BACKGROUND Recurrence of hepatocellular carcinoma(HCC)following liver transplantation(LT)has a devastating influence on recipients’survival;however,the risk of recur-rence is not routinely stratified.Risk stratificat...BACKGROUND Recurrence of hepatocellular carcinoma(HCC)following liver transplantation(LT)has a devastating influence on recipients’survival;however,the risk of recur-rence is not routinely stratified.Risk stratification is vital with a long LT waiting time,as that could influence the recurrence despite strict listing criteria.AIM This study aims to identify predictors of recurrence and develop a novel risk pre-diction score to forecast HCC recurrence following LT.METHODS A retrospective review of LT for HCC recipients at University Hospitals Bir-mingham between July 2011 and February 2020.Univariate and multivariate analyses were performed to identify recurrence predictors,based on which the novel SIMAP500(satellite nodules,increase in size,microvascular invasion,AFP>500,poor differentiation)risk score was proposed.RESULTS 234 LTs for HCC were performed with a median follow-up of 5.3 years.Recurrence developed in 25 patients(10.7%).On univariate analyses,RETREAT score>3,α-fetoprotein(AFP)at listing 100-500 and>500,bridging,increased tumour size between imaging at the listing time and explant histology,increase in the size of viable tumour between listing and explant,presence of satellite nodules,micro-and macrovascular invasion on explant and poor differentiation of tumours were significantly associated with recurrence,based on which,the SIMAP500 risk score is proposed.The SIMAP500 demonstrated an excellent predictive ability(c-index=0.803)and outper-formed the RETREAT score(c-index=0.73).SIMAP500 is indicative of the time to disease recurrence.CONCLUSION SIMAP500 risk score identifies the LT recipients at risk of HCC recurrence.Risk stratification allows patient-centric post-transplant surveillance programs.Further validation of the score is recommended.展开更多
The World Health Organisation(WHO)classifies clinical diagnoses with the International Statistical Classification of Disease and Related Health Problems(ICD).There have been various iterations of ICD since it is incep...The World Health Organisation(WHO)classifies clinical diagnoses with the International Statistical Classification of Disease and Related Health Problems(ICD).There have been various iterations of ICD since it is inception.For oncology,ICD-O was introduced in 1976 as a special adaption of ICD for cancers to facilitate greater coding detail of the topography,which describes the anatomical location of the tumour origin,and the morphology concerns the histology of a neoplasm.ICD-10 began in 1983 and was first used in 1994.At the same time,a code for cholangiocarcinoma(CCA)was also introduced(https://icd.who.int/browse10/2010/en).展开更多
Cholangiocarcinoma(CCA)is a rare and very aggressive malignancy arising from the biliary tract.Based on the location of the tumor,CCA can be divided in intrahepatic cholangiocarcinoma(iCCA),perihilar cholangiocarcinom...Cholangiocarcinoma(CCA)is a rare and very aggressive malignancy arising from the biliary tract.Based on the location of the tumor,CCA can be divided in intrahepatic cholangiocarcinoma(iCCA),perihilar cholangiocarcinoma(pCCA)and distal cholangiocarcinoma(dCCA).Many other characteristics differentiate these groups,including pathological features,oncological approach and surgical techniques,which in turn influences patient outcomes.展开更多
文摘BACKGROUND Recurrence of hepatocellular carcinoma(HCC)following liver transplantation(LT)has a devastating influence on recipients’survival;however,the risk of recur-rence is not routinely stratified.Risk stratification is vital with a long LT waiting time,as that could influence the recurrence despite strict listing criteria.AIM This study aims to identify predictors of recurrence and develop a novel risk pre-diction score to forecast HCC recurrence following LT.METHODS A retrospective review of LT for HCC recipients at University Hospitals Bir-mingham between July 2011 and February 2020.Univariate and multivariate analyses were performed to identify recurrence predictors,based on which the novel SIMAP500(satellite nodules,increase in size,microvascular invasion,AFP>500,poor differentiation)risk score was proposed.RESULTS 234 LTs for HCC were performed with a median follow-up of 5.3 years.Recurrence developed in 25 patients(10.7%).On univariate analyses,RETREAT score>3,α-fetoprotein(AFP)at listing 100-500 and>500,bridging,increased tumour size between imaging at the listing time and explant histology,increase in the size of viable tumour between listing and explant,presence of satellite nodules,micro-and macrovascular invasion on explant and poor differentiation of tumours were significantly associated with recurrence,based on which,the SIMAP500 risk score is proposed.The SIMAP500 demonstrated an excellent predictive ability(c-index=0.803)and outper-formed the RETREAT score(c-index=0.73).SIMAP500 is indicative of the time to disease recurrence.CONCLUSION SIMAP500 risk score identifies the LT recipients at risk of HCC recurrence.Risk stratification allows patient-centric post-transplant surveillance programs.Further validation of the score is recommended.
文摘The World Health Organisation(WHO)classifies clinical diagnoses with the International Statistical Classification of Disease and Related Health Problems(ICD).There have been various iterations of ICD since it is inception.For oncology,ICD-O was introduced in 1976 as a special adaption of ICD for cancers to facilitate greater coding detail of the topography,which describes the anatomical location of the tumour origin,and the morphology concerns the histology of a neoplasm.ICD-10 began in 1983 and was first used in 1994.At the same time,a code for cholangiocarcinoma(CCA)was also introduced(https://icd.who.int/browse10/2010/en).
文摘Cholangiocarcinoma(CCA)is a rare and very aggressive malignancy arising from the biliary tract.Based on the location of the tumor,CCA can be divided in intrahepatic cholangiocarcinoma(iCCA),perihilar cholangiocarcinoma(pCCA)and distal cholangiocarcinoma(dCCA).Many other characteristics differentiate these groups,including pathological features,oncological approach and surgical techniques,which in turn influences patient outcomes.
