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