Comparison of Models for Tumor Recurrence after Liver Transplantation for the Patients with Hepatocellular Carcinoma: A Multicenter Long-Term Follow-Up Study
Background and Aims: Several models have been developed to predict tumor the recurrence of hepatocellular carcinoma (HCC) after liver transplantation besides the conventional Milan criteria (MC), including the MoRAL score. This study aimed to compare the prognostication power of the MoRAL score to m...
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MDPI AG
2019-09-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/11/9/1295 |
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| author | Young Chang Yuri Cho Jeong-Hoon Lee Yun Bin Lee Eun Ju Cho Su Jong Yu Dong Hyun Sinn Bo Hyun Kim Seoung Hoon Kim Nam-Joon Yi Kwang-Woong Lee Jong Man Kim Joong-Won Park Yoon Jun Kim Jung-Hwan Yoon Jae-Won Joh Kyung-Suk Suh |
| author_facet | Young Chang Yuri Cho Jeong-Hoon Lee Yun Bin Lee Eun Ju Cho Su Jong Yu Dong Hyun Sinn Bo Hyun Kim Seoung Hoon Kim Nam-Joon Yi Kwang-Woong Lee Jong Man Kim Joong-Won Park Yoon Jun Kim Jung-Hwan Yoon Jae-Won Joh Kyung-Suk Suh |
| author_sort | Young Chang |
| collection | DOAJ |
| description | Background and Aims: Several models have been developed to predict tumor the recurrence of hepatocellular carcinoma (HCC) after liver transplantation besides the conventional Milan criteria (MC), including the MoRAL score. This study aimed to compare the prognostication power of the MoRAL score to most models designed so far in the Eastern and Western countries. Methods: This study included 564 patients who underwent living donor liver transplantation (LDLT) in three large-volume hospitals in Korea. The primary and secondary endpoints were time-to-recurrence, and overall survival (OS), respectively. The performance of the MoRAL score was compared with those of other various Liver transplantation (LT) criteria, including the Milan criteria, University of California San Francisco (UCSF) criteria, up-to-seven criteria, Kyoto criteria, AFP model, total tumor volume/AFP criteria, Metroticket 2.0 model, and Weill Cornell Medical College group model. Results: The median follow-up duration was 78.1 months. Among all models assessed, the MoRAL score showed the best discrimination function for predicting the risk of tumor recurrence after LT, with <i>c</i>-index of 0.78, compared to other models (all <i>p</i> < 0.001). The MoRAL score also represented the best calibration function by Hosmer-Lemeshow test (<i>p</i> = 0.15). Especially in the beyond-MC sub-cohort, the MoRAL score predicted tumor recurrence (<i>c</i>-index, 0.80) and overall survival (OS) (<i>c</i>-index, 0.70) significantly better than any other models (all <i>p</i> < 0.001). When the MoRAL score was low (<314.8), the five-year cumulative risks of tumor recurrence and death were excellent in beyond-MC (27.8%, and 20.5%, respectively) and within-MC (16.3%, and 21.1%, respectively) sub-cohorts. Conclusions: The MoRAL score provides the most refined prognostication for predicting HCC recurrence after LDLT. |
| first_indexed | 2024-03-12T09:09:50Z |
| format | Article |
| id | doaj.art-5affb602728d4d1fa6f7dca21f6064ed |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-12T09:09:50Z |
| publishDate | 2019-09-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-5affb602728d4d1fa6f7dca21f6064ed2023-09-02T15:02:31ZengMDPI AGCancers2072-66942019-09-01119129510.3390/cancers11091295cancers11091295Comparison of Models for Tumor Recurrence after Liver Transplantation for the Patients with Hepatocellular Carcinoma: A Multicenter Long-Term Follow-Up StudyYoung Chang0Yuri Cho1Jeong-Hoon Lee2Yun Bin Lee3Eun Ju Cho4Su Jong Yu5Dong Hyun Sinn6Bo Hyun Kim7Seoung Hoon Kim8Nam-Joon Yi9Kwang-Woong Lee10Jong Man Kim11Joong-Won Park12Yoon Jun Kim13Jung-Hwan Yoon14Jae-Won Joh15Kyung-Suk Suh16Department of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul 03080, KoreaDepartment of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul 03080, KoreaDepartment of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul 03080, KoreaDepartment of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul 03080, KoreaDepartment of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul 03080, KoreaDepartment of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul 03080, KoreaDepartment of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, KoreaCenter for Liver Cancer, National Cancer Center, Goyang-Si, Gyeonggi-Do 10408, KoreaCenter for Liver Cancer, National Cancer