Prognostic Impact of Intraoperative Blood Loss in Liver Transplant Patients with Advanced Hepatocellular Carcinoma Blood Loss and HCC Recurrence

Kornberg, Arno; Witt, Ulrike; Kornberg, Jennifer; Ceyhan, Güralp O.; Mueller, Katharina; Frieß, Helmut; Thrum, Katharina

doi:10.21873/anticanres.11109

Cited by 13 publications

(15 citation statements)

References 38 publications

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“…Along with PET-status, tumor grading and AFP level, IOBL was identified as an independent predictor of cancer-specific survival. Furthermore, IOBL correlated independently with cancer relapse in unfavourable tumor phenotypes, such as Milan Out and PET+ tumors, but not in low-risk HCC [127] .…”

Section: Impact Of Intraoperative Blood Loss and Red Blood Cell Tramentioning

confidence: 90%

“…Kornberg et al . [127] 111 Post-LT RFS rates at 3 and 5 years' post-LT were 91.9% and 91.9% in IOBL ≤ 1500 mL, but only 43.9% and 37.1% in IOBL > 1500 mL (P < 0.001). IOBL was identified as independent predictor of beneficial RFS (HR = 3.91; 1.442-17.185; P = 0.011) and PET+ patients (HR = 2.98; 95%CI 1.071-8.280; P = 0.037) Nagai et al .…”

Section: Reference Nmentioning

confidence: 94%

“…We have recently studied the impact of IOBL with a cut-off value of 1500 mL in 111 LT patients with HCC [127] . Post-LT RFS rates at 3 and 5 years were 91.9% and 91.9% in the low, but only 43.9% and 37.1% in the high IOBL subset (P < 0.001).…”

Section: Impact Of Intraoperative Blood Loss and Red Blood Cell Tramentioning

confidence: 99%

“…Enhanced spread of occult cancer cells, aggravation of I/R injury to the graft and induction of proinflammatory and immunosuppressive mechanisms are currently discussed as underlying cancerogenic mechanisms [125][126][127][128][129] . Apart from that, IOBL increases the need of red blood cell transfusion, which in turn enhances the oncological risk by induction of pro-inflammatory and immunosuppressive mechanisms [130,131] .…”

Section: Impact Of Intraoperative Blood Loss and Red Blood Cell Tramentioning

confidence: 99%

“…The negative prognostic impact of blood transfusion was particularly evident in patients with vascular invasion. We have recently identified application of > 3 red blood cell units as significant and independent prognostic factor in patients with Milan Out HCC and patients with PET-positive tumors [127] .…”

Section: Impact Of Intraoperative Blood Loss and Red Blood Cell Tramentioning

confidence: 99%

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Liver transplantation for hepatocellular carcinoma - non-cancer factors and implications for improving outcome beyond standard tumor criteria

Kornberg¹,

Schernhammer²

2018

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How to cite this article: Kornberg A, Schernhammer M. Liver transplantation for hepatocellular carcinoma -non-cancer factors and implications for improving outcome beyond standard tumor criteria. Hepatoma Res 2018;4:60. http://dx. AbstractLiver transplantation (LT) is recognized as best treatment option in patients with early hepatocellular cancer (HCC) in underlying liver cirrhosis. Apart from tumor size and number implemented in the Milan criteria, which are current worldwide standards for patient selection, several biological tumor factors have been identified to affect cancer-specific outcome. In particular, grading and vascular tumor invasions were shown to correlate with aggressive biological tumor behavior and poor survival following LT. Identifying tumors with favorable biology is one important approach for expanding the pool of eligible liver recipients beyond the Milan burden limits. Improving the immunological state and condition for appropriate defense against circulating cancer cell attack may be another important prognostic aspect. Therefore, there is increasing interest in non-cancer factors related to the peritransplant period that may influence the oncological outcome by providing negative immunomodulatory actions. Considering and modulation of these non-HCC factors of prognosis might contribute in safely expanding the HCC LT selection criteria.

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Section: Impact Of Intraoperative Blood Loss and Red Blood Cell Tramentioning

confidence: 90%

Section: Reference Nmentioning

confidence: 94%

Section: Impact Of Intraoperative Blood Loss and Red Blood Cell Tramentioning

confidence: 99%

Section: Impact Of Intraoperative Blood Loss and Red Blood Cell Tramentioning

confidence: 99%

Section: Impact Of Intraoperative Blood Loss and Red Blood Cell Tramentioning

confidence: 99%

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Liver transplantation for hepatocellular carcinoma - non-cancer factors and implications for improving outcome beyond standard tumor criteria

Kornberg¹,

Schernhammer²

2018

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The role of preoperative albumin‐bilirubin grade for oncological risk stratification in liver transplant patients with hepatocellular carcinoma

Kornberg

Witt

Schernhammer

et al. 2019

Journal of Surgical Oncology

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Background and Objectives: Albumin-bilirubin (ALBI) score was shown to correlate with liver function and tumor recurrence after hepatectomy for hepatocellular carcinoma (HCC). The aim of this study was to assess the prognostic value of ALBI grade in liver transplantation (LT) patients with HCC.Methods: Pre-LT available independent predictors of recurrence-free survival (RFS) and microvascular tumor invasion (MVI) were determined in 123 patients with HCC.Results: Posttransplant HCC recurrence rates were 10.5%, 15.9%, and 68.2% in ALBI grade 1, 2, and 3, respectively (P < .001). Along with serum α-fetoprotein (AFP) and Creactive protein (CRP) levels, ALBI grades 1 or 2 was identified as an independent predictor of RFS (hazard ratio, 3.52; 95% confidence interval [CI], 1.577-7.842; P = .002). Furthermore, ALBI grade 3 proved to be the strongest indicator of MVI (odds ratio, 11.59; 95% CI, 3.412-39.381; P < .001). A novel oncological risk scorebased on AFP, CRP, and ALBI grade provided the best discriminative capacity (cstatistic 0.806) in selecting liver recipients with low oncological risk profile.Conclusion: Preoperative ALBI grade seems to be valuable for refinement of oncological risk stratification at LT for HCC. K E Y W O R D Salbumin-bilirubin grade, hepatocellular carcinoma, liver transplantation, microvascular invasion, tumor recurrence

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A practical recurrence risk model based on Lasso-Cox regression for gastric cancer

Huang,

Ding,

2023

J Cancer Res Clin Oncol

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Prognostic Impact of Intraoperative Blood Loss in Liver Transplant Patients with Advanced Hepatocellular Carcinoma Blood Loss and HCC Recurrence

Abstract: Intraoperative bleeding is associated with increased likelihood of tumor recurrence following LT for HCC. Limiting IOBL should be considered for improving post-LT outcome, particularly in patients with HCC beyond standard criteria.

Cited by 13 publications

References 38 publications

Liver transplantation for hepatocellular carcinoma - non-cancer factors and implications for improving outcome beyond standard tumor criteria

Liver transplantation for hepatocellular carcinoma - non-cancer factors and implications for improving outcome beyond standard tumor criteria

The role of preoperative albumin‐bilirubin grade for oncological risk stratification in liver transplant patients with hepatocellular carcinoma

A practical recurrence risk model based on Lasso-Cox regression for gastric cancer

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