, Pageaux, Georges-Philippe, Chazouillères, Olivier, Salame, Ephrem, Hilleret, Marie-Noelle, Lebray, Pascal, Abergel, Armand, Debette-Gratien, Marilyne, Kluger, Michael, D., Mallat, Ariane, Azoulay, Daniel, Cherqui, Daniel

المساهمون: Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Pôle Recherche Clinique-Santé Publique Mondor, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor, Service de santé publique Mondor, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Pôle évaluation - biostatistique, Agence de la biomédecine Saint-Denis la Plaine, Service de Transplantation, Hôpital de Hautepierre Strasbourg, Service d'hépatologie, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7)-Hôpital Beaujon AP-HP, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de Chirurgie Hépatobiliaire et Digestive Rennes = Hepatobiliary and Digestive Surgery Rennes, Centre Hospitalier Universitaire de Rennes CHU Rennes = Rennes University Hospital Ponchaillou, Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté COMUE (UBFC)-Université Bourgogne Franche-Comté COMUE (UBFC), service d'Hépato-gastro-entérologie, Hospices Civiles de Lyon-Hôpital Edouard Heriault, Hôpital Claude Hurriez, Centre méditerranéen de médecine moléculaire (C3M), Université Nice Sophia Antipolis (1965 - 2019) (UNS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Côte d'Azur (UniCA), Service d'Hépato-Gastro-Entérologie, CHU Bordeaux-Hôpital Saint-André, Centre hépato-biliaire (CHB), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM), Hospices Civils de Lyon (HCL)-Hôpital de la Croix-Rousse CHU - HCL, Hospices Civils de Lyon (HCL), Chirurgie Générale et Digestive Rangueil, Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), CHU Saint-Antoine AP-HP, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Service de Chirurgie, Assistance Publique - Hôpitaux de Marseille (APHM)-Hospices Civiles de Marseille-Hôpital de la Conception CHU - APHM (LA CONCEPTION), Centre Hospitalier Régional Universitaire Montpellier (CHRU Montpellier)-Hôpital Saint Eloi (CHRU Montpellier), Centre Hospitalier Régional Universitaire Montpellier (CHRU Montpellier), Département de Chirurgie CHU Caen, Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Tumorothèque de Caen Basse-Normandie (TCBN), Département de Gastroentérologie et hépatologie, Université Joseph Fourier - Grenoble 1 (UJF)-Centre Hospitalier Universitaire CHU Grenoble (CHUGA)-Hôpital Michallon, CHU Pitié-Salpêtrière AP-HP, CHU Etaing, Service d'Hépato-gastro-entérologie et Nutrition CHU Dupuytren 1, Limoges, CHU Limoges-Hôpital Dupuytren CHU Limoges

المصدر: ISSN: 0016-5085.

مصطلحات موضوعية: Liver Transplantation, Hepatocellular Carcinoma, AFP, MESH: Area Under Curve, MESH: Multivariate Analysis, MESH: Neoplasm Invasiveness, MESH: Neoplasm Recurrence, Local, MESH: Patient Selection, MESH: Practice Guidelines as Topic, MESH: Predictive Value of Tests, MESH: Proportional Hazards Models, MESH: alpha-Fetoproteins, MESH: Adult, MESH: Carcinoma, Hepatocellular, MESH: Decision Support Techniques, MESH: Female, MESH: Humans, MESH: Liver Neoplasms, MESH: Liver Transplantation, MESH: Male, MESH: Middle Aged, [SDV.MHEP.HEG]Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology

