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Impact of Preoperative α-Fetoprotein Level on Disease-Free Survival After Liver Transplantation for Hepatocellular Carcinoma

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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.

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Authors and Affiliations

  1. Department of Digestive Surgery and Liver Transplantation, CHU Rangueil, 1 Avenue Jean Poulhès, 31059, Toulouse Cedex, France

    Fabrice Muscari, Jean-Pascal Guinard & Bertrand Suc

  2. Department of Epidemiology and Inserm U1027, Toulouse, France

    Fabrice Muscari

  3. Department of Organ Transplantation and Nephrology, CHU Rangueil, Toulouse, France

    Nassim Kamar

  4. Department of Hepatology, CHU Purpan, Toulouse, France

    Jean-Marie Peron

  5. Department of Radiology, CHU Rangueil, Toulouse, France

    Philippe Otal

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  1. Fabrice Muscari
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  2. Jean-Pascal Guinard
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  3. Nassim Kamar
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Correspondence to Fabrice Muscari.

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Muscari, F., Guinard, JP., Kamar, N. et al. Impact of Preoperative α-Fetoprotein Level on Disease-Free Survival After Liver Transplantation for Hepatocellular Carcinoma. World J Surg 36, 1824–1831 (2012). https://doi.org/10.1007/s00268-012-1587-z

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