Dados do Trabalho

Título

Evaluation of the AFP score in hepatocellular carcinoma progression during waiting list and recurrence after liver transplantation

Introdução

The French AFP selection model has been shown to be superior in the prediction of recurrence of hepatocellular carcinoma (HCC) after liver transplantation (LT).Our objective was to evaluate the AFP score in the prediction of tumor progression during the waiting list and HCC recurrence after LT.

Material e Método

This multicenter and multinational cohort study conducted in Latin America included adult patients listed for LT with HCC between the years 2011-2018. Development of HCC tumor progression by RECIST 1.1 (PD) and/or post LT recurrence was evaluated as a combined primary event. A multivariable competing risk regression analysis was performed (competitive event = death or withdrawal from other causes), with Sub-Hazard Ratios (SHR) and respective 95% confidence intervals (CI 95%) calculations.

Resultados

From 994 patients with HCC, 81.4% were in Milan Criteria, 8.4% of them had AFP score >2 and outside MC 47.9% had AFP score > 2. The risk of developing the combined primary event was 21.8% for those patients with an AFP score ≤2 points at LISTING/≤2 points at LAST evaluation, similar to those with AFP score >2 points LISTING/≤2 points LAST (21.2%) adjusted SHR 0.65 (CI 0.32-1.34; P=0.25), and lower than those with an AFP score ≤2 points LISTING/>2 points LAST (38.5%) adjusted SHR 1.54 (CI 1.13-2.08; P=0.006) and with an AFP score >points LISTING/>2 points LAST (42.3%) adjusted SHR 1.77 (CI 1.21-2.59, P=0.003).

Discussão e Conclusões

The AFP score has been shown to be effective in categorizing the risk of post-transplant recurrence, as well as the risk of tumor progression on the waiting list.

Palavras Chave

AFP, LIVER TRANSPLANTATION, TUMOR PROGRESSIONWhile in those beyond Milan at enrollment (n=180), 50.3% and 47.9% had an AFP score of ≤2 and >2 points, respectively