Performance of pre-transplant criteria in prediction of hepatocellular carcinoma progression and waitlist dropout / Sergio Iván Hoyos Duque  

Público ISBD Título : Performance of pre-transplant criteria in prediction of hepatocellular carcinoma progression and waitlist dropout Tipo de documento : documento electrónico Autores : Sergio Iván Hoyos Duque, Fecha de publicación : 2022 Títulos uniformes : Liver International Idioma : Inglés (eng) Palabras clave : delisting  liver cancer  outcomes  radiological progression Resumen : Background & aim: Liver transplantation (LT) selection models for hepatocellular carcinoma (HCC) have not been proposed to predict waitlist dropout because of tumour progression. The aim of this study was to compare the alpha-foetoprotein (AFP) model and other pre-LT models in their prediction of HCC dropout. Methods: A multicentre cohort study was conducted in 20 Latin American transplant centres, including 994 listed patients for LT with HCC from 2012 to 2018. Longitudinal tumour characteristics, and patterns of progression were recorded at time of listing, after treatments and at last follow-up over the waitlist period. Competing risk regression models were performed, and model's discrimination was compared estimating Harrell's adapted c-statistics. Results: HCC dropout rate was significantly higher in patients beyond (24% [95% CI 16-28]) compared to those within Milan criteria (8% [95% IC 5%-12%]; p 2 (adjusted SHR of 3.17 [CI 2.13-4.71]), c-index of 0.71 (95% CI 0.65-0.77; p = .09 vs Milan). Similar discrimination power for HCC dropout was observed between the AFP score and the Metroticket 2.0 model. In patients within Milan, an AFP score >2 points discriminated two populations with a higher risk of HCC dropout (SHR 1.68 [95% CI 1.08-2.61]). Conclusions: Pre-transplant selection models similarly predicted HCC dropout. However, the AFP model can discriminate a higher risk of dropout among patients within Milan criteria. Mención de responsabilidad : Federico Piñero, Marcos Thompson, Ilka Boin, Aline Chagas, Emilio Quiñonez, Carla Bermúdez, Mario Vilatobá, Luisa Santos, Margarita Anders, Sergio Hoyos Duque, Agnaldo Soares Lima, Josemaría Menendez, Martín Padilla, Jaime Poniachik, Rodrigo Zapata, Martín Maraschio, Ricardo Chong Menéndez, Linda Muñoz, Diego Arufe, Rodrigo Figueroa, Simone R. Perales, Claudia Maccali, Rodrigo Vergara Sandoval, Lucas McCormack, Adriana Varón, Sebastián Marciano, Juan Mattera, Flair Carrilho, Marcelo Silva Referencia : Liver Int. 2022 Aug;42(8):1879-1890. DOI (Digital Object Identifier) : 10.1111/liv.15223 PMID : 35304813 En línea : https://onlinelibrary.wiley.com/doi/10.1111/liv.15223 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=6091 Performance of pre-transplant criteria in prediction of hepatocellular carcinoma progression and waitlist dropout [documento electrónico] / Sergio Iván Hoyos Duque,  . - 2022. Obra : Liver International Idioma : Inglés (eng) Palabras clave : delisting  liver cancer  outcomes  radiological progression Resumen : Background & aim: Liver transplantation (LT) selection models for hepatocellular carcinoma (HCC) have not been proposed to predict waitlist dropout because of tumour progression. The aim of this study was to compare the alpha-foetoprotein (AFP) model and other pre-LT models in their prediction of HCC dropout. Methods: A multicentre cohort study was conducted in 20 Latin American transplant centres, including 994 listed patients for LT with HCC from 2012 to 2018. Longitudinal tumour characteristics, and patterns of progression were recorded at time of listing, after treatments and at last follow-up over the waitlist period. Competing risk regression models were performed, and model's discrimination was compared estimating Harrell's adapted c-statistics. Results: HCC dropout rate was significantly higher in patients beyond (24% [95% CI 16-28]) compared to those within Milan criteria (8% [95% IC 5%-12%]; p 2 (adjusted SHR of 3.17 [CI 2.13-4.71]), c-index of 0.71 (95% CI 0.65-0.77; p = .09 vs Milan). Similar discrimination power for HCC dropout was observed between the AFP score and the Metroticket 2.0 model. In patients within Milan, an AFP score >2 points discriminated two populations with a higher risk of HCC dropout (SHR 1.68 [95% CI 1.08-2.61]). Conclusions: Pre-transplant selection models similarly predicted HCC dropout. However, the AFP model can discriminate a higher risk of dropout among patients within Milan criteria. Mención de responsabilidad : Federico Piñero, Marcos Thompson, Ilka Boin, Aline Chagas, Emilio Quiñonez, Carla Bermúdez, Mario Vilatobá, Luisa Santos, Margarita Anders, Sergio Hoyos Duque, Agnaldo Soares Lima, Josemaría Menendez, Martín Padilla, Jaime Poniachik, Rodrigo Zapata, Martín Maraschio, Ricardo Chong Menéndez, Linda Muñoz, Diego Arufe, Rodrigo Figueroa, Simone R. Perales, Claudia Maccali, Rodrigo Vergara Sandoval, Lucas McCormack, Adriana Varón, Sebastián Marciano, Juan Mattera, Flair Carrilho, Marcelo Silva Referencia : Liver Int. 2022 Aug;42(8):1879-1890. DOI (Digital Object Identifier) : 10.1111/liv.15223 PMID : 35304813 En línea : https://onlinelibrary.wiley.com/doi/10.1111/liv.15223 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=6091

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Recurrence of hepatocellular carcinoma after liver transplantation: Prognostic and predictive factors of survival in a Latin American cohort / Sergio Iván Hoyos Duque  

Público ISBD Título : Recurrence of hepatocellular carcinoma after liver transplantation: Prognostic and predictive factors of survival in a Latin American cohort Tipo de documento : documento electrónico Autores : Sergio Iván Hoyos Duque, Fecha de publicación : 2021 Títulos uniformes : Liver International Idioma : Inglés (eng) Palabras clave : hepatocellular carcinoma  liver transplantation  prognosis  recurrence  treatment Resumen : Background & aim: Recurrence of hepatocellular carcinoma (HCC) after liver transplantation (LT) has a poor prognosis, and the adjusted effect of different treatments on post-recurrence survival (PRS) has not been well defined. This study aims to evaluate prognostic and predictive variables associated with PRS. Methods: This Latin American multicenter retrospective cohort study included HCC patients who underwent LT between the years 2005-2018. We evaluated the effect of baseline characteristics at time of HCC recurrence diagnosis and PRS (Cox regression analysis). Early recurrences were those occurring within 12 months of LT. To evaluate the adjusted treatment effect for HCC recurrence, a propensity score matching analysis was performed to assess the probability of having received any specific treatment for recurrence. Results: From a total of 1085 transplanted HCC patients, the cumulative incidence of recurrence was 16.6% (CI 13.5-20.3), with median time to recurrence of 13.0 months (IQR 6.0-26.0). Factors independently associated with PRS were early recurrence (47.6%), treatment with sorafenib and surgery/trans-arterial chemoembolization (TACE). Patients who underwent any treatment presented "early recurrences" less frequently, and more extrahepatic metastasis. This unbalanced distribution was included in the propensity score matching, with correct calibration and discrimination (receiving operator curve of 0.81 [CI 0.72;0.88]). After matching, the adjusted effect on PRS for any treatment was HR of 0.2 (0.10;0.33); P Mención de responsabilidad : Claudia Maccali, Aline L Chagas, Ilka Boin, Emilio Quiñonez, Sebastián Marciano, Mario Vilatobá, Adriana Varón, Margarita Anders, Sergio Hoyos Duque, Agnaldo S Lima, Josemaría Menendez, Martín Padilla-Machaca, Jaime Poniachik, Rodrigo Zapata, Martín Maraschio, Ricardo Chong Menéndez, Linda Muñoz, Diego Arufe, Rodrigo Figueroa, Alejandro Soza, Martín Fauda, Simone R Perales, Rodrigo Vergara