Department of Hepatobiliary and Pancreatic Surgery, First Affiliated Hospital, Zhejiang University School of Medicine; Institution of Organ Transplantation, Zhejiang University, Hangzhou, 310003, China.
NHFPC Key Laboratory of Combined Multi-organ Transplantation, Hangzhou, 310003, Zhejiang Province, China.
BMC Cancer. 2019 Nov 21;19(1):1136. doi: 10.1186/s12885-019-6343-4.
Early recurrence of hepatocellular carcinoma (HCC) after liver transplantation (LT) is associated with poor surgical outcomes. This study aims to construct a preoperative model to predict individual risk of post-LT HCC recurrence.
Data of 748 adult patients who underwent deceased donor LT for HCC between January 2015, and February 2019 were collected retrospectively from the China Liver Transplant Registry database and randomly divided into training (n = 486) and validation(n = 262) cohorts. A multivariate analysis was performed and the five-eight model was developed.
A total of 748 patients were included in the study; of them, 96% had hepatitis B virus (HBV) and 84% had cirrhosis. Pre-LT serum alpha-fetoprotein (AFP), tumor number and largest tumor diameter were incorporated to construct the 5-8 model which can stratify patients accurately according to their risk of recurrence into three prognostic subgroups; low-(0-5 points), medium-(6-8 points) and high-risk (> 8 points) with 2-year post-LT recurrence rate of (5,20 and 51%,p < 0.001) respectively. The 5-8 model was better than Milan, Hangzhou, and AFP-model for prediction of HCC early recurrence. These findings were confirmed by the results of the validation cohort.
The 5-8 model is a simple validated and accurate tool for preoperative stratification of early recurrence of HCC after LT.
肝移植（LT）后肝细胞癌（HCC）的早期复发与手术结果不佳有关。本研究旨在构建一个术前模型，以预测 LT 后 HCC 复发的个体风险。
回顾性收集了 2015 年 1 月至 2019 年 2 月期间，来自中国肝移植注册数据库的 748 例成人接受尸肝 LT 治疗 HCC 的患者数据，并将其随机分为训练（n=486）和验证（n=262）队列。进行多变量分析并建立五八模型。
共有 748 例患者纳入研究，其中 96%患有乙型肝炎病毒（HBV），84%患有肝硬化。将术前血清甲胎蛋白（AFP）、肿瘤数量和最大肿瘤直径纳入构建五八模型，该模型可根据患者的复发风险将其准确分层为三个预后亚组；低危（0-5 分）、中危（6-8 分）和高危（>8 分），2 年 LT 后复发率分别为（5%、20%和 51%，p<0.001）。五八模型优于米兰、杭州和 AFP 模型，用于预测 HCC 早期复发。验证队列的结果证实了这些发现。
五八模型是一种简单、验证良好且准确的 LT 后 HCC 早期复发的术前分层工具。
