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Shin Hwang,Kyung Jin Lee,Deok-Bog Moon,Gi-Won Song,Dong-Hwan Jung,Yun Kyu Kim,Hunji Yang,Da Eun An,Sion Lee,Sung-Gyu Lee 대한외과학회 2022 Annals of Surgical Treatment and Research(ASRT) Vol.102 No.1
Purpose: The programmed death protein 1 (PD-1) pathway is the critical mechanism in development of hepatocellular carcinoma (HCC). The present study analyzed the prognostic impact of pretransplant serum soluble PD-1 (sPD-1) concentration and α-FP–des-γ-carboxyprothrombin–tumor volume (ADV) score in patients with previously untreated HCC undergone liver transplantation (LT). Methods: This retrospective single-center study enrolled 100 patients with HCC who underwent living donor LT from 2010 to 2016. Concentrations of sPD-1 were measured in stored serum samples. Results: Receiver operating characteristic curve analysis of 2-year tumor recurrence resulted in an sPD-1 cutoff of 177.1 μg/mL, which was associated with higher rates of tumor recurrence (P = 0.022), but not with overall patient survival (P = 0.460). The derived cutoff for pretransplant ADV score was 5.4log, which was associated with higher tumor recurrence rate (P < 0.001) and lower overall patient survival rate (P < 0.001). Both sPD-1 of >177.1 μg/mL (hazard ratio [HR], 2.26; P = 0.020) and pretransplant ADV score of >5.4log (HR, 3.56; P < 0.001) were independent risk factors for posttransplant HCC recurrence. The combination of these 2 factors enabled the stratification of patients into 3 groups, with groups having 0, 1, and 2 risk factors differing significantly in the prognosis of tumor recurrence (P < 0.001) and overall patient survival (P = 0.006). Conclusion: Both sPD-1 concentration and ADV score have prognostic impacts in patients who underwent LT for untreated HCCs. These factors, both individually and combined, can help in predicting posttransplant prognosis.
( Gil-chun Park ),( Kyung Jin Lee ),( Shin Hwang ),( Yun Kyu Kim ),( Chul-soo Ahn ),( Ki-hun Kim ),( Deok-bog Moon ),( Tae-yong Ha ),( Gi-won Song ),( Dong-hwan Jung ),( Hunji Yang ),( Young-in Yoon ) 대한간학회 2020 춘·추계 학술대회 (KASL) Vol.2020 No.1
Aims: The study aimed to assess the prognostic influence of pretransplant serum soluble programmed death protein 1 (sPD-1) in patients undergoing liver transplantation for treatment of hepatocellular carcinoma (HCC). Methods: Data from 229 patients with HCC who underwent living donor liver transplantation between January 2010 and December 2015 were retrospectively evaluated. Stored serum samples were used to evaluate sPD-1 concentrations. Results: Tumor recurrence, overall survival, and HCC-specific survival rates were 25.5%, 94.3%, and 96.0% at 1 year; 40.8%, 78.2%, and 80.7% at 3 years; and 44.5%, 75.4%, and 77.9% at 5 years, respectively. Prognostic analysis using pretransplant serum sPD-1 with a cutoff of 93.6 μg/mL (median value of the study cohort) did not have significant prognostic influence on HCC recurrence, HCC-specific patient survival and post-recurrence patient survival (P≥0.26). Prognostic analysis using sPD-1 with a cutoff of 300 μg/mL showed marginally higher tumor recurrence (P=0.069), similar HCC-specific patient survival (P=0.25) and higher post-recurrence patient survival (P=0.045). Multivariate analysis revealed that Milan criteria were prognostic for HCC recurrence and HCC-specific patient survival, but pretransplant sPD1 with a cutoff of 300 μg/mL did not become an independent prognostic factor. Conclusions: The results of this study demonstrate that pretransplant serum sPD-1 did not show significant influences on post-transplant outcomes in patients with HCC, although there was be some potential prognostic influences from very high expression of serum sPD-1. Further large-scale, multicenter studies are necessary to clarify the role of serum sPD-1 in LT recipients.