Usefulness of preoperative C-reactive protein and alpha-fetoprotein levels for prognostication of patients with hepatocellular carcinoma after living donor liver transplantation
Mori, S.; Choi, Y.; Park, M.-S.; Kim, H.; Hong, G.; Yi, N.-J.; Lee, K.-W.; Suh, K.-S.
Hepato-Gastroenterology 61(136): 2353-2358
2014
ISSN/ISBN: 0172-6390 PMID: 25699382 Document Number: 674206
The C-reactive protein level has been reported as a prognostic predictor for hepatocellular carcinoma after surgery. We investigated the usefulness of preoperative C-reactive protein levels in predicting outcomes after living donor liver transplantation for hepatocellular carcinoma and identified preoperative risk factors. We retrospectively analyzed 96 hepatocellular carcinoma patients who underwent living donor liver transplantation in March 2003-November 2009. The effect of preoperative variables on overall survival was evaluated by multivariate analysis. The 5-year overall survival rate was significantly lower for C-reactive protein levels >0.3 mg/dL than for C-reactive protein levels ≤0.3 mg/dL (55.8% vs. 89.8%; P=0.001). In multivariate analysis, C-reactive protein levels >0.3 mg/dL (P=0.006) and alpha-fetoprotein levels >200 ng/mL (P<0.001) were significant risk factors for survival. For patients within Milan criteria (n=68), the 3-year overall survival rate with 2 risk factors (n=8) was 20%; of these patients, 63% experienced recurrence. For patients outside Milan criteria (n=28), the 5-year overall survival rate without 1-2 risk factors (n=21) was 80.9%; of these patients, 33% experienced recurrence. Preoperative C-reactive protein levels predicted prognosis after living donor liver transplantation for hepatocellular carcinoma. C-reactive protein and alpha-fetoprotein levels together with Milan criteria may improve hepatocellular carcinoma patient selection for liver transplantation.