AGMA Score: A Novel Prognostic Score for Patients Undergoing Liver Transplant for Hepatocellular Carcinoma |
| |
| Affiliation: | 1. Department of Surgery, The Johns Hopkins University School of Medicine, Baltimore, MD;2. Unità di Chirurgia Epatobiliare e Trapianto Epatico, Azienda Ospedaliera-Università di Padova, Padova, Italy;3. Department of Medical Oncology, The Johns Hopkins University School of Medicine, Baltimore, MD;4. Department of Radiology, Interventional Radiology, The Johns Hopkins University School of Medicine, Baltimore, MD;1. Department of Anesthesia and Pain Medicine, Ulsan University College of Medicine, Gangneung Asan Hospital, Gangneung, South Korea;2. Department of Surgery, Ulsan University College of Medicine, Gangneung Asan Hospital, Gangneung, South Korea;3. Medical Research Institute, Gangneung Asan Hospital, Gangneung, South Korea;1. Hepatobiliary Center, The First Affiliated Hospital of Nanjing Medical University, Nanjing, China;2. Key Laboratory of Liver Transplantation, Chinese Academy of Medical Sciences, Nanjing, China;3. Department of Hepatobiliary Surgery, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China;1. 2nd Department of Propaedeutic Surgery, National and Kapodistrian University of Athens, Medical School, Athens, Greece;2. 1st Division of Cardiothoracic Surgery and Transplantation Services, Onassis Cardiac Surgical Centre, Athens, Greece |
| |
| Abstract: | BackgroundHepatocellular carcinoma (HCC) in cirrhosis represents one of the leading indications for liver transplant. In an effort to expand the listing criteria, a variety of scoring systems have been suggested, mainly based on the tumor number/size criterion. The objective of our study was to evaluate the feasibility of proposing a transplant score for HCC excluding the tumor number/size criterion.Patients and MethodsData corresponding to patients who received transplants because of HCC were reviewed for the purposes of this study. Deceased donor and living donor liver transplants were included. Demographic, clinical and tumor-related parameters were evaluated. Uni- and multivariate regression analyses and survival analysis were performed.ResultsOne hundred patients were included in the study. Fifty-five patients underwent deceased donor liver transplant, and 45 patients received living donor liver transplants. Tumor differentiation (G1/2 vs G3), alpha-fetoprotein levels (AFP), recipient age, and recipient laboratory Model for End-Stage Liver Disease Score (MELD) showed statistical significance. A scoring system was developed, with prognostic points assigned as follows: age 60 years or younger:age older than 60 years = 1:0 points, tumor grading well or moderate:tumor grading poor = 1:0 points, MELD score ≤22:MELD score >22 = 1:0 points, and AFP level ≤400 ng/mL:AFP level >400 ng/mL = 1:0 points. This stratification delineated 3 separate population samples corresponding to patients with scores of 4, 3, and 1 to 2, respectively. The calculated 5-year survival for scores 4, 3, and 1 to 2 was 76%, 47%, and 20%, respectively (P < .001).ConclusionThe AGMA score (age, grading, MELD, AFP) showed prognostic value in this single-center analysis and may find clinical implication avoiding the tumor number/size criterion. |
| |
| Keywords: | |
| 本文献已被 ScienceDirect 等数据库收录！ |
|
