O-13 PERFORMANCE OF PRE-TRANSPLANT CRITERIA IN PREDICTION OF HEPATOCELLULAR CARCINOMA PROGRESSION AND WAITLIST DROPOUT
Federico Piñero1,2, Marcos Thompson1, Ilka Boin3, Aline Chagas4, Emilio Quiñonez5, Carla Bermúdez6, Mario Vilatobá7, Luisa Santos8, Margarita Anders9, Sergio Hoyos Duque10, Agnaldo Soares Lima11, Josemaría Menendez12, Martín Padilla13, Jaime Poniachik14, Rodrigo Zapata15, Martín Maraschio16, Ricardo Chong Menéndez17, Linda Muñoz18, Diego Arufe19, Rodrigo Figueroa20..., Adriana Varón8, Sebastián Marciano6, Juan Mattera5, Flair Carrilho4, Marcelo Silva1,2Ver más
1 Latin American Liver Research Educational and Awareness Network (LALREAN)
2 Austral University Hospital, Austral University, School of Medicine, Buenos Aires, Argentina
3 Clinics Hospital UNICAMP Campinas, Sao Paulo, Brazil
4 Division of Clinical Gastroenterology and Hepatology, Clinics Hospital Department of Gastroenterology, School of Medicine, University of São Paulo, Brazil
5 El Cruce Hospital, Florencio Varela, Argentina
6 Buenos Aires Italian Hospital, Buenos Aires, Argentina
7 National Institute of Medical Sciences and Nutrition “Salvador Zubirán”, México City, México
8 Cardioinfantil Foundation, Bogotá, Colombia
9 Germany Hospital of Buenos Aires, Buenos Aires, Argentina
10 Pablo Tobón Uribe Hospital & Gastroenterology Group from the University of Antioquia, Medellín, Colombia
11 Clinics Hospital of Federal de Minas Gerais Federal University, Minas Gerais, Brazil
12 Clinics Hospital, Montevideo, Uruguay
13 San Marcos National University, Guillermo Almenara Hospital, Lima, Perú
14 University of Chile Hospital, Santiago, Chile
15 Germany Clinic, Medical School, University of Desarrollo, Santiago, Chile
16 Córdoba Private Hospital, Córdoba, Argentina
17 Carlos Andrade Marín Hospital, Quito, Ecuador
18 “Dr. José E. González” University Hospital, Monterrey, México
19 Sacred Heart Sanatorium, Buenos Aires, Argentina
20 Allende Sanatorium, Córdoba, Argentina
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González” University Hospital, Monterrey, México" "etiqueta" => "18" "identificador" => "aff0018" ] 18 => array:3 [ "entidad" => "Sacred Heart Sanatorium, Buenos Aires, Argentina" "etiqueta" => "19" "identificador" => "aff0019" ] 19 => array:3 [ "entidad" => "Allende Sanatorium, Córdoba, Argentina" "etiqueta" => "20" "identificador" => "aff0020" ] ] ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "tieneResumen" => true "resumen" => array:1 [ "en" => array:2 [ "resumen" => "<span id="abss0001" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cesectitle0001">Introduction and Objectives</span><p id="spara001" class="elsevierStyleSimplePara elsevierViewall">Liver transplantation (LT) selection models for hepatocellular carcinoma (HCC) have not been proposed to predict waitlist dropout due to tumor progression. This study aimed to compare the alfa-fetoprotein (AFP) model and other pre-LT models in their prediction of HCC dropout.</p></span> <span id="abss0002" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cesectitle0002">Materials and Methods</span><p id="spara002" class="elsevierStyleSimplePara elsevierViewall">A multicenter cohort study was conducted in 20 Latin American transplant centers, including 994 listed patients for LT with HCC from 2012 to 2018. Longitudinal tumor characteristics and patterns of progression were recorded at the time of listing, after treatments and at last follow-up over the waitlist period. Competing risk regression models were performed, and the model's discrimination was compared by estimating Harrell's adapted c-statistics.</p></span> <span id="abss0003" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cesectitle0003">Results</span><p id="spara003" class="elsevierStyleSimplePara elsevierViewall">HCC dropout rate was significantly higher in patients beyond [24% (95% CI 16-28)] compared to those within Milan criteria [8% (95% IC 5-12%); P<.0001], with an SHR of 3.01 (95% CI 2.03-4.47)], adjusted for waiting list time and bridging therapies (c-index 0.63 (95% CI 0.57;0.69). HCC dropout rates were higher in patients with AFP scores >2 [adjusted SHR of 3.17 (CI 2.13-4.71)], c-index of 0.71 (95% CI 0.65-0.77; P=0.09 vs. Milan). Similar discrimination power for HCC dropout was observed between the AFP score and the Metroticket 2.0 model. In patients within Milan, an AFP score >2 points discriminated two populations with a higher risk of HCC dropout [SHR 1.68 (95% CI 1.08-2.61)].</p></span> <span id="abss0004" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cesectitle0004">Conclusions</span><p id="spara004" class="elsevierStyleSimplePara elsevierViewall">Pre-transplant selection models similarly predicted HCC dropout. However, the AFP model can discriminate a higher risk of dropout among patients within Milan criteria.</p></span>" "secciones" => array:4 [ 0 => array:2 [ "identificador" => "abss0001" "titulo" => "Introduction and Objectives" ] 1 => array:2 [ "identificador" => "abss0002" "titulo" => "Materials and Methods" ] 2 => array:2 [ "identificador" => "abss0003" "titulo" => "Results" ] 3 => array:2 [ "identificador" => "abss0004" "titulo" => "Conclusions" ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/16652681/00000028000000S1/v2_202308150516/S1665268123001278/v2_202308150516/en/main.assets" "Apartado" => null "PDF" => "https://static.elsevier.es/multimedia/16652681/00000028000000S1/v2_202308150516/S1665268123001278/v2_202308150516/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S1665268123001278?idApp=UINPBA00004N" ]
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