ArticleTransplantation2018
Alpha-Fetoprotein Slope >7.5 ng/mL per Month Predicts Microvascular Invasion and Tumor Recurrence After Liver Transplantation for Hepatocellular Carcinoma.
Article in Transplantation, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers.
What it found
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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
23 citing papers in PubMed, 38 citations in OpenAlex.
- Distinct Alpha-Fetoprotein Trajectories Preceding Hepatocellular Carcinoma Diagnosis: A Latent Class Mixed-Model Analysis.Cancers · 2026Article
- Hepatocellular Carcinoma and the Role of Liver Transplantation: An Update and Review.Journal of clinical and translational hepatology · 2025Review
- Impact of Linggui Zhugan decoction on microwave ablation outcomes and recurrence in liver cancer.World journal of gastrointestinal oncology · 2025Article
- Predictors of early and late hepatocellular carcinoma recurrence.World journal of gastroenterology · 2023Review
- Hepatocellular Carcinoma, Alpha Fetoprotein, and Liver Allocation for Transplantation: Past, Present and Future.Current oncology (Toronto, Ont.) · 2022Review
- [Research progress of microvascular invasion in hepatocellular carcinoma].Zhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chinese journal of hepatology · 2022Review
- Recurrence of Hepatocellular Carcinoma After Liver Transplantation: Risk Factors and Predictive Models.Annals of transplantation · 2022Review
- Liver Transplantation for Hepatocellular Carcinoma: How Should We Improve the Thresholds?Cancers · 2022Review
- The Landscape Of Alpha Fetoprotein In Hepatocellular Carcinoma: Where Are We?International journal of biological sciences · 2022Review
- Prognostic Factors for 10-Year Survival in Patients With Hepatocellular Cancer Receiving Liver Transplantation.Frontiers in oncology · 2022Article
- Review
- Liver Transplantation for Hepatocellular Carcinoma: A Real-Life Comparison of Milan Criteria and AFP Model.Cancers · 2021Article
- Hepatocellular Carcinoma: Downstaging to Liver Transplantation as Curative Therapy.Journal of clinical and translational hepatology · 2021Review
- Review
- Importance of Intraoperative Transfusions of Packed Red Blood Cells and Fresh Frozen Plasma in Liver Transplantation for Hepatocellular Cancer.Annals of transplantation · 2020Article
- When to call it off: defining transplant candidacy limits in liver donor liver transplantation for hepatocellular carcinoma.BMC cancer · 2020Article
- Liver Transplantation Beyond Milan Criteria.Journal of clinical and translational hepatology · 2020Review
- Article
- Hepatocellular carcinoma recurrence after liver transplantation: Risk factors, screening and clinical presentation.World journal of hepatology · 2019Review
- Epidemiology and Management of Hepatocellular Carcinoma.Gastroenterology · 2019Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 1 institution in 1 country.
Funding
Abstract
backgroundRising alpha-fetoprotein (AFP) is a potential marker of worse prognosis after liver transplant (LT) for hepatocellular carcinoma (HCC), but prior studies relied on only 2 data points and were imprecise in assessing AFP slope. The aim of this study was to examine the association between AFP slope and post-LT HCC recurrence, with AFP slope estimated from multiple data points over time.
methodsOur cohort included 336 patients undergoing LT with Model for End Stage Liver Disease exception for HCC within Milan criteria from 2003 to 2013. Most (98%) had pre-LT locoregional therapy. AFP slope was estimated by fitting a regression line to the AFP levels over time.
resultsThe 1- and 5-year post-LT survivals were 94% and 77% and 1- and 5-year recurrence-free probabilities were 95% and 86%, respectively. In univariate analysis, HCC recurrence was significantly associated with microvascular invasion (hazard ratio [HR], 13.1; P<0.001), tumor grade (HR, 1.8; P<0.001), pathologic stage >Milan criteria (HR, 8.9; P<0.001), 3 tumor nodules (HR, 5.5; P=0.002), AFP slope greater than 7.5 ng/mL per month (HR, 3.9; P=0.005), and female sex (HR, 2.3; P=0.01). In multivariable analysis of factors known before LT, 3 tumor nodules (HR, 7.6; P<0.001), female sex (HR, 2.5; P=0.01), and AFP slope >7.5 (HR, 3.0; P=0.03) were significantly associated with HCC recurrence. AFP slope greater than 7.5 was also associated with microvascular invasion (odds ratio, 6.8; P=0.008).
conclusionsAFP slope increasing greater than 7.5 ng/mL per month despite locoregional therapy is associated with post-LT HCC recurrence and may serve as a surrogate for microvascular invasion. These findings support incorporating changes in the AFP into candidate selection for LT.
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Registered trials
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