Significance of preoperative fluorodeoxyglucose-positron emission tomography in prediction of tumor recurrence after liver transplantation for hepatocellular carcinoma patients: a Japanese multicenter study.
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Takada Yasutsugu, Kaido Toshimi, Shirabe Ken, Nagano Hiroaki, Egawa Hiroto, Sugawara Yasuhiko, Taketomi Akinobu, Takahara Takeshi, Wakabayashi Go, Nakanishi Chikashi, Kawagishi Naoki, Kenjo Akira, Gotoh Mitsukazu, Toyoki Yoshikazu, Hakamada Kenichi, Ohtsuka Masayuki, Akamatsu Nobuhisa, Kokudo Norihiro, Takeda Kazuhisa, Endo Itaru, Takamura Hiroyuki, Okajima Hideaki, Wada Hiroshi, Kubo Shoji, Kuramitsu Kaoru, Ku Yonson, Ishiyama Kohei, Ohdan Hideki, Ito Eitaro, Maehara Yoshihiko, Honda Masaki, Inomata Yukihiro, Furukawa Hiroyuki, Uemoto Shinji, Yamaue Hiroki, Miyazaki Masaru, Takada Tadahiro, LTx-PET study group of the Japanese Society of Hepato-Biliary-Pancreatic Surgery and the Japanese Liver Transplantation Society
Аннотация
METHODS: From 16 Japanese LT centers, data were collected on 182 recipients with HCC who underwent living donor liver transplantation (LDLT) between February 2005 and November 2013. PET-positive status was defined as increased uptake of FDG in the tumor compared to the surrounding non-tumor liver tissue. The median follow-up after LDLT was 54.5 months (range 1-125 months).
RESULTS: Postoperative HCC recurrence occurred in 23 patients. Multivariate analysis revealed that exceeding the Milan criteria (MC), alpha-fetoprotein (AFP) level ≥115 ng/ml, and PET-positive status were significant and independent risk factors for recurrence. In the over-MC group, a subgroup of patients with AFP level <115 ng/ml and PET-negative status (n = 22) had a significantly lower 5-year recurrence rate than the other patients (n = 27, 19% vs. 53%, P = 0.019).
CONCLUSIONS: These results suggest that preoperative FDG-PET status offers additional information on HCC recurrence risk after LT. Over-MC patients with PET-negative status and lower AFP level may achieve successful outcome comparable to that of within-MC patients.