الوصف: International audience ; BACKGROUND & AIMS: The aim of this study was to generate an improved prognostic model for predicting recurrence in liver transplant candidates with hepatocellular carcinoma (HCC). METHODS: Predictors of recurrence were tested by a Cox model analysis in a training cohort of 537 patients transplanted for HCC. A prognostic score was developed and validated in a national cohort of 435 patients followed up prospectively. RESULTS: α-Fetoprotein (AFP) independently predicted tumor recurrence and correlated with vascular invasion and differentiation. At a Cox score threshold of 0.7 (area under the receiver operating characteristic curve, 0.701; 95% confidence interval, 0.63-0.76; accuracy, 75.8%), a model combining log(10) AFP, tumor size, and number was highly predictive of tumor recurrence and death. By using a simplified version of the model, with untransformed AFP values, a cut-off value of 2 was identified. In the validation cohort, a score greater than 2 predicted a marked increase in 5-year risk of recurrence (50.6% ± 10.2% vs 8.8% ± 1.7%; P < .001) and decreased survival (47.5% ± 8.1% vs 67.8% ± 3.4%; P = .002) as compared with others. Among patients exceeding Milan criteria, a score of 2 or lower identified a subgroup of patients with AFP levels less than 100 ng/mL with a low 5-year risk of recurrence (14.4% ± 5.3% vs 47.6% ± 11.1%; P = .006). Among patients within Milan criteria, a score greater than 2 identified a subgroup of patients with AFP levels greater than 1000 ng/mL at high risk of recurrence (37.1% ± 8.9% vs 13.3% ± 2.0%; P < .001). Net reclassification improvement showed that predictability of the AFP model was superior to Milan criteria. CONCLUSIONS: Prediction of tumor recurrence is improved significantly by a model that incorporates AFP. We propose the adoption of new selection criteria for HCC transplant candidates, taking into account AFP.

العلاقة: info:eu-repo/semantics/altIdentifier/pmid/22750200; inserm-00865368; https://inserm.hal.science/inserm-00865368Test; PUBMED: 22750200

الإتاحة: https://doi.org/10.1053/j.gastro.2012.05.052Test
https://inserm.hal.science/inserm-00865368Test

المؤلفون: Duvoux, Christophe, Roudot-Thoraval, Françoise, Decaens, Thomas, Pessione, Fabienne, Badran, Hanaa, Piardi, Tullio, Francoz, Claire, Compagnon, Philippe, Vanlemmens, Claire, Dumortier, Jérome, Dharancy, Sébastien, Gugenheim, Jean, Bernard, Pierre-Henri, Adam, René, Radenne, Sylvie, Muscari, Fabrice, Conti, Filomena, Hardwigsen, Jean, Pageaux, Georges-Philippe, Chazouillères, Olivier, Salame, Ephrem, Hilleret, Marie-Noelle, Lebray, Pascal, Abergel, Armand, Debette-Gratien, Marilyne, Kluger, Michael, D., Mallat, Ariane, Azoulay, Daniel, Cherqui, Daniel

المساهمون: Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Pôle Recherche Clinique-Santé Publique Mondor, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor, Service de santé publique Mondor, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Pôle évaluation - biostatistique, Agence de la biomédecine Saint-Denis la Plaine, Service de Transplantation, Hôpital de Hautepierre Strasbourg, Service d'hépatologie, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7)-Hôpital Beaujon AP-HP, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de Chirurgie Hépatobiliaire et Digestive Rennes = Hepatobiliary and Digestive Surgery Rennes, Centre Hospitalier Universitaire de Rennes CHU Rennes = Rennes University Hospital Ponchaillou, Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté COMUE (UBFC)-Université Bourgogne Franche-Comté COMUE (UBFC), service d'Hépato-gastro-entérologie, Hospices Civiles de Lyon-Hôpital Edouard Heriault, Hôpital Claude Hurriez, Centre méditerranéen de médecine moléculaire (C3M), Université Nice Sophia Antipolis (1965 - 2019) (UNS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Côte d'Azur (UniCA), Service d'Hépato-Gastro-Entérologie, CHU Bordeaux-Hôpital Saint-André, Centre hépato-biliaire (CHB), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM), Hospices Civils de Lyon (HCL)-Hôpital de la Croix-Rousse CHU - HCL, Hospices Civils de Lyon (HCL), Chirurgie Générale et Digestive Rangueil, Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), CHU Saint-Antoine AP-HP, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Service de Chirurgie, Assistance Publique - Hôpitaux de Marseille (APHM)-Hospices Civiles de Marseille-Hôpital de la Conception CHU - APHM (LA CONCEPTION), Centre Hospitalier Régional Universitaire Montpellier (CHRU Montpellier)-Hôpital Saint Eloi (CHRU Montpellier), Centre Hospitalier Régional Universitaire Montpellier (CHRU Montpellier), Département de Chirurgie CHU Caen, Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Tumorothèque de Caen Basse-Normandie (TCBN), Département de Gastroentérologie et hépatologie, Université Joseph Fourier - Grenoble 1 (UJF)-Centre Hospitalier Universitaire CHU Grenoble (CHUGA)-Hôpital Michallon, CHU Pitié-Salpêtrière AP-HP, CHU Etaing, Service d'Hépato-gastro-entérologie et Nutrition CHU Dupuytren 1, Limoges, CHU Limoges-Hôpital Dupuytren CHU Limoges

