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    Mean Platelet Volume Is a Poor Prognostic Factor in Patients Undergoing Liver Transplantation for Hepatocellular Carcinoma
    (Aves, 2025) Senturk, Mustafa; Ince, Volkan; Ureyen, Orhan; Eyvaz, Kemal; Isik, Burak; Carr, Brian, I; Yilmaz, Sezai
    Background/Aims: Mean platelet volume (MPV) reflects platelet activation. Platelets have an important role in tumor progression and metastasis. In this study, we wanted to investigate the effect of MPV on survival in patients undergoing liver transplantation (LT) for hepatocellular carcinoma (HCC). Materials and Methods: All data of 376 patients who underwent LT and pathologically diagnosed with HCC were analyzed. Bydetermin- ing the cut-off of MPV (10.2 fL), 2 groups with high and low MPV were formed. The groups were compared within themselves. Factors affecting survival were determined by univariate and multivariate analysis. Results: When the groups were compared, patients with low MPV had significantly higher platelet counts, larger tumor sizes, lower BMI, and higher recurrence rates. In multivariate analysis, GGT >104, AFP >200 mu g/L, largest tumor diameter >5 cm, and lower MPV were found to be independent risk factors that affected the prognosis. Tumor-free survival was significantly worse in the lower MPV group (P = .002). Conclusion: Pre-transplant low MPV maybe useful in predicting poor prognosis and a high rate of tumor recurrence in patients with HCC after liver transplantation.
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    Value of the prognostic nutritional index after liver transplantation of hepatocellular carcinoma patients
    (2023) Şentürk, Mustafa; Yılmaz, Sezai; Işık, Burak; Eyvaz, Kemal; İnce, Volkan; Üreyen, Orhan; Usta, Sertaç
    Introduction: Hepatocellular carcinoma (HCC) is an important cause of cancer-related deaths in the world. Liver transplantation (LT) is a major treatment option for HCC. Therefore, studies predicting the prognosis of patients after transplantation have special importance. Materials and Methods: Three hundred and ninety-six patients who underwent LT for HCC between March 2006 and November 2021 were enrolled in this study. The prognostic nutritional index (PNI) was analyzed to evaluate its use in the prognosis of patients after LT. Receiver operating curve (ROC) analysis was performed to detect the cutoff values and then logistic regression and survival analyses were performed to identify independent risk factors of prognosis. Results: Overall survival (OS) was 9 years (8.2–9.7), disease-free survival (DFS) was 8.7 years (7.9–9.4) and recurrence was 19%. The median PNI value was 35 (15.7–116). Child–Pugh score-A was significant for DFS (P = 0.042) with a cutoff value of 31.02 in ROC analysis. However, no correlation was found between PNI and either OS, DFS, or recurrence. Conclusion: Pre-operative PNI level may not be a good indicator for predicting the survival or recurrence of HCC patients with LT. Further prospective studies are needed to evaluate the importance of PNI levels in patients with LT for HCC.