Increased hepatocellular carcinoma recurrence in women compared to men with high alpha fetoprotein at liver transplant
Título del documento: Increased hepatocellular carcinoma recurrence in women compared to men with high alpha fetoprotein at liver transplant
Revue: Annals of hepatology
Base de datos: PERIÓDICA
Número de sistema: 000407478
ISSN: 1665-2681
Autores: 1
2
2
1
1
1
Instituciones: 1University of California at San Francisco, Division of Gastroenterology and Hepatology, San Francisco, California. Estados Unidos de América
2University of California at San Francisco, Division of Transplant Surgery, San Francisco, California. Estados Unidos de América
Año:
Periodo: Jul-Ago
Volumen: 15
Número: 4
Paginación: 545-549
País: México
Idioma: Inglés
Tipo de documento: Artículo
Enfoque: Analítico, descriptivo
Resumen en inglés Men have higher risk for hepatocellular carcinoma (HCC) than women. Pre liver transplant (LT) alpha fetoprotein (AFP) levels strongly predict post LT HCC recurrence. Though women with HCC have higher AFP, the contribution of AFP level by gender to post LT HCC recurrence is unknown. Material and methods. In this UNOSbased, retrospective cohort study we investigate sex differences in HCC recurrence among LT recipients with MELD exception between 2006-2010. Covariates include race, disease etiology, co-morbidities, AFP at listing and LT, tumor burden, loco-regional therapy, and donor risk index. HCC recurrence was assessed by competing risks regression. Results. Of the eligible cohort (n = 5,002) included 3,872 men and 1,130 women. HCC recurred in 258 men (7%) and 66 women (6%). Median listing AFP was higher in women than men (14 vs. 11 ng/dL, p < 0.001). While no sex difference in overall HCC recurrence was detected (HR 0.9, 95% CI 0.7-1.2, p = 0.38), there was a strong interaction between gender and AFP on recurrence risk (p = 0.02). HCC recurrence was nearly three times higher in women (HR 4.2, 95% CI 2.2-8.2, p < 0.001) than men (HR 1.5, 95% CI 1.1-2.1, p = 0.02) with AFP at LT between 101-500 ng/dL. Conclusion. This study reveals novel sex differences in post LT HCC recurrence, which was nearly three times higher in women than men with high AFP at LT. Pre-LT AFP levels appear to carry a different prognosis in women than men, and a subset of female LT recipients may benefit from more intensive HCC surveillance after LT
Disciplinas: Medicina
Palabras clave: Gastroenterología,
Oncología,
Carcinoma hepatocelular,
Alfa fetoproteína,
Diferencias de género
Keyword: Medicine,
Gastroenterology,
Oncology,
Hepatocellular carcinoma,
Alpha fetoprotein,
Gender differences
Texte intégral: Texto completo (Ver PDF)