Abstract
BackgroundAlthough criteria for liver transplantation, such as the Milan criteria and Hangzhou experiences, have become popular, criteria to guide adjuvant therapy for patients with hepatocellular carcinoma after liver transplantation are lacking.MethodsWe collected data from all consecutive patients from 2012 to 2019 at three liver transplantation centers in China retrospectively. Univariate and multivariate analyses were used to analyze preoperative parameters, such as demographic and clinical data. Using data obtained in our center, calibration curves and the concordance Harrell’s C-indices were used to establish the final model. The validation cohort comprised the patients from the other centers.ResultsData from 233 patients were used to construct the nomogram. The validation cohort comprised 36 patients. Independent predictors of overall survival (OS) were identified as HbeAg positive (P = 0.044), blood-type compatibility unmatched (P = 0.034), liver transplantation criteria (P = 0.003), and high MELD score (P = 0.037). For the validation cohort, to predict OS, the C-index of the nomogram was 0.874. Based on the model, patients could be assigned into low-risk (≥ 50%), intermediate-risk (30–50%), and high-risk (≤ 30%) groups to guide adjuvant therapy after surgery and to facilitate personalized management.ConclusionsThe OS in patients with hepatocellular carcinoma after liver transplantation could be accurately predicted using the developed nomogram.
Highlights
Criteria for liver transplantation, such as the Milan criteria and Hangzhou experiences, have become popular, criteria to guide adjuvant therapy for patients with hepatocellular carcinoma after liver transplantation are lacking
Other patients in our center were used as the training cohort (n = 233) and the patients in the remaining centers comprised the validation cohort (n = 36)
Overall survival (OS)-related prognostic factors Univariate and multivariate Cox regression analyses were used to assess the demographic, clinical, and biochemical parameters of the training cohort to identify independent risk factors associated with overall survival (OS)
Summary
Criteria for liver transplantation, such as the Milan criteria and Hangzhou experiences, have become popular, criteria to guide adjuvant therapy for patients with hepatocellular carcinoma after liver transplantation are lacking. Thereafter, criteria for postoperative guidance were lacking until Agopian et al reported a prognostic system that could accurately predict HCC recurrence after LT [4]. This model focused on HCC recurrence and was constructed on Caucasian population data. We established this large, multiple-center retrospective study comprising Chinese patients with HCC who underwent LT at three liver transplantation centers in China. The study aimed to formulate a nomogram to predict the long-term survival of these patients, to guide adjuvant therapy, and facilitate personalized management
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
