Des-Gamma-Carboxy Prothrombin in Hepatocellular Cancer Patients Waiting for Liver Transplant: A Systematic Review and Meta-Analysis

Lai, Quirino; Iesari, Samuele; Sandri, Giovanni Battista Levi; Lerut, Jan

doi:10.5301/ijbm.5000276

Cited by 40 publications

(41 citation statements)

References 21 publications

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“…Curiously, none of the aforementioned Guidelines focused on other biomarkers, despite recent (merely Eastern) studies confirming the remarkable role of PIVKA-II in the prediction of post-LT recurrence (32). Also of note the complete absence of inflammatory markers as possible tools for identifying outcome of HCC patients (33).…”

Section: Afp and Its Prognostic Value In Ltmentioning

confidence: 99%

“…It is still believed that PIVKA-II is not available in the Western world: however, a slightly growing but consistent number of articles coming from Europe and US have been recently reported, mainly thanks to the possibility to dose DCP also in Western countries (Wako Chemicals GmbH, Neuss, GERMANY) (32,34,35). Another recurring argument is that it is frequently said that Eastern and Western HCC patients are different.…”

Section: Afp and Its Prognostic Value In Ltmentioning

confidence: 99%

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The growing impact of alpha-fetoprotein in the field of liver transplantation for hepatocellular cancer: time for a revolution

Lai

Iesari²,

Melandro

et al. 2017

Transl. Gastroenterol. Hepatol.

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The role of alpha-fetoprotein (AFP) in the specific setting of the diagnosis and prognosis of patients with hepatocellular cancer (HCC) waiting for liver transplantation (LT) is still controversial. Recently, a marked interest for this marker has been reported, mainly related to its ability to predict the outcome of HCC patients after LT. The growing number of papers in PubMed indicates that AFP has begun a "second life" in the particular context of LT. Looking at the most recent International Guidelines on HCC, it looks obvious that time is ripe to reevaluate the value of AFP in relation to its prognostic ability to identify HCC patients at high-risk for drop-out before and recurrence after LT. Many discrepancies exist worldwide regarding the use of biomarkers in HCC. In contrast to the Western world, AFP is widely used in Asian countries, the reason why being unclear. Indeed, in the (merely Western-dominated) HCC treatment algorithms, the role of AFP as a prognostic tumor marker is still considered to be "under investigation". One should however realize that the underestimation of the value of AFP in the LT context will hamper further refinements of both the liver allograft allocation process and the selection of the best candidates for this procedure. Moreover, AFP has an important role to play in the monitoring of bridging and/or downstaging procedures bringing eventually the patient to transplantation. So, time has come to reconsider the role and value of AFP (dynamics) in the field of transplant oncology.

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Section: Afp and Its Prognostic Value In Ltmentioning

confidence: 99%

Section: Afp and Its Prognostic Value In Ltmentioning

confidence: 99%

The growing impact of alpha-fetoprotein in the field of liver transplantation for hepatocellular cancer: time for a revolution

Lai

Iesari²,

Melandro

et al. 2017

Transl. Gastroenterol. Hepatol.

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“…The use of tumor‐marker des‐gamma‐carboxy prothrombin (DCP) as a predictor of risk of HCC recurrence after LT has also recently gained interest. In a meta‐analysis, DCP was a useful predictive factor indicating a 5‐fold increased risk for recurrence after transplantation . These markers, such as AFP and DCP, may represent a way to further refine selection criteria for LT based on tumor biology.…”

Section: The Development Of Modern‐day Criteriamentioning

confidence: 99%

Evolving thresholds for liver transplantation in hepatocellular carcinoma: A Western experience

Yopp

2020

Annals of Gastroent Surgery

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Hepatocellular carcinoma (HCC) is the second leading cause of cancer-related deaths worldwide. Once considered an experimental treatment with dismal survival rates, liver transplantation for HCC entered a new era with the establishment of the Milan criteria over 20 years ago. In the modern post-Milan-criteria era, 5-year survival outcomes are now upwards of 70% in select patients. Liver transplantation (LT) is now considered the optimal treatment for patients with moderate to severe cirrhosis and HCC, and the rates of transplantation in the United States are continuing to rise. Several expanded selection criteria have been proposed for determining which patients with HCC should be candidates for undergoing LT with similar overall and recurrence-free survival rates to patients within the Milan criteria. There is also a growing experience with downstaging of patients who fall outside conventional LT criteria at the time of HCC diagnosis with the goal of tumor shrinkage via locoregional therapies to become a candidate for transplantation. The aim of this review article is to characterize the various patient selection criteria for LT, discuss balancing organ stewardship with outcome measures in HCC patients, present evidence on the role of downstaging for large tumors, and explore future directions of LT for HCC.

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“…Authors advertise the Kyushu criteria as the most potent predictive criteria for post-LT HCC recurrence. However, this last two criteria deriving on Japanese studies were achieved in the setting of LDLT only and needs additional validation in the Western world both in the context of LDLT and post-mortem donor LT (15).…”

Section: A Third Elementmentioning

confidence: 99%

Liver transplant for patients outside Milan criteria

Sandri¹,

Rayar

Qi³

et al. 2018

Transl. Gastroenterol. Hepatol

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Hepatocellular carcinoma (HCC) is one of the most indication to Liver Transplantation (LT). Milan criteria are worldwide accepted as the gold standard for LT indication for HCC. Nevertheless, expanded criteria are often used to transplant patient outside Milan. We described the most important proposed criteria outside Milan criteria. From the University of California San Francisco, to the Toronto criteria. From East to Western, and for living donor liver transplantation. In order to achieve similar results the downstaging strategy is more frequently used and for patients with locally advanced HCC. Carefully selected patients beyond the traditional criteria for transplantation may achieve excellent LT outcomes through a planned, multidisciplinary approach to treatment.

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Des-Gamma-Carboxy Prothrombin in Hepatocellular Cancer Patients Waiting for Liver Transplant: A Systematic Review and Meta-Analysis

Cited by 40 publications

References 21 publications

The growing impact of alpha-fetoprotein in the field of liver transplantation for hepatocellular cancer: time for a revolution

The growing impact of alpha-fetoprotein in the field of liver transplantation for hepatocellular cancer: time for a revolution

Evolving thresholds for liver transplantation in hepatocellular carcinoma: A Western experience

Liver transplant for patients outside Milan criteria

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