ArticleCancers2023
The Role of PIVKA-II as a Predictor of Early Hepatocellular Carcinoma Recurrence-Free Survival after Liver Transplantation in a Low Alpha-Fetoprotein Population.
Article in Cancers, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
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13 citing papers in PubMed, 1 synthesis or guideline pooled it, 9 citations in OpenAlex.
- Pan-Asian adapted ESMO Clinical Practice Guidelines for the diagnosis, treatment, and follow-up of patients with hepatocellular carcinoma.ESMO open · 2026Guideline
- Review Article: Biomarkers in Liver Transplantation for Hepatocellular Carcinoma: Towards Precision Medicine.Alimentary pharmacology & therapeutics · 2026Review
- Serum biomarkers as personalised medicine for diagnostic and therapeutic approaches of hepatocellular carcinoma.Journal of the Egyptian National Cancer Institute · 2026Review
- Serum protein induced by vitamin K absence or antagonist-II predicts aggressive tumor biology in alpha-fetoprotein-normal hepatocellular carcinoma.World journal of gastrointestinal oncology · 2026Article
- Gamma-Glutamyl Transferase Improves Biological Risk Stratification in Living Donor Liver Transplantation for Hepatocellular Carcinoma.Journal of gastrointestinal cancer · 2026Article
- Protein Induced by Vitamin K Absence or Antagonist II in Primary Liver Cancer: Basic Research Insights and Clinical Applications.Journal of clinical and translational hepatology · 2025Review
- Establishing a Decision-Making Threshold for PIVKA II in the Diagnosis of Pancreatic Ductal Adenocarcinoma (PDAC): A Single Centre Experience.Asian Pacific journal of cancer prevention : APJCP · 2025Article
- Elevated platelet distribution width and diabetes may serve as preoperative predictors of microvascular invasion in primary hepatocellular carcinoma.Journal of cancer research and clinical oncology · 2025Article
- Tumor burden score combined with AFP and PIVKA-II (TAP score) to predict the prognosis of hepatocellular carcinoma patients after radical liver resection.Langenbeck's archives of surgery · 2025Article
- Prognostic Value of Des-Gamma-Carboxy Prothrombin in AFP-Negative Hepatocellular Carcinoma Patients Following Liver Resection:Journal of Cancer · 2025Article
- Long-Term Prognostic Value of AFP and PIVKA-II in HCC After Living Donor Liver Transplantation: A Single-Center Retrospective Study.Transplant international : official journal of the European Society for Organ Transplantation · 2025Article
- Early PIVKA-II Response Predicts Treatment Efficacy of Immune Checkpoint Inhibitors in Patients with Advanced Hepatocellular Carcinoma.Journal of hepatocellular carcinoma · 2025Article
- Review
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9 authors at 2 institutions in 1 country.
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Abstract
introductionAFP and the RETREAT score are currently used to predict HCC recurrence after LT. However, superior discriminating models are needed for low AFP populations. The aim of this study is to investigate the predictive value of PIVKA-II on recurrence-free survival after LT in a low AFP population and microvascular invasion on explant.
methodsA retrospective cohort study including all consecutive patients transplanted for HCC between 1989 and 2019 in the Erasmus MC University Medical Center in Rotterdam, the Netherlands, was used. AFP and PIVKA-II levels were determined in serum samples collected at the time of transplantation. Data on tumor load and microvascular invasion were retrieved from patients' records.
resultsThe study cohort consisted of 121 patients, with HCC recurrence in 15 patients (12.4%). The median AFP was 7.7 ng/mL (4.4-20.2), and the median PIVKA-II was 72.0 mAU/mL (41.0-213.5). Patients with low AFP (≤8 ng/mL) and PIVKA-II (≤90 mAU/mL) had a 5-year recurrence-free survival of 100% compared to 85.7% in patients with low AFP and high PIVKA-II (
conclusionsThe dual model of PIVKA-II ≤ 90 mAU/mL with either AFP ≤ 8 ng/mL or with patients within the Milan criteria identifies patient groups which can be exempted from HCC surveillance after LT in a low AFP population. PIVKA-II may be a better predictor for explant microvascular invasion than AFP and could play a role in future models identifying LT candidates with the highest risk for HCC recurrence.
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