R3-AFP score is a new composite tool to refine prediction of hepatocellular carcinoma recurrence after liver transplantation

Costentin, Charlotte; Boin, I.F.S.F.; Baccaro, Cinzia; Benedetto, Fabrizio Di; Cillo, Umberto; Rubinstein, Fernando; Boudjéma, Karim; Bachellier, Philippe; Conti, Filoména; Scatton, Olivier; Muscari, Fabrice; Salamé, Ephrem; Bernard, Pierre; Francoz, Claire; Durand, François; Dharancy, Sébastien; Woehl, Marie-lorraine; Vanlemmens, Claire; Laurent, Alexis; Radenne, Sylvie; Dumortier, Jérôme; Abergel, Armand; Cherqui, Daniel; Barbier, Louise; Houssel‐Debry, Pauline; Pageaux, Georges Philippe; Chiche, Laurence; Deledinghen, Victor; Hardwigsen, Jean; Gugenheim, Jean; Altieri, Mario; Hilleret, Marie Noelle; Decaens, Thomas; Duvoux, Christophe; Piñero, Federico; Chagas, Aline Lopes; Costa, Paulo; Ataíde, Elaine Cristina de; Quiñones, Emilio; Duque, Sergio Hoyos; Marciano, Sebastián; Anders, Margarita; Varón, Adriana; Zerega, Alina; Poníachik, Jaime; Soza, Alejandro; Machaca, Martín Padilla; Arufe, Diego; Menéndez, J. Carlos; Zapata, Rodrigo; Vilatobá, Mario; Muñoz, Linda; Menéndez, Ricardo Chong; Maraschio, Martín; Podestá, Luis G.; McCormack, Lucas; Mattera, Juan; Gadano, Adrián; Boin, Ilka de Fátima Ferreira; Garcia, José Huygens Parente; Carrilho, Flair José; Silva, Marcelo; Notarpaolo, Andrea; Magini, Giulia; Miglioresi, L.; Gambato, Martina; Benedetto, Fabrizio Di; D’Ambrosio, C.; Ettorre, Giuseppe Maria; Vitale, Alessandro; Burra, Patrizia; Fagiuoli, S.; Cillo, U.; Colledan, M.; Pinelli, D.; Magistri, Paolo; Vennarecci, Giovanni; Colasanti, Marco; Giannelli, V.; Pellicelli, A.; Baccaro, Cizia; Lai, Quirino; Degroote, Helena; Vlierberghe, Hans Van; Callebout, Eduard; Iesari, Samuele; Dekervel, Jeroen; Schreiber, Jonas; Jacques, Pirenne; Verslype, Chris; Dirk, Ysebaert; Peter, Michielsen; Lucidi, Valério; Christophe, Moreno; Olivier, Detry; Delwaide, Jean; Roberto, T.; Paul, Lerut Jan

doi:10.1016/j.jhepr.2022.100445

Cited by 15 publications

(7 citation statements)

References 48 publications

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“…In addition, the R3-AFP predictive model, established using a large and international cohort of patients transplanted for HCC, includes various parameters like the number of nodules, the size of the largest nodule, the presence of microvascular invasion, nuclear grade, and the last pre-liver transplantation AFP value, demonstrating its utility in predicting HCC recurrence after transplantation. 137 Finally, a recent scoring system, RELAPSE, showed an accurate 2- and 5-year recurrence risk discrimination and was consistent with external validation. 138 Notably, the variables, which included AFP were identified through Fine and Gray competing risk analysis and machine-learning algorithms.…”

Section: Afp As a Prognostic Biomarker For Hccsupporting

confidence: 58%

Alpha-fetoprotein: Past, present, and future

Yeo,

Lee,

Tseng

et al. 2024

Hepatology Communications

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Alpha-fetoprotein (AFP) is a glycoprotein that plays an important role in immune regulation with critical involvement in early human development and maintaining the immune balance during pregnancy. Postfetal development, the regulatory mechanisms controlling AFP undergo a shift and AFP gene transcription is suppressed. Instead, these enhancers refocus their activity to maintain albumin gene transcription throughout adulthood. During the postnatal period, AFP expression can increase in the setting of hepatocyte injury, regeneration, and malignant transformation. It is the first oncoprotein discovered and is routinely used as part of a screening strategy for HCC. AFP has been shown to be a powerful prognostic biomarker, and multiple HCC prognosis models confirmed the independent prognostic utility of AFP. AFP is also a useful predictive biomarker for monitoring the treatment response of HCC. In addition to its role as a biomarker, AFP plays important roles in immune modulation to promote tumorigenesis and thus has been investigated as a therapeutic target in HCC. In this review article, we aim to provide an overview of AFP, encompassing the discovery, biological role, and utility as an HCC biomarker in combination with other biomarkers and how it impacts clinical practice and future direction.

