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Misdiagnosis of hepatocellular carcinoma in patients receiving no local-regional therapy prior to liver transplant: An analysis of the Organ Procurement and Transplantation Network explant pathology form.
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- معلومة اضافية
- المصدر:
Publisher: Munksgaard Country of Publication: Denmark NLM ID: 8710240 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1399-0012 (Electronic) Linking ISSN: 09020063 NLM ISO Abbreviation: Clin Transplant Subsets: MEDLINE
- بيانات النشر:
Original Publication: Copenhagen : Munksgaard,
- الموضوع:
- نبذة مختصرة :
Patients with T1 hepatocellular carcinoma (HCC) are not eligible for Model for End Stage Liver Disease (MELD) exception for liver transplant (LT) in part due to a high rate of misdiagnosis (no HCC on explant). The likelihood of misdiagnosis for T2 HCC and factors associated with misdiagnosis are unknown. We analyzed the Organ Procurement and Transplantation Network database including 5664 adults who underwent LT from 2012 to 2015 with MELD exception for T2 HCC, and searched for no evidence of HCC in the explant pathology file. We focused on those (n = 324) receiving no local-regional therapy (LRT) to evaluate the probability of no HCC found in explant. Median waiting time was short at 1.7 months, and 35 (11%) had no HCC on explant. On multivariable logistic regression, factors associated with no HCC on explant were age <50 (OR: 17.3, P < .001), non-HCV (OR: 5.4, P = .001), and alpha-fetoprotein <10 (OR: 2.9, P = .04). Tumor size and number were not different between groups. The proportion of misdiagnosis did not change significantly after implementation of Liver Imaging Reporting and Data System (LI-RADS) for HCC diagnosis.
Conclusion: The rate of misdiagnosis was 11% among T2 HCC patients who underwent LT without receiving LRT prior to LT and did not change significantly after implementation of LI-RADS. More efforts are needed to eliminate unnecessary LT for patients without HCC.
(© 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)
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- Grant Information:
P30 DK026743 United States DK NIDDK NIH HHS
- Contributed Indexing:
Keywords: Liver Imaging Reporting and Data System; Organ Procurement and Transplantation Network; United Network for Organ Sharing; alpha-fetoprotein
- الموضوع:
Date Created: 20170908 Date Completed: 20180627 Latest Revision: 20181113
- الموضوع:
20231215
- الرقم المعرف:
PMC5937711
- الرقم المعرف:
10.1111/ctr.13107
- الرقم المعرف:
28881064
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