المصدر: ISSN: 0016-5085.

مصطلحات موضوعية: Liver Transplantation, Hepatocellular Carcinoma, AFP, MESH: Area Under Curve, MESH: Multivariate Analysis, MESH: Neoplasm Invasiveness, MESH: Neoplasm Recurrence, Local, MESH: Patient Selection, MESH: Practice Guidelines as Topic, MESH: Predictive Value of Tests, MESH: Proportional Hazards Models, MESH: alpha-Fetoproteins, MESH: Adult, MESH: Carcinoma, Hepatocellular, MESH: Decision Support Techniques, MESH: Female, MESH: Humans, MESH: Liver Neoplasms, MESH: Liver Transplantation, MESH: Male, MESH: Middle Aged, [SDV.MHEP.HEG]Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology

الوصف: International audience ; BACKGROUND & AIMS: The aim of this study was to generate an improved prognostic model for predicting recurrence in liver transplant candidates with hepatocellular carcinoma (HCC). METHODS: Predictors of recurrence were tested by a Cox model analysis in a training cohort of 537 patients transplanted for HCC. A prognostic score was developed and validated in a national cohort of 435 patients followed up prospectively. RESULTS: α-Fetoprotein (AFP) independently predicted tumor recurrence and correlated with vascular invasion and differentiation. At a Cox score threshold of 0.7 (area under the receiver operating characteristic curve, 0.701; 95% confidence interval, 0.63-0.76; accuracy, 75.8%), a model combining log(10) AFP, tumor size, and number was highly predictive of tumor recurrence and death. By using a simplified version of the model, with untransformed AFP values, a cut-off value of 2 was identified. In the validation cohort, a score greater than 2 predicted a marked increase in 5-year risk of recurrence (50.6% ± 10.2% vs 8.8% ± 1.7%; P < .001) and decreased survival (47.5% ± 8.1% vs 67.8% ± 3.4%; P = .002) as compared with others. Among patients exceeding Milan criteria, a score of 2 or lower identified a subgroup of patients with AFP levels less than 100 ng/mL with a low 5-year risk of recurrence (14.4% ± 5.3% vs 47.6% ± 11.1%; P = .006). Among patients within Milan criteria, a score greater than 2 identified a subgroup of patients with AFP levels greater than 1000 ng/mL at high risk of recurrence (37.1% ± 8.9% vs 13.3% ± 2.0%; P < .001). Net reclassification improvement showed that predictability of the AFP model was superior to Milan criteria. CONCLUSIONS: Prediction of tumor recurrence is improved significantly by a model that incorporates AFP. We propose the adoption of new selection criteria for HCC transplant candidates, taking into account AFP.

