Prognostic Value of Pre-transplantation Serum Alpha-Fetoprotein Levels in Hepatocellular Carcinoma Recurrence

Autores de IIS La Fe

• Eva María Montalvá Orón

  Autor

• Andrea Boscà Robledo

  Autor

• Ángel Rubín Suárez

  Autor

• Carmen Vinaixa Aunés

  Autor

• Pablo Granero Castro

  Autor

• Javier Maupoey Ibáñez

  Autor

• Rafael López Andújar

  Autor

Participantes ajenos a IIS La Fe

• Cantos M

Grupos

• Hepatología experimental y Trasplante hepático

• Hepatología, Cirugia Hepatobiliopancreática y Trasplantes

Abstract

Serum alpha-fetoprotein (AFP) value is still not included in the consensus guidelines to make decisions referring to liver transplantation (LT) for hepatocellular carcinoma (HCC). Many studies demonstrated the influence of high AFP level in poor prognosis after LT for HCC. We studied 301 consecutive recipients transplanted for HCC from January 2002 to December 2011. The median follow-up was 64.3 months (interquartile range, 41.6-90.8). HCC recurrence was 31.6% when AFP was >400 ng/mL and 50% when AFP was >1,000 ng/mL. Specificity to predict HCC recurrence was 95.1% (95% confidence interval [CI], 91.9-97.1) when AFP was >400 ng/mL and 98.9% (95% CI, 96.8-99.6) when AFP was >1,000 ng/mL. The overall survival (P = .008) and disease-free survival (P = .004) differed between patients groups when an AFP cutoff level of 1,000 ng/mL was used. The predictive accuracy of high pre-transplantation serum AFP level for HCC post-transplantation recurrence should be used in decision algorithms for LT.