Graduate Program in Medicine: Hepatology, School of Medicine, Universidade Federal de Ciências da Saúde de Porto Alegre, Rua Sarmento Leite, 245, Centro 90050-170, Porto Alegre, RS, Brazil.
Graduate Program in Medicine: Hepatology, School of Medicine, Universidade Federal de Ciências da Saúde de Porto Alegre, Rua Sarmento Leite, 245, Centro 90050-170, Porto Alegre, RS, Brazil; Department of Hepatology, Hospital Vozandes Quito-HVQ, Av. Juan José de Villalengua Oe2-37, Quito 170521, Ecuador.
Ann Hepatol. 2024 Mar-Apr;29(2):101184. doi: 10.1016/j.aohep.2023.101184. Epub 2023 Nov 24.
Liver transplantation is the optimal treatment for patients with early hepatocellular carcinoma and cirrhosis. However, hepatocellular carcinoma recurs in approximately 15 % of individuals. This study aimed to assess the efficacy of predictive models for hepatocellular carcinoma recurrence after liver transplantation.
This retrospective study included 381 patients with HCC and evaluated the performance of the following models: R3-AFP score, alpha-fetoprotein (AFP) model, University of California, Los Angeles (UCLA) nomogram, Pre-Model of Recurrence after Liver Transplantation (MORAL), Post-MORAL, and Combo MORAL models, Risk Estimation of Tumor Recurrence (RETREAT) model and Platelet to Lymphocyte Ratio (PLR) model.
The R3-AFP score, UCLA nomogram, AFP model, RETREAT, Combo MORAL, and Post-MORAL models exhibited comparable AUROCs, ranging from 0.785 to 0.733. The AUROCs for the R3-AFP model and AFP model were superior to those of the Pre-MORAL and PLR models. The UCLA nomogram, RETREAT score, Combo MORAL model, and Post-MORAL model performed similarly to the first two models, but were only superior to the PLR model.
The R3-AFP model, UCLA nomogram, AFP model, RETREAT, Combo MORAL, and Post-MORAL models demonstrated a moderate predictive capacity for hepatocellular carcinoma recurrence following transplantation. No significant differences were observed among these models in their ability to predict recurrence.
肝移植是治疗早期肝细胞癌和肝硬化患者的最佳方法。然而，大约有 15%的患者会出现肝癌复发。本研究旨在评估肝移植后肝癌复发预测模型的疗效。
本回顾性研究纳入了 381 例 HCC 患者，并评估了以下模型的性能：R3-AFP 评分、甲胎蛋白（AFP）模型、加利福尼亚大学洛杉矶分校（UCLA）列线图、移植后复发模型（MORAL）、后-MORAL 和组合-MORAL 模型、肿瘤复发风险评估（RETREAT）模型和血小板与淋巴细胞比值（PLR）模型。
R3-AFP 评分、UCLA 列线图、AFP 模型、RETREAT、组合-MORAL 和后-MORAL 模型的 AUROC 相当，范围在 0.785 到 0.733 之间。R3-AFP 模型和 AFP 模型的 AUROC 优于前-MORAL 和 PLR 模型。UCLA 列线图、RETREAT 评分、组合-MORAL 模型和后-MORAL 模型的表现与前两个模型相似，但仅优于 PLR 模型。
R3-AFP 模型、UCLA 列线图、AFP 模型、RETREAT、组合-MORAL 和后-MORAL 模型对移植后肝细胞癌复发具有中等的预测能力。这些模型在预测复发方面没有显著差异。