العلاقة: info:eu-repo/semantics/altIdentifier/pmid/22750200; inserm-00865368; https://inserm.hal.science/inserm-00865368Test; PUBMED: 22750200

الإتاحة: https://doi.org/10.1053/j.gastro.2012.05.052Test
https://inserm.hal.science/inserm-00865368Test

المؤلفون: Duvoux, Christophe, Roudot-Thoraval, Françoise, Decaens, Thomas, Pessione, Fabienne, Badran, Hanaa, Piardi, Tullio, Francoz, Claire, Compagnon, Philippe, Vanlemmens, Claire, Dumortier, Jérome, Dharancy, Sébastien, Gugenheim, Jean, Bernard, Pierre-Henri, Adam, René, Radenne, Sylvie, Muscari, Fabrice, Conti, Filomena, Hardwigsen, Jean, Pageaux, Georges-Philippe, Chazouillères, Olivier, Salame, Ephrem, Hilleret, Marie-Noelle, Lebray, Pascal, Abergel, Armand, Debette-Gratien, Marilyne, Kluger, Michael, D., Mallat, Ariane, Azoulay, Daniel, Cherqui, Daniel

المساهمون: Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Pôle Recherche Clinique-Santé Publique Mondor, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor, Service de santé publique Mondor, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Pôle évaluation - biostatistique, Agence de la biomédecine Saint-Denis la Plaine, Service de Transplantation, Hôpital de Hautepierre Strasbourg, Service d'hépatologie, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7)-Hôpital Beaujon AP-HP, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de Chirurgie Hépatobiliaire et Digestive Rennes = Hepatobiliary and Digestive Surgery Rennes, Centre Hospitalier Universitaire de Rennes CHU Rennes = Rennes University Hospital Ponchaillou, Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté COMUE (UBFC)-Université Bourgogne Franche-Comté COMUE (UBFC), service d'Hépato-gastro-entérologie, Hospices Civiles de Lyon-Hôpital Edouard Heriault, Hôpital Claude Hurriez, Centre méditerranéen de médecine moléculaire (C3M), Université Nice Sophia Antipolis (1965 - 2019) (UNS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Côte d'Azur (UniCA), Service d'Hépato-Gastro-Entérologie, CHU Bordeaux-Hôpital Saint-André, Centre hépato-biliaire (CHB), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM), Hospices Civils de Lyon (HCL)-Hôpital de la Croix-Rousse CHU - HCL, Hospices Civils de Lyon (HCL), Chirurgie Générale et Digestive Rangueil, Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), CHU Saint-Antoine AP-HP, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Service de Chirurgie, Assistance Publique - Hôpitaux de Marseille (APHM)-Hospices Civiles de Marseille-Hôpital de la Conception CHU - APHM (LA CONCEPTION), Centre Hospitalier Régional Universitaire Montpellier (CHRU Montpellier)-Hôpital Saint Eloi (CHRU Montpellier), Centre Hospitalier Régional Universitaire Montpellier (CHRU Montpellier), Département de Chirurgie CHU Caen, Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Tumorothèque de Caen Basse-Normandie (TCBN), Département de Gastroentérologie et hépatologie, Université Joseph Fourier - Grenoble 1 (UJF)-Centre Hospitalier Universitaire CHU Grenoble (CHUGA)-Hôpital Michallon, CHU Pitié-Salpêtrière AP-HP, CHU Etaing, Service d'Hépato-gastro-entérologie et Nutrition CHU Dupuytren 1, Limoges, CHU Limoges-Hôpital Dupuytren CHU Limoges

المصدر: ISSN: 0016-5085.

مصطلحات موضوعية: Liver Transplantation, Hepatocellular Carcinoma, AFP, MESH: Area Under Curve, MESH: Multivariate Analysis, MESH: Neoplasm Invasiveness, MESH: Neoplasm Recurrence, Local, MESH: Patient Selection, MESH: Practice Guidelines as Topic, MESH: Predictive Value of Tests, MESH: Proportional Hazards Models, MESH: alpha-Fetoproteins, MESH: Adult, MESH: Carcinoma, Hepatocellular, MESH: Decision Support Techniques, MESH: Female, MESH: Humans, MESH: Liver Neoplasms, MESH: Liver Transplantation, MESH: Male, MESH: Middle Aged, [SDV.MHEP.HEG]Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology

