Logo Annals of Transplantation Logo Annals of Transplantation Logo Annals of Transplantation

28 October 2016 : Original article  

Assigning Treatment to HCC Patients for Transplantation: Utility of a New Decision-Making Tool

Najmul Hassan ShahABDEF, Faisal Saud DarADEF, Abu Bakar Hafeez BhattiABCDEF, Atif RanaACDE, Mohammad SalihDEF

DOI: 10.12659/AOT.899715

Ann Transplant 2016; 21:668-674

Abstract

BACKGROUND: The Barcelona clinic liver cancer (BCLC) staging system is considered the standard of care for hepatocellular carcinoma (HCC) management. It has various limitations, including lack of second-line treatment options and combination therapy. We prospectively collected data on our HCC patients based on a new decision-making tool (NDT). The objective of this study was to determine the applicability of this tool and compare it with BCLC for treatment allocation, in particular with respect to liver transplantation.

MATERIAL AND METHODS: We retrospectively reviewed HCC patients who were managed based on an NDT that was developed in 2012. All patients whose treatment decision was based on this tool between 2012 and 2015 were included. Comparison was made with BCLC. Survival was compared for patients who underwent liver transplantation.

RESULTS: Based on the NDT, 406 (40.6%) patients were eligible for curative treatment versus only 22 (2.2%) patients based on BCLC. A total of 58 (5.8%) patients underwent liver transplant based on the NDT, while only 2 (0.2%) were transplantable based on BCLC. Estimated 3-year survival for transplanted patients based on the NDT was 73%. There were 41 (4.1%) stage C and 15 (1.5%) stage D BCLC patients who received transplant based on the NDT. Estimated 3-year survival for stage A, C, and D BCLC patients who received transplantation was 100%,72%, and 67%, respectively (P=0.6).

CONCLUSIONS: The NDT correctly identified a group of HCC patients for liver transplantation who would otherwise have received palliative treatment based on the BCLC algorithm.

Keywords: Transplantation, Outcome Assessment (Health Care)

Add Comment 0 Comments

In Press

Original article  

Impact of Preoperative Treatment on Donor Hepatic Steatosis in Living Donor Liver Transplantation

Ann Transplant In Press; DOI: 10.12659/AOT.947772  

Original article  

Effects of Donor-Recipient Race Matching on Kidney Transplant Survival

Ann Transplant In Press; DOI: 10.12659/AOT.947720  

Most Viewed Current Articles

03 Jan 2023 : Original article   6,996

Impact of Autologous Stem Cell Transplantation on Primary Central Nervous System Lymphoma in First-Line and...

DOI :10.12659/AOT.938467

Ann Transplant 2023; 28:e938467

15 Aug 2023 : Review article   6,986

Free-Circulating Nucleic Acids as Biomarkers in Patients After Solid Organ Transplantation

DOI :10.12659/AOT.939750

Ann Transplant 2023; 28:e939750

16 May 2023 : Original article   6,742

Breaking Antimicrobial Resistance: High-Dose Amoxicillin with Clavulanic Acid for Urinary Tract Infections ...

DOI :10.12659/AOT.939258

Ann Transplant 2023; 28:e939258

28 May 2024 : Original article   6,162

Effect of Dexmedetomidine Combined with Remifentanil on Emergence Agitation During Awakening from Sevoflura...

DOI :10.12659/AOT.943281

Ann Transplant 2024; 29:e943281

Your Privacy

We use cookies to ensure the functionality of our website, to personalize content and advertising, to provide social media features, and to analyze our traffic. If you allow us to do so, we also inform our social media, advertising and analysis partners about your use of our website, You can decise for yourself which categories you you want to deny or allow. Please note that based on your settings not all functionalities of the site are available. View our privacy policy.

Annals of Transplantation eISSN: 2329-0358
Annals of Transplantation eISSN: 2329-0358