ArticleJHEP reports : innovation in hepatology2021
International study on the outcome of locoregional therapy for liver transplant in hepatocellular carcinoma beyond Milan criteria.
Article in JHEP reports : innovation in hepatology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03775863 (Evaluation of the AFP Model in Predicting Recurrence of Hepatocellular Carcinoma After Liver Transplantation in Patients Without Microvascular Invasion.), which is not on this map. Cited by 11 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.
Evaluation of the AFP Model in Predicting Recurrence of Hepatocellular Carcinoma After Liver Transplantation in Patients Without Microvascular Invasion.
Who cites it
11 citing papers in PubMed, 21 citations in OpenAlex.
- New Scenarios in Liver Transplantation for Hepatocellular Carcinoma.Liver international : official journal of the International Association for the Study of the Liver · 2025Review
- Challenges in Liver Transplantation for Hepatocellular Carcinoma: A Review of Current Controversies.Cancers · 2024Review
- Transarterial chemoembolization plus camrelizumab is an effective and tolerable bridging therapy for patients with intermediate‑stage hepatocellular carcinoma: A pilot study.Oncology letters · 2023Article
- Evolving Landscape in Liver Transplantation for Hepatocellular Carcinoma: From Stage Migration to Immunotherapy Revolution.Life (Basel, Switzerland) · 2023Review
- Article
- European Society of Organ Transplantation (ESOT) Consensus Report on Downstaging, Bridging and Immunotherapy in Liver Transplantation for Hepatocellular Carcinoma.Transplant international : official journal of the European Society for Organ Transplantation · 2023Article
- Review
- Patient Selection for Downstaging of Hepatocellular Carcinoma Prior to Liver Transplantation-Adjusting the Odds?Transplant international : official journal of the European Society for Organ Transplantation · 2022Review
- Experimental Validation of Novel Glypican 3 Exosomes for the Detection of Hepatocellular Carcinoma in Liver Cirrhosis.Journal of hepatocellular carcinoma · 2021Article
- Bridging locoregional treatment prior to liver transplantation for cirrhotic patients with hepatocellular carcinoma within the Milan criteria: a systematic review and meta-analysis.Annals of gastroenterologyArticle
- Indian National Association for the Study of Liver (INASL) Guidance Statements for Determining Futility in Liver Transplantation.Journal of clinical and experimental hepatologyReview
Corrections and comments
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Authors and funding
26 authors at 20 institutions in 8 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
BACKGROUND &
aimsGood outcomes after liver transplantation (LT) have been reported after successfully downstaging to Milan criteria in more advanced hepatocellular carcinoma (HCC). We aimed to compare post-LT outcomes in patients receiving locoregional therapies (LRT) before LT according to Milan criteria and University of California San Francisco downstaging (UCSF-DS) protocol and 'all-comers'.
methodsThis multicentre cohort study included patients who received any LRT before LT from Europe and Latin America (2000-2018). We excluded patients with alpha-foetoprotein (AFP) above 1,000 ng/ml. Competing risk regression analysis for HCC recurrence was conducted, estimating subdistribution hazard ratios (SHRs) and corresponding 95% CIs.
resultsFrom 2,441 LT patients, 70.1% received LRT before LT (n = 1,711). Of these, 80.6% were within Milan, 12.0% within UCSF-DS, and 7.4% all-comers. Successful downstaging was achieved in 45.2% (CI 34.8-55.8) and 38.2% (CI 25.4-52.3) of the UCSF-DS group and all-comers, respectively. The risk of recurrence was higher for all-comers (SHR 6.01 [
conclusionsPatients within the UCSF-DS protocol at listing have similar post-transplant outcomes compared with those within Milan when successfully downstaged. Meanwhile, all-comers have a higher recurrence and inferior survival irrespective of response to LRT. Additionally, in the UCSF-DS group, an ALP of ≤20 ng/ml might be a novel tool to optimise selection of candidates for LT. CLINICAL TRIAL NUMBER: This study was registered as part of an open public registry (NCT03775863). LAY SUMMARY: Patients with more extended HCC (within the UCSF-DS protocol) successfully downstaged to the conventional Milan criteria do not have a higher recurrence rate after LT compared with the group remaining in the Milan criteria from listing to transplantation. Moreover, in the UCSF-DS patient group, an ALP value equal to or below 20 ng/ml at listing might be a novel tool to further optimise selection of candidates for LT.
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