Sandoval, Carla Bermudez, Oscar Beltran, Isabel Arenas Hoyos, Lucas McCormack, Francisco Juan Mattera, Adrián Gadano, Jose H Parente García , Claudia Megumi Tani, Luiz Augusto Carneiro D'Albuquerque, Flair J Carrilho, Marcelo Silva, Federico Piñero Referencia : Liver Int. 2021 Apr;41(4):851-862. DOI (Digital Object Identifier) : 10.1111/liv.14736 PMID : 33217193 En línea : https://onlinelibrary.wiley.com/doi/10.1111/liv.14736 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=5193 Recurrence of hepatocellular carcinoma after liver transplantation: Prognostic and predictive factors of survival in a Latin American cohort [documento electrónico] / Sergio Iván Hoyos Duque,  . - 2021. Obra : Liver International Idioma : Inglés (eng) Palabras clave : hepatocellular carcinoma  liver transplantation  prognosis  recurrence  treatment Resumen : Background & aim: Recurrence of hepatocellular carcinoma (HCC) after liver transplantation (LT) has a poor prognosis, and the adjusted effect of different treatments on post-recurrence survival (PRS) has not been well defined. This study aims to evaluate prognostic and predictive variables associated with PRS. Methods: This Latin American multicenter retrospective cohort study included HCC patients who underwent LT between the years 2005-2018. We evaluated the effect of baseline characteristics at time of HCC recurrence diagnosis and PRS (Cox regression analysis). Early recurrences were those occurring within 12 months of LT. To evaluate the adjusted treatment effect for HCC recurrence, a propensity score matching analysis was performed to assess the probability of having received any specific treatment for recurrence. Results: From a total of 1085 transplanted HCC patients, the cumulative incidence of recurrence was 16.6% (CI 13.5-20.3), with median time to recurrence of 13.0 months (IQR 6.0-26.0). Factors independently associated with PRS were early recurrence (47.6%), treatment with sorafenib and surgery/trans-arterial chemoembolization (TACE). Patients who underwent any treatment presented "early recurrences" less frequently, and more extrahepatic metastasis. This unbalanced distribution was included in the propensity score matching, with correct calibration and discrimination (receiving operator curve of 0.81 [CI 0.72;0.88]). After matching, the adjusted effect on PRS for any treatment was HR of 0.2 (0.10;0.33); P Mención de responsabilidad : Claudia Maccali, Aline L Chagas, Ilka Boin, Emilio Quiñonez, Sebastián Marciano, Mario Vilatobá, Adriana Varón, Margarita Anders, Sergio Hoyos Duque, Agnaldo S Lima, Josemaría Menendez, Martín Padilla-Machaca, Jaime Poniachik, Rodrigo Zapata, Martín Maraschio, Ricardo Chong Menéndez, Linda Muñoz, Diego Arufe, Rodrigo Figueroa, Alejandro Soza, Martín Fauda, Simone R Perales, Rodrigo Vergara Sandoval, Carla Bermudez, Oscar Beltran, Isabel Arenas Hoyos, Lucas McCormack, Francisco Juan Mattera, Adrián Gadano, Jose H Parente García , Claudia Megumi Tani, Luiz Augusto Carneiro D'Albuquerque, Flair J Carrilho, Marcelo Silva, Federico Piñero Referencia : Liver Int. 2021 Apr;41(4):851-862. DOI (Digital Object Identifier) : 10.1111/liv.14736 PMID : 33217193 En línea : https://onlinelibrary.wiley.com/doi/10.1111/liv.14736 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=5193

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International and multicenter real‐world study of sorafenib‐treated patients with hepatocellular carcinoma under dialysis / Juan Ignacio Marín Zuluaga  