الوصف: International audience ; BACKGROUND & AIMS: The aim of this study was to generate an improved prognostic model for predicting recurrence in liver transplant candidates with hepatocellular carcinoma (HCC). METHODS: Predictors of recurrence were tested by a Cox model analysis in a training cohort of 537 patients transplanted for HCC. A prognostic score was developed and validated in a national cohort of 435 patients followed up prospectively. RESULTS: α-Fetoprotein (AFP) independently predicted tumor recurrence and correlated with vascular invasion and differentiation. At a Cox score threshold of 0.7 (area under the receiver operating characteristic curve, 0.701; 95% confidence interval, 0.63-0.76; accuracy, 75.8%), a model combining log(10) AFP, tumor size, and number was highly predictive of tumor recurrence and death. By using a simplified version of the model, with untransformed AFP values, a cut-off value of 2 was identified. In the validation cohort, a score greater than 2 predicted a marked increase in 5-year risk of recurrence (50.6% ± 10.2% vs 8.8% ± 1.7%; P < .001) and decreased survival (47.5% ± 8.1% vs 67.8% ± 3.4%; P = .002) as compared with others. Among patients exceeding Milan criteria, a score of 2 or lower identified a subgroup of patients with AFP levels less than 100 ng/mL with a low 5-year risk of recurrence (14.4% ± 5.3% vs 47.6% ± 11.1%; P = .006). Among patients within Milan criteria, a score greater than 2 identified a subgroup of patients with AFP levels greater than 1000 ng/mL at high risk of recurrence (37.1% ± 8.9% vs 13.3% ± 2.0%; P < .001). Net reclassification improvement showed that predictability of the AFP model was superior to Milan criteria. CONCLUSIONS: Prediction of tumor recurrence is improved significantly by a model that incorporates AFP. We propose the adoption of new selection criteria for HCC transplant candidates, taking into account AFP.

العلاقة: info:eu-repo/semantics/altIdentifier/pmid/22750200; inserm-00865368; https://inserm.hal.science/inserm-00865368Test; PUBMED: 22750200

الإتاحة: https://doi.org/10.1053/j.gastro.2012.05.052Test
https://inserm.hal.science/inserm-00865368Test

المؤلفون: Duvoux, Christophe, Roudot-Thoraval, Françoise, Decaens, Thomas, Pessione, Fabienne, Badran, Hanaa, Piardi, Tullio, Francoz, Claire, Compagnon, Philippe, Vanlemmens, Claire, Dumortier, Jérome, Dharancy, Sébastien, Gugenheim, Jean, Bernard, Pierre-Henri, Adam, René, Radenne, Sylvie, Muscari, Fabrice, Conti, Filomena, Hardwigsen, Jean, Pageaux, Georges-Philippe, Chazouillères, Olivier, Salame, Ephrem, Hilleret, Marie-Noelle, Lebray, Pascal, Abergel, Armand, Debette-Gratien, Marilyne, Kluger, Michael, D., Mallat, Ariane, Azoulay, Daniel, Cherqui, Daniel

