Full metadata record
DC Field | Value | Language |
---|---|---|
dc.contributor.author | 김휘영 | * |
dc.date.accessioned | 2019-11-19T16:30:45Z | - |
dc.date.available | 2019-11-19T16:30:45Z | - |
dc.date.issued | 2016 | * |
dc.identifier.issn | 0003-4932 | * |
dc.identifier.issn | 1528-1140 | * |
dc.identifier.other | OAK-25876 | * |
dc.identifier.uri | https://dspace.ewha.ac.kr/handle/2015.oak/251993 | - |
dc.description.abstract | Objective:To develop and validate a model to predict tumor recurrence after living donor liver transplantation (LDLT) (MoRAL) for hepatocellular carcinoma (HCC) beyond the Milan criteria (MC).Background:Some subgroups of HCC exceeding the MC experience substantial benefit from LDLT.Methods:This multicenter study included a total of 566 consecutive patients who underwent LDLT in Korea: the beyond-MC cohort (n = 205, the derivation [n = 92] and validation [n = 113] sets) and the within-MC cohort (n = 361). The primary endpoint was time-to-recurrence.Results:Using multivariate Cox proportional hazard model, we derived the MoRAL score using serum levels of protein induced by vitamin K absence-II and alpha-fetoprotein, which provided a good discriminant function on time-to-recurrence (concordance index = 0.88). Concordance index was maintained similarly on both internal and external validations (mean 0.87 and 0.84, respectively). At cut off of 314.8 (75th percentile value), a low MoRAL score (314.8) was associated with significantly longer recurrence-free (versus > 314.8, HR = 5.29, P < 0.001) and overall survivals (HR = 2.59, P = 0.001) in the beyond-MC cohort. The 5-year recurrence-free and overall survival rates of beyond-MC patients with a low MoRAL score were as high as 66.3% and 82.6%, respectively. The within-MC patients with a high MoRAL score showed a higher risk of recurrence than beyond-MC patients with a low MoRAL score (HR = 2.56, P = 0.035). The MoRAL score was significantly correlated with explant histology.Conclusions:This new model using protein induced by vitamin K absence-II and alpha-fetoprotein provides refined prognostication. Among beyond-MC HCC patients, those with a MoRAL score 314.8 and without extrahepatic metastasis might be potential candidates for LDLT. | * |
dc.language | English | * |
dc.publisher | LIPPINCOTT WILLIAMS & | * |
dc.publisher | WILKINS | * |
dc.subject | beyond the Milan criteria | * |
dc.subject | hepatocellular carcinoma | * |
dc.subject | living donor liver transplantation | * |
dc.subject | MoRAL score | * |
dc.title | Serum Tumor Markers Provide Refined Prognostication in Selecting Liver Transplantation Candidate for Hepatocellular Carcinoma Patients Beyond the Milan Criteria | * |
dc.type | Article | * |
dc.relation.issue | 5 | * |
dc.relation.volume | 263 | * |
dc.relation.index | SCIE | * |
dc.relation.index | SCOPUS | * |
dc.relation.startpage | 842 | * |
dc.relation.lastpage | 850 | * |
dc.relation.journaltitle | ANNALS OF SURGERY | * |
dc.identifier.doi | 10.1097/SLA.0000000000001578 | * |
dc.identifier.wosid | WOS:000374871600009 | * |
dc.author.google | Lee, Jeong-Hoon | * |
dc.author.google | Cho, Yuri | * |
dc.author.google | Kim, Hwi Young | * |
dc.author.google | Cho, Eun Ju | * |
dc.author.google | Lee, Dong Hyeon | * |
dc.author.google | Yu, Su Jong | * |
dc.author.google | Lee, Jae Woo | * |
dc.author.google | Yi, Nam-Joon | * |
dc.author.google | Lee, Kwang-Woong | * |
dc.author.google | Kim, Seoung Hoon | * |
dc.author.google | Kim, Jong Man | * |
dc.author.google | Joh, Jae-Won | * |
dc.author.google | Teperman, Lewis W. | * |
dc.author.google | Park, James S. | * |
dc.author.google | Kim, Yoon Jun | * |
dc.author.google | Suh, Kyung-Suk | * |
dc.author.google | Yoon, Jung-Hwan | * |
dc.contributor.scopusid | 김휘영(56493773500) | * |
dc.date.modifydate | 20240601081000 | * |