Charlotte E Costentin1, Giuliana Amaddeo1, Thomas Decaens2, Karim Boudjema3, Philippe Bachellier4, Fabrice Muscari5, Ephrem Salamé6, Pierre-Henri Bernard7, Claire Francoz8, Sébastien Dharancy9, Claire Vanlemmens10, Sylvie Radenne11, Jérôme Dumortier12, Marie-Noelle Hilleret2, Olivier Chazouillères13, Georges P Pageaux14, Julien Calderaro15, Alexis Laurent16, Françoise Roudot-Thoraval1, Christophe Duvoux1. 1. Service d'hépatologie, Hôpital Henri Mondor, Créteil, France. 2. Service d'hépatologie, CHU Grenoble Alpes, Grenoble, France. 3. Service de Chirurgie digestive, Hôpital Pontchaillou, Rennes, France. 4. Service de Chirurgie digestive, CHU de Strasbourg, Strasbourg, France. 5. Service de Chirurgie digestive, Hôpital Rangueil, Toulouse, France. 6. Service de Chirurgie digestive, CHU de Tours, Chambray-lès-Tours, France. 7. Service d'hépatologie, Hôpital Saint André, Bordeaux, France. 8. Service hépatologie, Hôpital Beaujon, Clichy, France. 9. Service hépatologie, Hôpital Claude Huriez, Lille, France. 10. Service d'hépatologie, Hôpital Jean Minjoz, Besancon, France. 11. Service d'hépatologie, Hôpital Lyon Croix Rousse, Lyon, France. 12. Service d'hépatologie, Hospices Civiles de Lyon, Hôpital Edouard Herriot, Lyon, France. 13. Service d'hépatologie, Hôpital Saint Antoine, Paris, France. 14. Service d'hépatologie, Hôpital Saint Eloi, Montpellier, France. 15. Département de Pathologie, Hôpital Henri Mondor, Créteil, France. 16. Service de Chirurgie digestive, Hôpital Henri Mondor, Créteil, France.
Abstract
AIM: Discordance between pre-LT imaging and explanted liver findings have been reported after liver transplantation (LT) for hepatocellular carcinoma (HCC), suggesting the need of reassessing the risk of HCC recurrence post-LT. Our aims were to compare pre-LT imaging and explants features and to test the performances of four explant-based predictive models of recurrence in an external cohort. METHODS: Staging according to pre-LT imaging and explant features were compared. Four explants-based models were retrospectively tested in a cohort of 372 patients transplanted for HCC in 19 French centres between 2003 and 2005. Accuracies of the scores were compared. RESULTS: Pre-LT imaging underestimated tumour burden in 83 (22.7%) patients according to Milan criteria. The highest AUCs for prediction of 5-years recurrence were observed in the "Up to seven" (0.7915 [95% CI: 0.7339-0.849]) and Decaens models (0.747 [95% CI: 0.6877-0.806]), with two levels of risk: low (10%) and high (>50%). Chan and Iwatsuki models identified 3 and 4 levels of risk, but had lower AUCs (0.68 and 0.70) respectively. Accuracy of the "Up to seven" model was superior to the Decaens model (P=.034), which was superior to the Chan model (P=.0041) but not to the Iwatsuki model (P=.17). CONCLUSION: Pre-LT imaging underestimates tumour burden, and prediction of recurrence should be reassessed after LT. The explant-based "Up to seven" and Decaens models provided the best accuracy for prediction of 5-year recurrence, identifying only two levels of risk. New models are needed to further refine the prediction of recurrence after LT.
AIM: Discordance between pre-LT imaging and explanted liver findings have been reported after liver transplantation (LT) for hepatocellular carcinoma (HCC), suggesting the need of reassessing the risk of HCC recurrence post-LT. Our aims were to compare pre-LT imaging and explants features and to test the performances of four explant-based predictive models of recurrence in an external cohort. METHODS: Staging according to pre-LT imaging and explant features were compared. Four explants-based models were retrospectively tested in a cohort of 372 patients transplanted for HCC in 19 French centres between 2003 and 2005. Accuracies of the scores were compared. RESULTS: Pre-LT imaging underestimated tumour burden in 83 (22.7%) patients according to Milan criteria. The highest AUCs for prediction of 5-years recurrence were observed in the "Up to seven" (0.7915 [95% CI: 0.7339-0.849]) and Decaens models (0.747 [95% CI: 0.6877-0.806]), with two levels of risk: low (10%) and high (>50%). Chan and Iwatsuki models identified 3 and 4 levels of risk, but had lower AUCs (0.68 and 0.70) respectively. Accuracy of the "Up to seven" model was superior to the Decaens model (P=.034), which was superior to the Chan model (P=.0041) but not to the Iwatsuki model (P=.17). CONCLUSION: Pre-LT imaging underestimates tumour burden, and prediction of recurrence should be reassessed after LT. The explant-based "Up to seven" and Decaens models provided the best accuracy for prediction of 5-year recurrence, identifying only two levels of risk. New models are needed to further refine the prediction of recurrence after LT.
Authors: Samir Zeair; Justyna Rajchert; Robert Stasiuk; Sławomir Cyprys; Janusz Miętkiewski; Katarzyna Zasada-Cedro; Ewa Karpińska; Marta Duczkowska; Miłosz Parczewski; Marta Wawrzynowicz-Syczewska Journal: Ann Transplant Date: 2019-08-23 Impact factor: 1.530
Authors: Charlotte Costentin; Federico Piñero; Helena Degroote; Andrea Notarpaolo; Ilka F Boin; Karim Boudjema; Cinzia Baccaro; Luis G Podestá; Philippe Bachellier; Giuseppe Maria Ettorre; Jaime Poniachik; Fabrice Muscari; Fabrizio Dibenedetto; Sergio Hoyos Duque; Ephrem Salame; Umberto Cillo; Sebastian Marciano; Claire Vanlemmens; Stefano Fagiuoli; Patrizia Burra; Hans Van Vlierberghe; Daniel Cherqui; Quirino Lai; Marcelo Silva; Fernando Rubinstein; Christophe Duvoux Journal: JHEP Rep Date: 2022-02-02
Authors: Astrid Herrero; Lucile Boivineau; Gianluca Cassese; Eric Assenat; Benjamin Riviere; Stéphanie Faure; José Ursic Bedoya; Fabrizio Panaro; Boris Guiu; Francis Navarro; Georges-Philippe Pageaux Journal: Transpl Int Date: 2022-03-23 Impact factor: 3.782