المساهمون: Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Pôle Recherche Clinique-Santé Publique Mondor, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor, Service de santé publique Mondor, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Pôle évaluation - biostatistique, Agence de la biomédecine Saint-Denis la Plaine, Service de Transplantation, Hôpital de Hautepierre Strasbourg, Service d'hépatologie, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7)-Hôpital Beaujon AP-HP, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service de Chirurgie Hépatobiliaire et Digestive Rennes = Hepatobiliary and Digestive Surgery Rennes, Centre Hospitalier Universitaire de Rennes CHU Rennes = Rennes University Hospital Ponchaillou, Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté COMUE (UBFC)-Université Bourgogne Franche-Comté COMUE (UBFC), service d'Hépato-gastro-entérologie, Hospices Civiles de Lyon-Hôpital Edouard Heriault, Hôpital Claude Hurriez, Centre méditerranéen de médecine moléculaire (C3M), Université Nice Sophia Antipolis (1965 - 2019) (UNS)-Institut National de la Santé et de la Recherche Médicale (INSERM)-Université Côte d'Azur (UniCA), Service d'Hépato-Gastro-Entérologie, CHU Bordeaux-Hôpital Saint-André, Centre hépato-biliaire (CHB), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM), Hospices Civils de Lyon (HCL)-Hôpital de la Croix-Rousse CHU - HCL, Hospices Civils de Lyon (HCL), Chirurgie Générale et Digestive Rangueil, Centre Hospitalier Universitaire de Toulouse (CHU Toulouse), CHU Saint-Antoine AP-HP, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Service de Chirurgie, Assistance Publique - Hôpitaux de Marseille (APHM)-Hospices Civiles de Marseille-Hôpital de la Conception CHU - APHM (LA CONCEPTION), Centre Hospitalier Régional Universitaire Montpellier (CHRU Montpellier)-Hôpital Saint Eloi (CHRU Montpellier), Centre Hospitalier Régional Universitaire Montpellier (CHRU Montpellier), Département de Chirurgie CHU Caen, Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Tumorothèque de Caen Basse-Normandie (TCBN), Département de Gastroentérologie et hépatologie, Université Joseph Fourier - Grenoble 1 (UJF)-Centre Hospitalier Universitaire CHU Grenoble (CHUGA)-Hôpital Michallon, CHU Pitié-Salpêtrière AP-HP, CHU Etaing, Service d'Hépato-gastro-entérologie et Nutrition CHU Dupuytren 1, Limoges, CHU Limoges-Hôpital Dupuytren CHU Limoges

المصدر: ISSN: 0016-5085.

مصطلحات موضوعية: Liver Transplantation, Hepatocellular Carcinoma, AFP, MESH: Area Under Curve, MESH: Multivariate Analysis, MESH: Neoplasm Invasiveness, MESH: Neoplasm Recurrence, Local, MESH: Patient Selection, MESH: Practice Guidelines as Topic, MESH: Predictive Value of Tests, MESH: Proportional Hazards Models, MESH: alpha-Fetoproteins, MESH: Adult, MESH: Carcinoma, Hepatocellular, MESH: Decision Support Techniques, MESH: Female, MESH: Humans, MESH: Liver Neoplasms, MESH: Liver Transplantation, MESH: Male, MESH: Middle Aged, [SDV.MHEP.HEG]Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology

الوصف: International audience ; BACKGROUND & AIMS: The aim of this study was to generate an improved prognostic model for predicting recurrence in liver transplant candidates with hepatocellular carcinoma (HCC). METHODS: Predictors of recurrence were tested by a Cox model analysis in a training cohort of 537 patients transplanted for HCC. A prognostic score was developed and validated in a national cohort of 435 patients followed up prospectively. RESULTS: α-Fetoprotein (AFP) independently predicted tumor recurrence and correlated with vascular invasion and differentiation. At a Cox score threshold of 0.7 (area under the receiver operating characteristic curve, 0.701; 95% confidence interval, 0.63-0.76; accuracy, 75.8%), a model combining log(10) AFP, tumor size, and number was highly predictive of tumor recurrence and death. By using a simplified version of the model, with untransformed AFP values, a cut-off value of 2 was identified. In the validation cohort, a score greater than 2 predicted a marked increase in 5-year risk of recurrence (50.6% ± 10.2% vs 8.8% ± 1.7%; P < .001) and decreased survival (47.5% ± 8.1% vs 67.8% ± 3.4%; P = .002) as compared with others. Among patients exceeding Milan criteria, a score of 2 or lower identified a subgroup of patients with AFP levels less than 100 ng/mL with a low 5-year risk of recurrence (14.4% ± 5.3% vs 47.6% ± 11.1%; P = .006). Among patients within Milan criteria, a score greater than 2 identified a subgroup of patients with AFP levels greater than 1000 ng/mL at high risk of recurrence (37.1% ± 8.9% vs 13.3% ± 2.0%; P < .001). Net reclassification improvement showed that predictability of the AFP model was superior to Milan criteria. CONCLUSIONS: Prediction of tumor recurrence is improved significantly by a model that incorporates AFP. We propose the adoption of new selection criteria for HCC transplant candidates, taking into account AFP.