Público ISBD Título : International and multicenter real‐world study of sorafenib‐treated patients with hepatocellular carcinoma under dialysis Tipo de documento : documento electrónico Autores : Juan Ignacio Marín Zuluaga, Fecha de publicación : 2020 Títulos uniformes : Liver International Idioma : Inglés (eng) Palabras clave : Hepatocellular carcinoma  sorafenib  dialysis  adverse events  safety  survival Resumen : Background & Aims: Information on safety and efficacy of systemic treatment in patients with hepatocellular carcinoma (HCC) under dialysis are limited due to patient exclusion from clinical trials. Thus, we aimed to evaluate the rate, prevalence, tolerability, and outcome of sorafenib in this population. Methods: We report a multicenter study comprising patients from Latin America and Europe. Patients treated with sorafenib were enrolled; demographics, dose modifications, adverse events (AEs), treatment duration, and outcome of patients undergoing dialysis were recorded. Results: As of March 2018, 6156 HCC patients were treated in 44 centres and 22 patients were concomitantly under dialysis (0.36%). The median age was 65.5 years, 40.9% had hepatitis C, 75% had Child‐Pugh A, and 85% were Barcelona Clinic Liver Cancer‐C. The median time to first dose modification, treatment duration and overall survival rate were 2.4 months (interquartile ranges [IQR], 0.8‐3.8), 10.8 months (IQR, 4.5‐16.9), and 17.5 months (95% CI, 7.2‐24.5), respectively. Seventeen patients required at least 1 dose modification. The main causes of first dose modification were asthenia/worsening of Eastern Cooperative Oncology Group‐Performance Status and diarrhoea. At the time of death or last follow‐up, four patients were still on treatment and 18 had discontinued sorafenib: 14 were due to tumour progression, 2 were sorafenib‐related, and 2 were non‐sorafenib‐related AE. Conclusions: The outcomes observed in this cohort seem comparable to those in the non‐dialysis population. Thus, to the best of our knowledge, this is the largest and most informative dataset regarding systemic treatment outcomes in HCC patients undergoing dialysis. Mención de responsabilidad : Álvaro Díaz-González, Marco Sanduzzi-Zamparelli, Leonardo G da Fonseca, Giovan G Di Costanzo, Rogerio Alves, Massimo Iavarone, Cassia Leal, Rodolfo Sacco, Ana M Matilla, Manuel Hernández-Guerra, Gabriel Aballay Soteras, Marcus-Alexander Wörns, Matthias Pinter, María Varela, Morten Ladekarl, Aline L Chagas, Beatriz Mínguez, Juan I Arenas, Alessandro Granito, Yolanda Sánchez-Torrijos, Ángela Rojas, Carlos Rodríguez de Lope, Mario R Alvares-da-Silva, Sonia Pascual, Lorenza Rimassa, José L Lledó, Carlos Huertas, Bruno Sangro, Edoardo G Giannini, Manuel Delgado, Mercedes Vergara, Christie Perelló, Alberto Lue, Margarita Sala, Adolfo Gallego, Susanna Coll, Tania Hernáez, Federico Piñero, Gustavo Pereira, Alex França, Juan Marín, Margarita Anders, Vivianne Mello, Mar Lozano, Jean C Nault, Josemaría Menéndez, Ignacio García Juárez, Jordi Bruix, María Reig Referencia : Liver Int. 2020 Jun;40(6):1467-1476. DOI (Digital Object Identifier) : 10.1111/liv.14436 PMID : 32170821 En línea : https://onlinelibrary.wiley.com/doi/epdf/10.1111/liv.14436 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=5102 International and multicenter real‐world study of sorafenib‐treated patients with hepatocellular carcinoma under dialysis [documento electrónico] / Juan Ignacio Marín Zuluaga,  . - 2020. Obra : Liver International Idioma : Inglés (eng) Palabras clave : Hepatocellular carcinoma  sorafenib  dialysis  adverse events  safety  survival Resumen : Background & Aims: Information on safety and efficacy of systemic treatment in patients with hepatocellular carcinoma (HCC) under dialysis are limited due to patient exclusion from clinical trials. Thus, we aimed to evaluate the rate, prevalence, tolerability, and outcome of sorafenib in this population. Methods: We report a multicenter study comprising patients from Latin America and Europe. Patients treated with sorafenib were enrolled; demographics, dose modifications, adverse events (AEs), treatment duration, and outcome of patients undergoing dialysis were recorded. Results: As of March 2018, 6156 HCC patients were treated in 44 centres and 22 patients were concomitantly under dialysis (0.36%). The median age was 65.5 years, 40.9% had hepatitis C, 75% had