AUTHOR=Herrero Astrid , Boivineau Lucile , Cassese Gianluca , Assenat Eric , Riviere Benjamin , Faure Stéphanie , Bedoya José Ursic , Panaro Fabrizio , Guiu Boris , Navarro Francis , Pageaux Georges-Philippe 

TITLE=Progression of AFP SCORE is a Preoperative Predictive Factor of Microvascular Invasion in Selected Patients Meeting Liver Transplantation Criteria for Hepatocellular Carcinoma

JOURNAL=Transplant International

VOLUME=Volume 35 - 2022

YEAR=2022

URL=https://www.frontierspartnerships.org/journals/transplant-international/articles/10.3389/ti.2022.10412

DOI=10.3389/ti.2022.10412

ISSN=1432-2277

ABSTRACT=Microvascular Invasion (MVI) is one of the main prognostic factors of Hepatocellular Carcinoma (HCC) after Liver Transplantation (LT), but its occurrence is unpredictable before surgery. The AFP model (composite score including size, number, AFP), currently used In France, defines the selection criteria for LT. This study’s aim was to evaluate the preoperative predictive value of AFP score progression on MVI and overall survival during the waiting period for LT. Data regarding LT recipients for HCC from 2007 to 2015 were retrospectively collected from a single institutional database. Among 159 collected cases, 34 patients progressed according to AFP score from diagnosis until LT. MVI was showed to be an independent histopathological prognostic factor according to cox regression and competing risk analysis in our cohort. AFP score progression was the only preoperative predictive factor of MVI (OR= 10.79 [2.35-49.4]; P 0.002). The 5 years overall survival in the progression and no progression groups were 63.9% vs 86,3% respectively (p=0.001). Cumulative incidence of HCC recurrence was significantly different between the progression and no progression groups (Sub-HR= 4.89 [CI 2-11.98]). In selected patients, the progression of AFP score during the waiting period can be a useful preoperative tool to predict MVI.