ArticleJournal of hepatology2015
Progenitor cell markers predict outcome of patients with hepatocellular carcinoma beyond Milan criteria undergoing liver transplantation.
Article in Journal of hepatology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 50 papers.
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Who cites it
50 citing papers in PubMed.
- Early Recurrent Hepatocellular Carcinoma with CK19 Positive Receiving Transarterial Chemoembolization After Surgical Resection: A Novel Risk Model Study.Journal of hepatocellular carcinoma · 2026Article
- Artificial intelligence predicts outcome-related molecular profiles and vascular invasion in hepatocellular carcinoma.JHEP reports : innovation in hepatology · 2025Article
- Hepatocellular carcinoma stem cells: the current state of small molecule-based inhibitors.Cell death & disease · 2025Review
- Model Construction for Predicting Preoperative Microvascular Invasion of Hepatocellular Carcinoma by Gadoxetic Acid Disodium-Enhanced Magnetic Resonance Imaging Combined with Serology.Medical science monitor : international medical journal of experimental and clinical research · 2025Article
- Multi-omic analysis reveals a CAF-stemness-governed classification in HCC liver transplant recipients beyond the Milan criteria.Nature communications · 2025Article
- Neoadjuvant Multiagent Systemic Therapy Approach to Liver Transplantation for Perihilar Cholangiocarcinoma.Transplantation direct · 2025Article
- MRI Parameters and Clinicopathologic Features in Predicting Hepatocellular Carcinomas With Aggressive-Related Marker Expression, Defined by Epithelial Cell Adhesion Molecule and Glypican-3 Status.International journal of general medicine · 2025Article
- Article
- Clonorchis sinensis infection amplifies hepatocellular carcinoma stemness, predicting unfavorable prognosis.PLoS neglected tropical diseases · 2024Article
- Histological diagnosis of polyploidy discriminates an aggressive subset of hepatocellular carcinomas with poor prognosis.British journal of cancer · 2023Article
- Incremental value of radiomics-based heterogeneity to the existing risk criteria in predicting recurrence of hepatocellular carcinoma after liver transplantation.European radiology · 2023Article
- Liver Transplant in Patients with Hepatocarcinoma: Imaging Guidelines and Future Perspectives Using Artificial Intelligence.Diagnostics (Basel, Switzerland) · 2023Review
- Recent therapeutics in hepatocellular carcinoma.American journal of cancer research · 2023Review
- Review
- Cuproptosis-Related Signature Predicts the Prognosis, Tumor Microenvironment, and Drug Sensitivity of Hepatocellular Carcinoma.Journal of immunology research · 2022Article
- Ultrasomics prediction for cytokeratin 19 expression in hepatocellular carcinoma: A multicenter study.Frontiers in oncology · 2022Article
- The Role of Chronic Liver Diseases in the Emergence and Recurrence of Hepatocellular Carcinoma: An Omics Perspective.Frontiers in medicine · 2022Review
- Molecular classification of hepatocellular carcinoma: prognostic importance and clinical applications.Journal of cancer research and clinical oncology · 2022Review
- Cancer stem cells in hepatocellular carcinoma - from origin to clinical implications.Nature reviews. Gastroenterology & hepatology · 2022Review
- Pathogenesis to management of hepatocellular carcinoma.Genes & cancer · 2022Review
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Authors and funding
17 authors.
Funding
Abstract
BACKGROUND &
aimsIn patients with hepatocellular carcinoma (HCC), liver transplantation (LT) is an excellent therapy if tumor characteristics are within the Milan criteria. We aimed to define genomic features enabling to identify HCC patients beyond Milan criteria who have acceptable transplant outcomes.
methodsAmong 770 consecutive HCC patients transplanted between 1990 and 2013, 132 had tumors exceeding Milan criteria on pathology and were enrolled in the study; 44% of the patients satisfied the 'up-to-7 rule' [7=sum of the size of the largest tumor and the number of tumors]. Explant tumors were assessed for genomic signatures and immunohistochemical markers associated with poor outcome.
resultsAt a median follow-up of 88months, 64 patients had died and 45 recurred; the 5-year overall survival (OS) and recurrence rates were 57% and 35%, respectively. Cytokeratin 19 (CK19) gene signature was independently associated with recurrence [Hazard ratio (HR)=2.95, p<0.001], along with tumor size (HR=3.37, p=0.023) and presence of satellites (HR=2.98, p=0.001). S2 subclass signature was independently associated with poor OS (HR=3.18, p=0.001), along with tumor size (HR=5.06, p<0.001) and up-to-7 rule (HR=2.50, p=0.002). Using the presence of progenitor cell markers (either CK19 or S2 signatures) patients were classified into poor prognosis (n=58; 5-year recurrence 53%, survival 45%) and good prognosis (n=74; 5-year recurrence 19%, survival 67%) (HR=3.16, p<0.001 for recurrence, and HR=1.72, p=0.04 for OS).
conclusionsHCC patients transplanted beyond Milan criteria without gene signatures of progenitor markers (CK19 and S2) achieved survival rates similar as those within Milan criteria. Once prospectively validated, these markers may support a limited expansion of LT indications.
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