Child‐Pugh A, and 85% were Barcelona Clinic Liver Cancer‐C. The median time to first dose modification, treatment duration and overall survival rate were 2.4 months (interquartile ranges [IQR], 0.8‐3.8), 10.8 months (IQR, 4.5‐16.9), and 17.5 months (95% CI, 7.2‐24.5), respectively. Seventeen patients required at least 1 dose modification. The main causes of first dose modification were asthenia/worsening of Eastern Cooperative Oncology Group‐Performance Status and diarrhoea. At the time of death or last follow‐up, four patients were still on treatment and 18 had discontinued sorafenib: 14 were due to tumour progression, 2 were sorafenib‐related, and 2 were non‐sorafenib‐related AE. Conclusions: The outcomes observed in this cohort seem comparable to those in the non‐dialysis population. Thus, to the best of our knowledge, this is the largest and most informative dataset regarding systemic treatment outcomes in HCC patients undergoing dialysis. Mención de responsabilidad : Álvaro Díaz-González, Marco Sanduzzi-Zamparelli, Leonardo G da Fonseca, Giovan G Di Costanzo, Rogerio Alves, Massimo Iavarone, Cassia Leal, Rodolfo Sacco, Ana M Matilla, Manuel Hernández-Guerra, Gabriel Aballay Soteras, Marcus-Alexander Wörns, Matthias Pinter, María Varela, Morten Ladekarl, Aline L Chagas, Beatriz Mínguez, Juan I Arenas, Alessandro Granito, Yolanda Sánchez-Torrijos, Ángela Rojas, Carlos Rodríguez de Lope, Mario R Alvares-da-Silva, Sonia Pascual, Lorenza Rimassa, José L Lledó, Carlos Huertas, Bruno Sangro, Edoardo G Giannini, Manuel Delgado, Mercedes Vergara, Christie Perelló, Alberto Lue, Margarita Sala, Adolfo Gallego, Susanna Coll, Tania Hernáez, Federico Piñero, Gustavo Pereira, Alex França, Juan Marín, Margarita Anders, Vivianne Mello, Mar Lozano, Jean C Nault, Josemaría Menéndez, Ignacio García Juárez, Jordi Bruix, María Reig Referencia : Liver Int. 2020 Jun;40(6):1467-1476. DOI (Digital Object Identifier) : 10.1111/liv.14436 PMID : 32170821 En línea : https://onlinelibrary.wiley.com/doi/epdf/10.1111/liv.14436 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=5102

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Liver transplantation for hepatocellular carcinoma: evaluation of the alpha-fetoprotein model in a multicenter cohort from Latin America / Sergio Iván Hoyos Duque  

Público ISBD Título : Liver transplantation for hepatocellular carcinoma: evaluation of the alpha-fetoprotein model in a multicenter cohort from Latin America Tipo de documento : documento electrónico Autores : Sergio Iván Hoyos Duque, Fecha de publicación : 2016 Títulos uniformes : Liver International Idioma : Inglés (eng) Palabras clave : Alpha-fetoprotein  candidate selection  liver cancer  prediction Resumen : Background & Aims: The French alpha‐fetoprotein (AFP) model has recently shown superior results compared to Milan criteria (MC) for prediction of hepatocellular carcinoma (HCC) recurrence after liver transplantation (LT) in European populations. The aim of this study was to explore the predictive capacity of the AFP model for HCC recurrence in a Latin American cohort. Methods: Three hundred twenty‐seven patients with HCC were included from a total of 2018 patients transplanted at 15 centres. Serum AFP and imaging data were both recorded at listing. Predictability was assessed by the Net Reclassification Improvement (NRI) method. Results: Overall, 82 and 79% of the patients were within MC and the AFP model respectively. NRI showed a superior predictability of the AFP model against MC. Patients with an AFP score >2 points had higher risk of recurrence at 5 years Hazard Ratio (HR) of 3.15 (P = 0.0001) and lower patient survival (HR = 1.51; P = 0.03). Among patients exceeding MC, a score ≤2 points identified a subgroup of patients with lower recurrence (5% vs 42%; P = 0.013) and higher survival rates (84% vs 45%; P = 0.038). In cases treated with bridging procedures, following restaging, a score >2 points