Alpha-fetoprotein and 18F-FDG standard uptake value predict tumor recurrence after liver transplantation for hepatocellular carcinoma with portal vein tumor thrombosis: Preliminary experience.

Yang, Zhe;Luo, Fang-Zhou;Wang, Shuo;Lerut, Jan;Zheng, Shu-Sen;et.al.
(2020) HPB : the official journal of the International Hepato Pancreato Biliary Association — Vol. 19, n° 3, p. 229-234 (2020)

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  • Yang, Zhe
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  • Luo, Fang-Zhou
    Author
  • Wang, Shuo
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  • Lerut, Janorcid-logoUCLouvain
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  • Zheng, Shu-Sen
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Abstract
(en) BACKGROUND: Portal vein tumor thrombosis (PVTT) is regarded as a contraindication for liver transplantation (LT) in hepatocellular carcinoma (HCC). However, some of these patients may have a favorable prognosis after LT. In this study, we evaluated the biological behavior of HCC with PVTT using tumor biomarker (alpha-fetoprotein, AFP) and 18F-FDG positron emission tomography (tumor standard uptake value) to identify a subset of patients who may be suitable for LT. METHODS: Seventy-five HCC-PVTT liver recipients transplanted during February 2016 and June 2018 were analyzed. Different pre-transplant prognostic factors were identified by univariate and multivariate analyses. PVTT status was identified following Vp classification (Vp1-Vp4). RESULTS: Three-year recurrence-free survival and overall survival rates were 40% and 65.4% in Vp2-Vp3 PVTT patients, 21.4% and 30.6% in Vp4 PVTT patients (P < 0.05). Total tumor diameter >8 cm, pre-transplant AFP level >1000 ng/mL and intrahepatic tumor maximal standard uptake value (SUVmax-tumor >5) were independent risk factors for HCC recurrence and overall survival after LT in Vp2-3 PVTT patients. Low risk patients were defined as total tumor diameter ≤8 cm; or if total tumor diameter more than 8 cm, with both pre-transplant AFP level less than 1000 ng/mL and intrahepatic tumor SUVmax less than 5, simultaneously. Twenty-two Vp2-3 PVTT HCC patients (46.8%) were identified as low risk patients, and their 3-year recurrence-free and overall survival rates were 67.6% and 95.2%, respectively. CONCLUSIONS: Patients with segmental or lobar PVTT and biologically favorable tumors defined by AFP and 18F-FDG SUVmax might be suitable for LT.
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Yang, Z., Luo, F.-Z., Wang, S., Lerut, J., Zhuang, L., Li, Q.-Y., Xu, X., & Zheng, S.-S. (2020). Alpha-fetoprotein and 18F-FDG standard uptake value predict tumor recurrence after liver transplantation for hepatocellular carcinoma with portal vein tumor thrombosis: Preliminary experience. HPB : the official journal of the International Hepato Pancreato Biliary Association, 19(3), 229-234. https://doi.org/10.1016/j.hbpd.2020.03.009 (Original work published 2020)