Center, Goyang-Si, Gyeonggi-Do 10408, KoreaDepartment of Surgery, Seoul National University College of Medicine, Seoul 03080, KoreaDepartment of Surgery, Seoul National University College of Medicine, Seoul 03080, KoreaDepartment of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, KoreaCenter for Liver Cancer, National Cancer Center, Goyang-Si, Gyeonggi-Do 10408, KoreaDepartment of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul 03080, KoreaDepartment of Internal Medicine and Liver Research Institute, Seoul National University College of Medicine, 101 Daehak-ro, Jongno-gu, Seoul 03080, KoreaDepartment of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, KoreaDepartment of Surgery, Seoul National University College of Medicine, Seoul 03080, KoreaBackground and Aims: Several models have been developed to predict tumor the recurrence of hepatocellular carcinoma (HCC) after liver transplantation besides the conventional Milan criteria (MC), including the MoRAL score. This study aimed to compare the prognostication power of the MoRAL score to most models designed so far in the Eastern and Western countries. Methods: This study included 564 patients who underwent living donor liver transplantation (LDLT) in three large-volume hospitals in Korea. The primary and secondary endpoints were time-to-recurrence, and overall survival (OS), respectively. The performance of the MoRAL score was compared with those of other various Liver transplantation (LT) criteria, including the Milan criteria, University of California San Francisco (UCSF) criteria, up-to-seven criteria, Kyoto criteria, AFP model, total tumor volume/AFP criteria, Metroticket 2.0 model, and Weill Cornell Medical College group model. Results: The median follow-up duration was 78.1 months. Among all models assessed, the MoRAL score showed the best discrimination function for predicting the risk of tumor recurrence after LT, with <i>c</i>-index of 0.78, compared to other models (all <i>p</i> < 0.001). The MoRAL score also represented the best calibration function by Hosmer-Lemeshow test (<i>p</i> = 0.15). Especially in the beyond-MC sub-cohort, the MoRAL score predicted tumor recurrence (<i>c</i>-index, 0.80) and overall survival (OS) (<i>c</i>-index, 0.70) significantly better than any other models (all <i>p</i> < 0.001). When the MoRAL score was low (<314.8), the five-year cumulative risks of tumor recurrence and death were excellent in beyond-MC (27.8%, and 20.5%, respectively) and within-MC (16.3%, and 21.1%, respectively) sub-cohorts. Conclusions: The MoRAL score provides the most refined prognostication for predicting HCC recurrence after LDLT.https://www.mdpi.com/2072-6694/11/9/1295hepatocellular carcinomaliving donor liver transplantationMoRAL scoresurvivalvalidation |
| spellingShingle | Young Chang Yuri Cho Jeong-Hoon Lee Yun Bin Lee Eun Ju Cho Su Jong Yu Dong Hyun Sinn Bo Hyun Kim Seoung Hoon Kim Nam-Joon Yi Kwang-Woong Lee Jong Man Kim Joong-Won Park Yoon Jun Kim Jung-Hwan Yoon Jae-Won Joh Kyung-Suk Suh Comparison of Models for Tumor Recurrence after Liver Transplantation for the Patients with Hepatocellular Carcinoma: A Multicenter Long-Term Follow-Up Study Cancers hepatocellular carcinoma living donor liver transplantation MoRAL score survival validation |
| title | Comparison of Models for Tumor Recurrence after Liver Transplantation for the Patients with Hepatocellular Carcinoma: A Multicenter Long-Term Follow-Up Study |
| title_full | Comparison of Models for Tumor Recurrence after Liver Transplantation for the Patients with Hepatocellular Carcinoma: A Multicenter Long-Term Follow-Up Study |
| title_fullStr | Comparison of Models for Tumor Recurrence after Liver Transplantation for the Patients with Hepatocellular Carcinoma: A Multicenter Long-Term Follow-Up Study |
| title_full_unstemmed | Comparison of Models for Tumor Recurrence after Liver Transplantation for the Patients with Hepatocellular Carcinoma: A Multicenter Long-Term Follow-Up Study |
| title_short | Comparison of Models for Tumor Recurrence after Liver Transplantation for the Patients with Hepatocellular Carcinoma: A Multicenter Long-Term Follow-Up Study |
| title_sort | comparison of models for tumor recurrence after liver transplantation for the patients with hepatocellular carcinoma a multicenter long term follow up study |
| topic | hepatocellular carcinoma living donor liver transplantation MoRAL score survival validation |
| url | https://www.mdpi.com/2072-6694/11/9/1295 |
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