العلاقة: info:eu-repo/semantics/altIdentifier/pmid/22750200; inserm-00865368; https://inserm.hal.science/inserm-00865368Test; PUBMED: 22750200

الإتاحة: https://doi.org/10.1053/j.gastro.2012.05.052Test
https://inserm.hal.science/inserm-00865368Test

المؤلفون: Duvoux, Christophe, Roudot-Thoraval, Françoise, Decaens, Thomas, Pessione, Fabienne, Badran, Hanaa, Piardi, Tullio, Francoz, Claire, Compagnon, Philippe, Vanlemmens, Claire, Dumortier, Jérome, Dharancy, Sébastien, Gugenheim, Jean, Bernard, Pierre-Henri, Adam, René, Radenne, Sylvie, Muscari, Fabrice, Conti, Filomena, Hardwigsen, Jean, Pageaux, Georges-Philippe, Chazouillères, Olivier, Salame, Ephrem, Hilleret, Marie-Noelle, Lebray, Pascal, Abergel, Armand, Debette-Gratien, Marilyne, Kluger, Michael, Mallat, Ariane, Azoulay, Daniel, Cherqui, Daniel

المساهمون: Institut Mondor de Recherche Biomédicale (IMRB), Institut National de la Santé et de la Recherche Médicale (INSERM)-IFR10-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Pôle Recherche Clinique-Santé Publique Mondor, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor, Service de santé publique Mondor, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Henri Mondor-Université Paris-Est Créteil Val-de-Marne - Paris 12 (UPEC UP12), Pôle évaluation - biostatistique, Agence de la biomédecine Saint-Denis la Plaine, Service de Transplantation, Hôpital de Hautepierre Strasbourg, Service d'hépatologie, Hôpital Beaujon AP-HP, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Université Paris Diderot - Paris 7 (UPD7), Service de Chirurgie Hépatobiliaire et Digestive Rennes = Hepatobiliary and Digestive Surgery Rennes, CHU Pontchaillou Rennes, Centre Hospitalier Régional Universitaire de Besançon (CHRU Besançon)-Université de Franche-Comté (UFC), Université Bourgogne Franche-Comté COMUE (UBFC)-Université Bourgogne Franche-Comté COMUE (UBFC), service d'Hépato-gastro-entérologie, Hospices Civiles de Lyon-Hôpital Edouard Heriault, Hôpital Claude Hurriez, Centre méditerranéen de médecine moléculaire (C3M), Université Nice Sophia Antipolis (. - 2019) (UNS), COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-COMUE Université Côte d'Azur (2015-2019) (COMUE UCA)-Université Côte d'Azur (UCA)-Institut National de la Santé et de la Recherche Médicale (INSERM), Service d'Hépato-Gastro-Entérologie, CHU Bordeaux Bordeaux -Hôpital Saint-André, Centre hépato-biliaire (CHB), Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Hôpital Paul Brousse-Institut National de la Santé et de la Recherche Médicale (INSERM), Hospices Civils de Lyon (HCL)-Hôpital de la Croix-Rousse CHU - HCL, Hospices Civils de Lyon (HCL), Chirurgie Générale et Digestive Rangueil, CHU Toulouse Toulouse -Hôpital de Rangueil, CHU Toulouse Toulouse, Service d'hépatologie Saint-Antoine, Université Pierre et Marie Curie - Paris 6 (UPMC)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-CHU Saint-Antoine AP-HP, Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Sorbonne Université (SU), Service de Chirurgie, Assistance Publique - Hôpitaux de Marseille (APHM)-Hospices Civiles de Marseille-Hôpital de la Conception CHU - APHM (LA CONCEPTION), Centre Hospitalier Régional Universitaire Montpellier (CHRU Montpellier)-CHU Saint-Eloi, Département de Chirurgie CHU Caen, Université de Caen Normandie (UNICAEN), Normandie Université (NU)-Normandie Université (NU)-CHU Caen, Normandie Université (NU)-Tumorothèque de Caen Basse-Normandie (TCBN)-Tumorothèque de Caen Basse-Normandie (TCBN), Département de Gastroentérologie et hépatologie, Université Joseph Fourier - Grenoble 1 (UJF)-CHU Grenoble-Hôpital Michallon, CHU Pitié-Salpêtrière AP-HP, Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), CHU Etaing, Service d'Hépato-Gastro-Entérologie et Nutrition CHU Limoges, CHU Limoges