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Section: Afp As a Prognostic Biomarker For Hccsupporting

confidence: 58%

Alpha-fetoprotein: Past, present, and future

Yeo,

Lee,

Tseng

et al. 2024

Hepatology Communications

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“…Our analysis further emphasizes the importance of the number of pre-LT treatments to better and more accurately depict patients’ staging and, consequently, their outcomes. In an effort to predict HCC recurrence and based on the different scores based on pathological findings [ 7 , 31 , 32 , 33 ], the number of locoregional treatments before LT could be used as a surrogate for tumor aggressiveness and/or advanced HCC at presentation, such as AFP [ 34 , 35 , 36 , 37 ].…”

Section: Discussionmentioning

confidence: 99%

Impact of Pre-Liver Transplant Treatments on the Imaging Accuracy of HCC Staging and Their Influence on Outcomes

Franchi,

Dondossola,

Marini

et al. 2024

Cancers

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The outcome of liver transplantation (LT) for hepatocarcinoma (HCC) is strongly influenced by HCC staging, which is based on radiological examinations in a pre-LT setting; concordance between pre-LT radiological and definitive pathological staging remains controversial. To address this issue, we retrospectively analyzed our LT series to assess concordance between radiology and pathology and to explore the factors associated with poor concordance and outcomes. We included all LTs with an HCC diagnosis performed between 2013 and 2018. Concordance (Co group) was defined as a comparable tumor burden in preoperative imaging and post-transplant pathology; otherwise, non-concordance was diagnosed (nCo group). Concordance between radiology and pathology was observed in 32/134 patients (Co group, 24%). The number and diameter of the nodules were higher when nCo was diagnosed, as was the number of pre-LT treatments. Although concordance did not affect survival, more than three pre-LT treatments led to a lower disease-free survival. Patients who met the Milan Criteria (Milan-in patients) were more likely to receive ≥three prior treatments, leading to a lower survival in multi-treated Milan-in patients than in other Milan-in patients. In conclusion, the concordance rate between the pre-LT imaging and histopathological results was low in patients with a high number of nodules. Multiple bridging therapies reduce the accuracy of pre-LT imaging in predicting HCC stages and negatively affect outcomes after LT.

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“…These three prediction models incorporated tumor burden, tumor biology, recipient health status, and other parameters (like donor serum sodium), which all showed excellent performance in the recurrence prediction. Moreover, many other models, such as the R3-AFP score 47 and Metroticket 2.0 model 48 , have been built mainly based on tumor burdens and tumor biology. Though the parameters involved were simplified, these models also helped with identifying recipients in high risks for recurrence and making clinical decisions.…”

Section: Discussionmentioning

confidence: 99%

Insights into the history and tendency of liver transplantation for liver cancer: A bibliometric-based visual analysis

He,

Xu,

Tang

et al. 2023

International Journal of Surgery

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Research on liver transplantation (LT) for liver cancer has gained increasing attention. This paper has comprehensively described the current status, hotspots and trends in this field. A total of 2991 relevant articles from January 1, 1963 to February 28, 2023 were obtained from the Web of Science Core Collection. VOSviewer and CiteSpace software were utilized as bibliometric tools to analyze and visualize knowledge mapping. Between 1963 and 2023, the number of papers in the area of LT for liver cancer increased continuously. A total of 70 countries/regions, 2303 institutions and 14840 researchers have published research articles, with the United States and China being the two most productive countries. Our bibliometric-based visual analysis revealed the expansion of LT indications for liver cancer and prevention/treatment of cancer recurrence as ongoing research hotspots over the past decades. Meanwhile, emerging studies also focus on downstaging/bridging treatments before LT and long-term survival of LT recipient, in particular the precise application of immunosuppressants.

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R3-AFP score is a new composite tool to refine prediction of hepatocellular carcinoma recurrence after liver transplantation

Cited by 15 publications

References 48 publications

Alpha-fetoprotein: Past, present, and future

Alpha-fetoprotein: Past, present, and future

Impact of Pre-Liver Transplant Treatments on the Imaging Accuracy of HCC Staging and Their Influence on Outcomes

Insights into the history and tendency of liver transplantation for liver cancer: A bibliometric-based visual analysis

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