Serum biomarkers and risk of hepatocellular carcinoma recurrence after liver transplantation
Entity
UAM. Departamento de MedicinaPublisher
Baishideng Publishing Group Inc.Date
2019-01-27Citation
10.4254/wjh.v11.i1.50
World Journal of Hepatology 11.1 (2019): 50-64
ISSN
1948-5182DOI
10.4254/wjh.v11.i1.50Editor's Version
https://doi.org/10.4254/wjh.v11.i1.50Subjects
Hepatocellular carcinoma; Liver transplantation; Recurrence; Selection criteria; Prognostic score; Biomarker; Alpha-fetoprotein; Systemic inflammatory marker; MedicinaRights
© The Author(s). 2019Esta obra está bajo una licencia de Creative Commons Reconocimiento-NoComercial-SinObraDerivada 4.0 Internacional.
Abstract
Liver transplantation (LT) is the only potentially curative treatment for selected
patients with cirrhosis and hepatocellular carcinoma (HCC) who are not
candidates for resection. When the Milan criteria are strictly applied, 75% to
85%of 3- to 4-year actuarial survival rates are achieved, but up to 20% of the
patients experience HCC recurrence after transplantation. The Milan criteria are
based on the preoperative tumor macromorphology, tumor size and number on
computed tomography or magnetic resonance imaging that neither correlate well
with posttransplant histological study of the liver explant nor accurately predict
HCC recurrence after LT, since they do not include objective measures of tumor
biology. Preoperative biological markers, including alpha-fetoprotein, desgamma-
carboxiprothrombin or neutrophil-to-lymphocyte ratio and platelet-tolymphocyte
ratio, can predict the risk for HCC recurrence after transplantation.
These biomarkers have been proposed as surrogate markers of tumor
differentiation and vascular invasion, with varied risk magnitudes depending on
the defined cutoffs. Different studies have shown that the combination of one or
several biomarkers integrated into prognostic models predict the risk of HCC
recurrence after LT more accurately than Milan criteria alone. In this review, we
focus on the potential utility of these serum biological markers to improve the
performance of Milan criteria to identify patients at high risk of tumoral
Files in this item
Google Scholar:Citores, María J.
-
Lucena, Jose L
-
Fuente, Sara de la
-
Cuervas-Mons Martínez, Valentín
This item appears in the following Collection(s)
Related items
Showing items related by title, author, creator and subject.