Liver transplantation should be offered to patients with small solitary hepatocellular carcinoma and a positive serum alpha fetoprotein rather than resection

2013 ◽  
Vol 205 (4) ◽  
pp. 374-380 ◽  
Author(s):  
Jay A. Graham ◽  
Joseph K. Melancon ◽  
Kirti Shetty ◽  
Lynt B. Johnson
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Transplantation ◽  
Alpha Fetoprotein ◽  
Positive Serum ◽  
Serum Alpha Fetoprotein ◽  
Solitary Hepatocellular Carcinoma

Extreme Elevation of Serum Alpha Fetoprotein in Decompensated Cirrhosis without Hcc: an Ominous Sign

2007 ◽  
Vol 22 (1) ◽  
pp. 19-23
Author(s):  
H. Senturk ◽  
R. Cumali
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Transplantation ◽  
Liver Cirrhosis ◽  
Liver Failure ◽  
Alpha Fetoprotein ◽  
Decompensated Cirrhosis ◽  
Serum Alpha Fetoprotein

Three cases of extreme elevation of serum alpha fetoprotein (>10,000 ng/mL) with decompensated cirrhosis without demonstrable hepatocellular carcinoma are reported. While 2 patients died of liver failure, 1 survived after liver transplantation. Extreme elevation of alpha fetoprotein not associated with hepatocellular carcinoma in liver cirrhosis heralds an ominous prognosis necessitating urgent liver transplantation.

Role of Alpha-Fetoprotein in Selection of Patients with Hepatocellular Carcinoma Waiting for Liver Transplantation: Must we Reconsider it?

2011 ◽  
Vol 26 (3) ◽  
pp. 153-159 ◽  
Author(s):  
Quirino Lai ◽  
Alfonso W. Avolio ◽  
Tommaso M. Manzia ◽  
Salvatore Agnes ◽  
Giuseppe Tisone ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Transplantation ◽  
Multivariate Logistic Regression Analysis ◽  
Alpha Fetoprotein ◽  
Rank Test ◽  
Recurrence Prediction ◽  
Serum Alpha Fetoprotein ◽  
Selection Of Patients ◽  
Hcc Recurrence ◽  
Selection Of

Background Milan criteria (MC) represent the most commonly adopted criteria for the selection of patients with hepatocellular carcinoma (HCC) waiting for liver transplantation (LT). However, MC are exclusively based on morphological aspects. The aim of the present study was to evaluate pre-LT–detectable biological parameters, to compare them with morphological ones in terms of tumor recurrence prediction and patient survival. Methods A cohort of 153 consecutive adult patients who underwent LT for HCC on cirrhosis from January 1999 to March 2009 was retrospectively analyzed. Results HCC recurrence was observed in 12 patients (7.8%). At multivariate logistic regression analysis, serum alpha-fetoprotein (AFP) was the unique independent negative risk factor for the development of HCC recurrence (odds ratio 2.0, p=0.03). Adopting a cutoff value of 210 ng/mL, patients who presented serum AFP ≥210 ng/mL showed a 5-year survival rate of 23.3% versus 76.2% observed in patients with pre-LT serum AFP <210 ng/mL (log-rank test: <0.0001). Conclusions In our experience, AFP was the strongest predictor of HCC recurrence, stronger than tumor morphology. AFP could ameliorate the selection of LT candidates. Further studies to evaluate the combination of morphological and biological criteria are needed.

Decreasing trend of serum alpha-fetoprotein level in hepatocellular carcinoma

2021 ◽  
Author(s):  
Aarshi Vipani ◽  
Marie Lauzon ◽  
Michael Luu ◽  
Lewis R. Roberts ◽  
Amit G. Singal ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Alpha Fetoprotein ◽  
Serum Alpha Fetoprotein

Liver transplantation for hepatocellular carcinoma with portal vein tumor thrombosis

2021 ◽  
Vol 21 (2) ◽  
pp. 105-112
Author(s):  
Sang Jin Kim ◽  
Jong Man Kim
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Transplantation ◽  
Radiation Therapy ◽  
Portal Vein ◽  
Alpha Fetoprotein ◽  
Advanced Hepatocellular Carcinoma ◽  
Portal Vein Tumor Thrombosis ◽  
Donor Liver Transplantation ◽  
Tumor Thrombosis ◽  
Locoregional Therapies

Traditionally, liver transplantation for hepatocellular carcinoma with portal vein tumor thrombosis is not recommended. However, with recent developments in locoregional therapies for hepatocellular carcinoma, more aggressive treatments have been attempted for advanced hepatocellular carcinoma. Recently, various studies on locoregional therapies for downstaging followed by living donor liver transplantation reported inspiring overall survival and recurrence-free survival of patients. These downstaging procedures included three-dimensional conformal radiation therapy, trans-arterial chemoembolization, stereotactic body radiation therapy, trans-arterial radioembolization, hepatic arterial infusion chemotherapy and combinations of these therapies. Selection of the optimal downstaging protocol should depend on tumor location, biology and background liver status. The risk factors affecting outcome include pre-downstaging alpha-fetoprotein values, delta alpha-fetoprotein values, disappearance of portal vein tumor thrombosis on imaging and meeting the Milan criteria or not after downstaging. For hepatocellular carcinoma with portal vein tumor thrombosis, downstaging procedure with liver transplantation in mind would be helpful. If the reaction of the downstaged tumor is good, liver transplantation may be performed.

Sign in / Sign up

Export Citation Format

Share Document