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World Journal of Surgery

, Volume 43, Issue 1, pp 221–229 | Cite as

Liver Resection for Solitary Transplantable Hepatocellular Carcinoma: The Role of AFP-Score

  • Benjamin Menahem
  • Christophe Duvoux
  • Nathalie Ganne
  • Ariane Mallat
  • Olivier Seror
  • Julien Calderaro
  • Guy Launoy
  • Arnaud Alves
  • Daniel Cherqui
  • Alain Luciani
  • Alexis LaurentEmail author
Original Scientific Report
  • 165 Downloads

Abstract

Background

In 2012, the Liver Transplant French Study Group built the alpha-fetoprotein-score (AFP-score), which improved significantly the prediction of tumor recurrence in case of liver transplantation for HCC when compared to Milan criteria. The aim of the study was to test the AFP score in case of liver resection (LR) for HCC.

Methods

From 1990 to 2012, 347 patients underwent a liver resection for HCC developed on chronic liver disease (CLD). All patients with solitary HCC <60 mm were included. The primary end point was to investigate if the AFP-score at the first LR was predictive of recurrence and if recurrence occurred within the AFP-score. The secondary end points were overall survival (OS) and disease-free survival.

Results

One hundred and eight patients fulfilled the inclusions criteria. After a median follow-up of 65.4IQR [13–114] months, recurrence occurred in 64.8% (70/108) patients. Among the study population, 96 were “in AFP-score” (i.e., ≤2) of whom 60.4% (58/96) developed a recurrence that was cured in curative intent. In contrast, all patients “out AFP-score” experienced recurrence, and 25% were eligible for curative treatment. At the end of the follow-up, 26 patients were listed for liver transplantation (LT). Among them, 21 were finally transplanted. The 5-year OS after salvage LT was 68.5%95%CI [50.2–93.0].

Conclusion

AFP-score is a useful tool for patients selection after LR for solitary HCC developed on CLD. For patients “in AFP-score,” up-front LR provides good survival and allows to avoid up-front LT in case of recurrence.

Notes

Compliance with ethical standards

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Copyright information

© Société Internationale de Chirurgie 2018

Authors and Affiliations

  • Benjamin Menahem
    • 1
    • 2
  • Christophe Duvoux
    • 3
    • 8
  • Nathalie Ganne
    • 5
  • Ariane Mallat
    • 3
  • Olivier Seror
    • 6
  • Julien Calderaro
    • 7
    • 8
  • Guy Launoy
    • 2
  • Arnaud Alves
    • 1
    • 2
  • Daniel Cherqui
    • 9
  • Alain Luciani
    • 8
    • 10
  • Alexis Laurent
    • 4
    • 8
    Email author
  1. 1.Department of Digestive SurgeryCHU de CaenCaen CedexFrance
  2. 2.UNICAEN, CEA, CNRS, CHU Caen, INSERM UMR1086, Centre François BaclesseNormandie UniversityCaen CedexFrance
  3. 3.Department of Hepatology, Hôpital Henri MondorAssistance Publique-Hôpitaux de ParisCréteilFrance
  4. 4.Department of Digestive, Hepatobiliary, Pancreatic Surgery and Liver Transplantation, Hôpital Henri MondorAssistance Publique-Hôpitaux de ParisCréteilFrance
  5. 5.Department of Hepatogastroenterology, Hôpital Jean VerdierAssistance Publique-Hôpitaux de ParisBondyFrance
  6. 6.Department of Radiology, Hôpital Jean Verdier MondorAssistance Publique-Hôpitaux de ParisCréteilFrance
  7. 7.Department of Histopathology, Hôpital Henri MondorAssistance Publique-Hôpitaux de ParisCréteilFrance
  8. 8.INSERMUMR 955CréteilFrance
  9. 9.Department of Digestive Surgery, Hôpital Paul BrousseAssistance Publique-Hôpitaux de ParisVillejuifFrance
  10. 10.Department of Radiology, Hôpital Henri MondorAssistance Publique-Hôpitaux de ParisCréteilFrance

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