Korean J Transplant.  2022 Nov;36(Supple 1):S37. 10.4285/ATW2022.F-1354.

Expression of tumor markers in liver transplant recipients showing complete pathological response of hepatocellular carcinoma

• Hwang S
• Kang WH
• Ahn CS
• Moon DB
• Ha TY
• Song GW
• Jung DH
• Park GC
• Yoon YI

• KMID: 2535209
• DOI: http://doi.org/10.4285/ATW2022.F-1354

Abstract

Background
Complete pathological response (CPR) is achieved with various pretransplant locoregional treatments (LRTs) for hepatocellular carcinoma (HCC). This study aimed to investigate pretransplant expression of HCC tumor markers in liver transplantation (LT) recipients showing CPR.
Methods
For CPR group, 166 patients were selected from single-institution LT database. A control group of 332 patients without HCC was also selected.
Results
Model for end-stage liver disease score in CPR group was 11.5±7.7. The number of transcatheter arterial chemoembo-lization sessions before LT was once in 68 (14.0%), twice in 38 (22.9%), and ≥3 times in 60 (36.1%). In the explant livers, non-vi-able solitary tumor was identified in 120 (86.4%) and the largest tumor size was 2.4±1.3 cm. Living-donor and deceased-donor LTs were performed in 152 (91.6%) and 14 (8.4%), respectively. The mean and median levels of α-fetoprotein (AFP) and pro-tein-induced by vitamin K absence or antagonist-II (PIVKA-II) measured within 2 weeks before LT were 19.6±50.4 ng/mL and 4.2 ng/mL, and 46.7±126.2 mAU/mL and 20.5 mAU/mL, respectively. Receiver operating characteristic curve analysis of AFP and PIVKA-II showed no definite cutoff values for CPR, and area under the curve was 0.552 (P=0.052) for AFP and 0.541 (P=0.126) for PIVKA-II. The 1-, 3- and 5-year disease recurrence-free and overall survival rates of CPR group were 94.9% and 93.3%, 92.4% and 89.6%, and 92.4% and 89.6%, respectively.
Conclusions
The present study results suggest that serum AFP and PIVKA-II are expressed variably in patients with CPR of HCC. Therefore, pretransplant values of HCC tumor markers should be interpreted with caution.