Background: Rising 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 VSports手机版. 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. .

Methods: Our 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. V体育安卓版.

Results: The 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 V体育ios版. 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). .

Conclusions: AFP 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 VSports最新版本. .