المصدر: ISSN: 0016-5085 ; Gastroenterology ; https://www.hal.inserm.fr/inserm-00865368Test ; Gastroenterology, WB Saunders, 2012, 143 (4), pp.986-94.e3; quiz e14-5. ⟨10.1053/j.gastro.2012.05.052⟩.

مصطلحات موضوعية: Liver Transplantation, Hepatocellular Carcinoma, AFP, MESH: Area Under Curve, MESH: Multivariate Analysis, MESH: Neoplasm Invasiveness, MESH: Neoplasm Recurrence, Local, MESH: Patient Selection, MESH: Practice Guidelines as Topic, MESH: Predictive Value of Tests, MESH: Proportional Hazards Models, MESH: alpha-Fetoproteins, MESH: Adult, MESH: Carcinoma, Hepatocellular, MESH: Decision Support Techniques, MESH: Female, MESH: Humans, MESH: Liver Neoplasms, MESH: Liver Transplantation, MESH: Male, MESH: Middle Aged, [SDV.MHEP.HEG]Life Sciences [q-bio]/Human health and pathology/Hépatology and Gastroenterology

الوصف: International audience ; BACKGROUND & AIMS: The aim of this study was to generate an improved prognostic model for predicting recurrence in liver transplant candidates with hepatocellular carcinoma (HCC). METHODS: Predictors of recurrence were tested by a Cox model analysis in a training cohort of 537 patients transplanted for HCC. A prognostic score was developed and validated in a national cohort of 435 patients followed up prospectively. RESULTS: α-Fetoprotein (AFP) independently predicted tumor recurrence and correlated with vascular invasion and differentiation. At a Cox score threshold of 0.7 (area under the receiver operating characteristic curve, 0.701; 95% confidence interval, 0.63-0.76; accuracy, 75.8%), a model combining log(10) AFP, tumor size, and number was highly predictive of tumor recurrence and death. By using a simplified version of the model, with untransformed AFP values, a cut-off value of 2 was identified. In the validation cohort, a score greater than 2 predicted a marked increase in 5-year risk of recurrence (50.6% ± 10.2% vs 8.8% ± 1.7%; P < .001) and decreased survival (47.5% ± 8.1% vs 67.8% ± 3.4%; P = .002) as compared with others. Among patients exceeding Milan criteria, a score of 2 or lower identified a subgroup of patients with AFP levels less than 100 ng/mL with a low 5-year risk of recurrence (14.4% ± 5.3% vs 47.6% ± 11.1%; P = .006). Among patients within Milan criteria, a score greater than 2 identified a subgroup of patients with AFP levels greater than 1000 ng/mL at high risk of recurrence (37.1% ± 8.9% vs 13.3% ± 2.0%; P < .001). Net reclassification improvement showed that predictability of the AFP model was superior to Milan criteria. CONCLUSIONS: Prediction of tumor recurrence is improved significantly by a model that incorporates AFP. We propose the adoption of new selection criteria for HCC transplant candidates, taking into account AFP.

العلاقة: info:eu-repo/semantics/altIdentifier/pmid/22750200; inserm-00865368; https://www.hal.inserm.fr/inserm-00865368Test; PUBMED: 22750200

الإتاحة: https://doi.org/10.1053/j.gastro.2012.05.052Test
https://www.hal.inserm.fr/inserm-00865368Test