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

World Journal of Surgery - 2012
Fabrice Muscari1,2, J Guinard3, Nassim Kamar4, Jean–Marie Péron5, Philippe Otal6, B. Suc3
1Department of Digestive Surgery and Liver Transplantation CHU Rangueil 1 Avenue Jean Poulhès 31059 Toulouse Cedex France
2Department of Epidemiology and Inserm U1027 Toulouse France
3Department of Digestive Surgery and Liver Transplantation, CHU Rangueil, Toulouse Cedex, France
4Department of Organ Transplantation and Nephrology, CHU Rangueil, Toulouse, France
5Department of Hepatology, CHU Purpan, Toulouse, France
6Department of Radiology, CHU Rangueil, Toulouse, France

Tóm tắt

AbstractBackgroundPreoperative 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.MethodsBetween 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.ResultsOf 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.ConclusionsThis 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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