ArticleLiver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society2016
Intention to treat outcome of T1 hepatocellular carcinoma with the "wait and not ablate" approach until meeting T2 criteria for liver transplant listing.
Article in Liver transplantation : official publication of the American Association for the Study of Liver Diseases and the International Liver Transplantation Society, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
30 citing papers in PubMed, 1 synthesis or guideline pooled it, 63 citations in OpenAlex.
- Hepatocellular carcinoma tumour volume doubling time: a systematic review and meta-analysis.Gut · 2021Pooled it
- Multi-Target HCC Blood Test Demonstrates Consistent Performance Across Subgroups of Patients with Chronic Liver Disease.Cancers · 2026Article
- Very Early-Stage Detection Is Associated With Improved Survival in Patients With Unifocal Hepatocellular Carcinoma.Alimentary pharmacology & therapeutics · 2026Article
- The Size-Growth Rate Relationship in Hepatocellular Carcinoma.JGH open : an open access journal of gastroenterology and hepatology · 2025Article
- Cost-Effectiveness of a Biomarker-Based Screening Strategy for Hepatocellular Carcinoma in Patients with Cirrhosis.Liver cancer · 2024Article
- Article
- Early-stage hepatocellular carcinoma screening in patients with chronic hepatitis B in China: a cost-effectiveness analysis.Journal of comparative effectiveness research · 2024Article
- Optimal treatment for small HCC (<3 cm): Resection, liver transplantation, or locoregional therapy?JHEP reports : innovation in hepatology · 2023Review
- Long-term outcomes of ablation, liver resection, and liver transplant as first-line treatment for solitary HCC of 3 cm or less using an intention-to-treat analysis: A retrospective cohort study.Annals of medicine and surgery (2012) · 2022Article
- Machine learning to predict waitlist dropout among liver transplant candidates with hepatocellular carcinoma.Cancer medicine · 2022Article
- Role of Pretransplant Treatments for Patients with Hepatocellular Carcinoma Waiting for Liver Transplantation.Cancers · 2022Review
- Neoadjuvant treatment strategies for hepatocellular carcinoma.World journal of gastrointestinal surgery · 2021Review
- Cost-Effectiveness of Hepatocellular Carcinoma Surveillance: An Assessment of Benefits and Harms.The American journal of gastroenterology · 2020Article
- Retrospective CT/MRI Texture Analysis of Rapidly Progressive Hepatocellular Carcinoma.Journal of personalized medicine · 2020Article
- Comparison of guidelines for diagnosis of hepatocellular carcinoma using gadoxetic acid-enhanced MRI in transplantation candidates.European radiology · 2020Article
- Detect or not to detect very early stage hepatocellular carcinoma? The western perspective.Clinical and molecular hepatology · 2019Review
- Predictors of low risk for dropout from the liver transplant waiting list for hepatocellular carcinoma in long wait time regions: Implications for organ allocation.American journal of transplantation : official journal of the American Society of Transplantation and the American Society of Transplant Surgeons · 2019Article
- Metabolic factors affecting hepatocellular carcinoma in steatohepatitis.Liver international : official journal of the International Association for the Study of the Liver · 2019Article
- Epidemiology and Management of Hepatocellular Carcinoma.Gastroenterology · 2019Review
- Definitive locoregional therapy (LRT) versus bridging LRT and liver transplantation with wait-and-not-treat approach for very early stage hepatocellular carcinoma.Diagnostic and interventional radiology (Ankara, Turkey) · 2018Article
Corrections and comments
- Commented on by
Authors and funding
6 authors at 1 institution in 1 country.
Funding
Abstract
Patients with T1 hepatocellular carcinoma (HCC; 1 lesion < 2 cm) are currently not eligible for priority listing for liver transplantation (LT). A common practice is to wait without locoregional therapy (LRT) until tumor growth occurs from T1 to T2 (1 lesion 2-5 cm or 2-3 lesions ≤ 3 cm) to be eligible for listing with Model for End-Stage Liver Disease exception. We aimed to evaluate the intention to treat outcome of the "wait and not ablate" approach for nonresection candidates with T1 HCC until tumor growth to T2. The study included 114 patients with T1 HCC 1.0-1.9 cm followed by serial imaging every 3 months. Two investigators performed independent imaging reviews to confirm the diagnosis. Median increase in total tumor diameter was 0.14 cm/month. Probabilities of progression from T1 to directly beyond T2 without LT listing were 4.4% at 6 months and 9.0% at both 12 and 24 months. The 1- and 3-year survival was 94.5% and 75.5%. In multivariate analysis, predictors of rapid tumor progression, defined as a > 1 cm increase in total tumor diameter over 3 months, included alcoholic liver disease (odds ratio [OR], 6.52; P = 0.02) and Hispanic race (OR, 3.86; P = 0.047), whereas hepatitis B appeared to be protective (OR, 0.09; P = 0.04). By competing risks regression, predictors of exclusion from LT (with or without listing for LT under T2) were alpha-fetoprotein (AFP) ≥ 500 ng/mL (HR, 12.69; 95% confidence interval, 2.8-57.0; P = 0.001) and rapid tumor progression (HR, 5.68; P < 0.001). In conclusion, the "wait and not ablate" approach until tumor growth from T1 to T2 before LT listing is associated with a <10% risk of tumor progression to directly beyond T2 criteria. However, patients with AFP ≥ 500 ng/mL and rapid tumor progression are at high risk for wait-list dropout and should receive early LRT.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.