Liver transplant for large hepatocellular carcinoma in Malatya: The role of gamma glutamyl transferase and alpha-fetoprotein, a retrospective cohort study

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dc.authoridErsan, Veysel/0000-0002-1510-0288
dc.authoridKutluturk, Koray/0000-0002-7030-4953
dc.authoridKARAKAS, SERDAR/0000-0001-8314-7806
dc.authoridGozukara Bag, Harika Gozde/0000-0003-1208-4072
dc.authoridYilmaz, Sezai/0000-0002-8044-0297
dc.authoridBASKIRAN, ADIL/0000-0002-7536-1631
dc.authoridince, volkan/0000-0002-0714-490X
dc.authorwosidErsan, Veysel/AAB-9595-2020
dc.authorwosidKutluturk, Koray/S-5493-2019
dc.authorwosidKARAKAS, SERDAR/AAB-3219-2021
dc.authorwosidGozukara Bag, Harika Gozde/ABG-7588-2020
dc.authorwosidYilmaz, Sezai/ABI-2323-2020
dc.authorwosidBASKIRAN, ADIL/ABI-2356-2020
dc.authorwosidKoc, Cemalettin/B-6430-2018
dc.contributor.authorInce, Volkan
dc.contributor.authorCarr, Brian, I
dc.contributor.authorBag, Harika Gozukara
dc.contributor.authorErsan, Veysel
dc.contributor.authorUsta, Sertac
dc.contributor.authorKoc, Cemalettin
dc.contributor.authorGonultas, Fatih
dc.date.accessioned2024-08-04T20:59:53Z
dc.date.available2024-08-04T20:59:53Z
dc.date.issued2020
dc.departmentİnönü Üniversitesien_US
dc.description.abstractBACKGROUND There is increasing interest in transplanting patients with hepatocellular carcinoma (HCC) with tumors greater than 5 cm (Milan criteria). AIM To investigate possible prognostically-useful factors for liver transplantation in HCC patients with large tumors. METHODS In this clinical study, 50 patients with HCC who were transplanted at our Liver Transplant Center between April 2006 and August 2019 and had tumors greater than 6 cm maximum diameter were retrospectively analyzed. Their survival and full clinical characteristics were examined, with respect to serum alpha-fetoprotein (AFP) and gamma glutamyl transpeptidase (GGT) levels. Kaplan-Meier survival estimates were used to determine overall survival and disease-free survival in these patients. The inclusion criterion was evidence of HCC. Exclusion criteria were the presence of macroscopic portal vein thrombosis or metastasis and a follow-up period of less than 90 d. RESULTS Using receiver operating characteristic curve (ROC) analysis, cutoff values of AFP 200 ng/mL and GGT 104 IU/L were identified and used in this study. Significantly longer overall survival (OS) and disease-free-survival (DFS) were found in patients who had lower values of either parameter, compared with higher values. Even greater differences in survival were found when the 2 parameters were combined. Two tumor size bands were identified, in searching for the limits of this approach with larger tumors, namely 6-10 cm and > 10 cm. Combination parameters in the 6-10 cm band reflected 5-year OS of 76.2% in patients with low AFP plus low GGT vs 0% for all other groups. Patients with tumors greater than 10 cm, did not have low AFP plus low GGT. The most consistent clinical correlates for longer survival were degree of tumor differentiation and absence of microscopic portal venous invasion. CONCLUSION Serum levels of AFP and GGT, both alone and combined, represent a simple prognostic identifier in patients with large HCCs undergoing liver transplant-ation.en_US
dc.identifier.doi10.4240/wjgs.v12.i12.520
dc.identifier.issn1948-9366
dc.identifier.issue12en_US
dc.identifier.pmid33437403en_US
dc.identifier.urihttps://doi.org/10.4240/wjgs.v12.i12.520
dc.identifier.urihttps://hdl.handle.net/11616/103600
dc.identifier.volume12en_US
dc.identifier.wosWOS:000604283100004en_US
dc.identifier.wosqualityQ2en_US
dc.indekslendigikaynakWeb of Scienceen_US
dc.indekslendigikaynakPubMeden_US
dc.language.isoenen_US
dc.publisherBaishideng Publishing Group Incen_US
dc.relation.ispartofWorld Journal of Gastrointestinal Surgeryen_US
dc.relation.publicationcategoryMakale - Uluslararası Hakemli Dergi - Kurum Öğretim Elemanıen_US
dc.rightsinfo:eu-repo/semantics/openAccessen_US
dc.subjectHepatic malignancyen_US
dc.subjectAdvanceden_US
dc.subjectGamma glutamyl transpeptidaseen_US
dc.subjectLiving donoren_US
dc.subjectBeyonden_US
dc.subjectExtendeden_US
dc.titleLiver transplant for large hepatocellular carcinoma in Malatya: The role of gamma glutamyl transferase and alpha-fetoprotein, a retrospective cohort studyen_US
dc.typeArticleen_US

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