Impact of Pre-Liver Transplant Treatments on the Imaging Accuracy of HCC Staging and Their Influence on Outcomes
The outcome of liver transplantation (LT) for hepatocarcinoma (HCC) is strongly influenced by HCC staging, which is based on radiological examinations in a pre-LT setting; concordance between pre-LT radiological and definitive pathological staging remains controversial. To address this issue, we ret...
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| Format: | Article |
| Language: | English |
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MDPI AG
2024-03-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/16/5/1043 |
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| author | Eloisa Franchi Daniele Eliseo Dondossola Giulia Maria Francesca Marini Massimo Iavarone Luca Del Prete Clara Di Benedetto Maria Francesca Donato Barbara Antonelli Pietro Lampertico Lucio Caccamo |
| author_facet | Eloisa Franchi Daniele Eliseo Dondossola Giulia Maria Francesca Marini Massimo Iavarone Luca Del Prete Clara Di Benedetto Maria Francesca Donato Barbara Antonelli Pietro Lampertico Lucio Caccamo |
| author_sort | Eloisa Franchi |
| collection | DOAJ |
| description | The outcome of liver transplantation (LT) for hepatocarcinoma (HCC) is strongly influenced by HCC staging, which is based on radiological examinations in a pre-LT setting; concordance between pre-LT radiological and definitive pathological staging remains controversial. To address this issue, we retrospectively analyzed our LT series to assess concordance between radiology and pathology and to explore the factors associated with poor concordance and outcomes. We included all LTs with an HCC diagnosis performed between 2013 and 2018. Concordance (Co group) was defined as a comparable tumor burden in preoperative imaging and post-transplant pathology; otherwise, non-concordance was diagnosed (nCo group). Concordance between radiology and pathology was observed in 32/134 patients (Co group, 24%). The number and diameter of the nodules were higher when nCo was diagnosed, as was the number of pre-LT treatments. Although concordance did not affect survival, more than three pre-LT treatments led to a lower disease-free survival. Patients who met the Milan Criteria (Milan-in patients) were more likely to receive ≥three prior treatments, leading to a lower survival in multi-treated Milan-in patients than in other Milan-in patients. In conclusion, the concordance rate between the pre-LT imaging and histopathological results was low in patients with a high number of nodules. Multiple bridging therapies reduce the accuracy of pre-LT imaging in predicting HCC stages and negatively affect outcomes after LT. |
| first_indexed | 2024-04-25T00:33:40Z |
| format | Article |
| id | doaj.art-be5112334c994dbdbbbf261aaf5d2b56 |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-04-25T00:33:40Z |
| publishDate | 2024-03-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-be5112334c994dbdbbbf261aaf5d2b562024-03-12T16:41:19ZengMDPI AGCancers2072-66942024-03-01165104310.3390/cancers16051043Impact of Pre-Liver Transplant Treatments on the Imaging Accuracy of HCC Staging and Their Influence on OutcomesEloisa Franchi0Daniele Eliseo Dondossola1Giulia Maria Francesca Marini2Massimo Iavarone3Luca Del Prete4Clara Di Benedetto5Maria Francesca Donato6Barbara Antonelli7Pietro Lampertico8Lucio Caccamo9General and Liver Transplant Surgery Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, ItalyGeneral and Liver Transplant Surgery Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, ItalyGeneral and Liver Transplant Surgery Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, ItalyDivision of Gastroenterology and Hepatology, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, ItalyGeneral and Liver Transplant Surgery Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, ItalyDivision of Gastroenterology and Hepatology, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, ItalyDivision of Gastroenterology and Hepatology, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, ItalyGeneral and Liver Transplant Surgery Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, ItalyDepartment of Pathophysiology and Transplantation, Università degli Studi, 20122 Milan, ItalyGeneral and Liver Transplant Surgery Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20122 Milan, ItalyThe outcome of liver transplantation (LT) for hepatocarcinoma (HCC) is strongly influenced by HCC staging, which is based on radiological examinations in a pre-LT setting; concordance between pre-LT radiological and definitive pathological staging remains controversial. To address this issue, we retrospectively analyzed our LT series to assess concordance between radiology and pathology and to explore the factors associated with poor concordance and outcomes. We included all LTs with an HCC diagnosis performed between 2013 and 2018. Concordance (Co group) was defined as a comparable tumor burden in preoperative imaging and post-transplant pathology; otherwise, non-concordance was diagnosed (nCo group). Concordance between radiology and pathology was observed in 32/134 patients (Co group, 24%). The number and diameter of the nodules were higher when nCo was diagnosed, as was the number of pre-LT treatments. Although concordance did not affect survival, more than three pre-LT treatments led to a lower disease-free survival. Patients who met the Milan Criteria (Milan-in patients) were more likely to receive ≥three prior treatments, leading to a lower survival in multi-treated Milan-in patients than in other Milan-in patients. In conclusion, the concordance rate between the pre-LT imaging and histopathological results was low in patients with a high number of nodules. Multiple bridging therapies reduce the accuracy of pre-LT imaging in predicting HCC stages and negatively affect outcomes after LT.https://www.mdpi.com/2072-6694/16/5/1043liver transplanthepatocarcinomaconcordance |
| spellingShingle | Eloisa Franchi Daniele Eliseo Dondossola Giulia Maria Francesca Marini Massimo Iavarone Luca Del Prete Clara Di Benedetto Maria Francesca Donato Barbara Antonelli Pietro Lampertico Lucio Caccamo Impact of Pre-Liver Transplant Treatments on the Imaging Accuracy of HCC Staging and Their Influence on Outcomes Cancers liver transplant hepatocarcinoma concordance |
| title | Impact of Pre-Liver Transplant Treatments on the Imaging Accuracy of HCC Staging and Their Influence on Outcomes |
| title_full | Impact of Pre-Liver Transplant Treatments on the Imaging Accuracy of HCC Staging and Their Influence on Outcomes |
| title_fullStr | Impact of Pre-Liver Transplant Treatments on the Imaging Accuracy of HCC Staging and Their Influence on Outcomes |
| title_full_unstemmed | Impact of Pre-Liver Transplant Treatments on the Imaging Accuracy of HCC Staging and Their Influence on Outcomes |
| title_short | Impact of Pre-Liver Transplant Treatments on the Imaging Accuracy of HCC Staging and Their Influence on Outcomes |
| title_sort | impact of pre liver transplant treatments on the imaging accuracy of hcc staging and their influence on outcomes |
| topic | liver transplant hepatocarcinoma concordance |
| url | https://www.mdpi.com/2072-6694/16/5/1043 |
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