identified a higher recurrence (HR 2.2, P = 0.12) and lower survival rate (HR 2.25, P = 0.03). A comparative analysis between HBV and non‐HBV patients showed that the AFP model performed better in non‐HBV patients. Conclusions: The AFP model could be useful in Latin‐American countries to better select patients for LT in subgroups presenting with extended criteria. However, particular attention should be focused on patients with HBV. Mención de responsabilidad : Federico Piñero, Matías Tisi Baña, Elaine Cristina de Ataide, Sergio Hoyos Duque, Sebastian Marciano, Adriana Varón, Margarita Anders, Alina Zerega, Josemaría Menéndez, Rodrigo Zapata, Linda Muñoz, Martín Padilla Machaca, Alejandro Soza, Lucas McCormack, Jaime Poniachik, Luis G Podestá, Adrian Gadano, Ilka S F Fatima Boin, Christophe Duvoux, Marcelo Silva, Latin American Liver Research, Education and Awareness Network LALREAN Referencia : Liver Int. 2016 Nov;36(11):1657-1667. DOI (Digital Object Identifier) : 10.1111/liv.13159 PMID : 27169841 En línea : https://onlinelibrary.wiley.com/doi/abs/10.1111/liv.13159 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=3982 Liver transplantation for hepatocellular carcinoma: evaluation of the alpha-fetoprotein model in a multicenter cohort from Latin America [documento electrónico] / Sergio Iván Hoyos Duque,  . - 2016. Obra : Liver International Idioma : Inglés (eng) Palabras clave : Alpha-fetoprotein  candidate selection  liver cancer  prediction Resumen : Background & Aims: The French alpha‐fetoprotein (AFP) model has recently shown superior results compared to Milan criteria (MC) for prediction of hepatocellular carcinoma (HCC) recurrence after liver transplantation (LT) in European populations. The aim of this study was to explore the predictive capacity of the AFP model for HCC recurrence in a Latin American cohort. Methods: Three hundred twenty‐seven patients with HCC were included from a total of 2018 patients transplanted at 15 centres. Serum AFP and imaging data were both recorded at listing. Predictability was assessed by the Net Reclassification Improvement (NRI) method. Results: Overall, 82 and 79% of the patients were within MC and the AFP model respectively. NRI showed a superior predictability of the AFP model against MC. Patients with an AFP score >2 points had higher risk of recurrence at 5 years Hazard Ratio (HR) of 3.15 (P = 0.0001) and lower patient survival (HR = 1.51; P = 0.03). Among patients exceeding MC, a score ≤2 points identified a subgroup of patients with lower recurrence (5% vs 42%; P = 0.013) and higher survival rates (84% vs 45%; P = 0.038). In cases treated with bridging procedures, following restaging, a score >2 points identified a higher recurrence (HR 2.2, P = 0.12) and lower survival rate (HR 2.25, P = 0.03). A comparative analysis between HBV and non‐HBV patients showed that the AFP model performed better in non‐HBV patients. Conclusions: The AFP model could be useful in Latin‐American countries to better select patients for LT in subgroups presenting with extended criteria. However, particular attention should be focused on patients with HBV. Mención de responsabilidad : Federico Piñero, Matías Tisi Baña, Elaine Cristina de Ataide, Sergio Hoyos Duque, Sebastian Marciano, Adriana Varón, Margarita Anders, Alina Zerega, Josemaría Menéndez, Rodrigo Zapata, Linda Muñoz, Martín Padilla Machaca, Alejandro Soza, Lucas McCormack, Jaime Poniachik, Luis G Podestá, Adrian Gadano, Ilka S F Fatima Boin, Christophe Duvoux, Marcelo Silva, Latin American Liver Research, Education and Awareness Network LALREAN Referencia : Liver Int. 2016 Nov;36(11):1657-1667. DOI (Digital Object Identifier) : 10.1111/liv.13159 PMID : 27169841 En línea : https://onlinelibrary.wiley.com/doi/abs/10.1111/liv.13159 Enlace permanente : https://hospitalpablotobon.cloudbiteca.com/pmb/opac_css/index.php?lvl=notice_display&id=3982

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