Universität zu Köln

Herden, Uta, Schoening, Wenzel, Pratschke, Johann, Manekeller, Steffen, Paul, Andreas, Linke, Richard, Lorf, Thomas, Lehner, Frank, Braun, Felix, Stippel, Dirk L., Sucher, Robert, Schmidt, Hartmut, Strassburg, Christian P., Guba, Markus, van Rosmalen, Marieke, Rogiers, Xavier, Samuel, Undine, Schoen, Gerhard MSc and Nashan, Bjoern (2019). Accuracy of Pretransplant Imaging Diagnostic for Hepatocellular Carcinoma: A Retrospective German Multicenter Study. Can. J. Gastroenterol. Hepatol., 2019. LONDON: HINDAWI LTD. ISSN 2291-2797

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Abstract

Selection and prioritization of patients with HCC for LT are based on pretransplant imaging diagnostic, taking the risk of incorrect diagnosis. According to the German waitlist guidelines, imaging has to be reported to the allocation organization (Eurotransplant) and pathology reports have to be submitted thereafter. In order to assess current procedures we performed a retrospective multicenter analysis in all German transplant centers with focus on accuracy of imaging diagnostic and tumor classification. 1168 primary LT for HCC were conducted between 2007 and 2013 in Germany. Patients inside the Milan, UCSF, and up-to-seven criteria were misclassified with definitive histologic results in 18%, 15%, and 11%, respectively. Patients pretransplant outside the Milan, UCSF, and up-to-seven criteria were otherwise misclassified in 34%, 43%, and 41%. Recurrence-free survival correlated with classification by posttransplant histological report, but not pretransplant imaging diagnostic. Univariate analysis revealed tumor size, vascular invasion, and grading as significant parameters for outcome, while tumor grading was the only parameter persisting by multivariate testing. Conclusion. There was a relevant percentage (15-40%) of patients misclassified by imaging diagnosis at a time prior to LI-RADS and guidelines to improve imaging of HCC. Outcome analysis showed a good correlation to histological, in contrast poor correlation to imaging diagnosis, suggesting an adjustment of the LT selection and prioritization criteria.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Herden, Uta UNSPECIFIED UNSPECIFIED UNSPECIFIED Schoening, Wenzel UNSPECIFIED UNSPECIFIED UNSPECIFIED Pratschke, Johann UNSPECIFIED UNSPECIFIED UNSPECIFIED Manekeller, Steffen UNSPECIFIED UNSPECIFIED UNSPECIFIED Paul, Andreas UNSPECIFIED UNSPECIFIED UNSPECIFIED Linke, Richard UNSPECIFIED UNSPECIFIED UNSPECIFIED Lorf, Thomas UNSPECIFIED UNSPECIFIED UNSPECIFIED Lehner, Frank UNSPECIFIED UNSPECIFIED UNSPECIFIED Braun, Felix UNSPECIFIED UNSPECIFIED UNSPECIFIED Stippel, Dirk L. UNSPECIFIED UNSPECIFIED UNSPECIFIED Sucher, Robert UNSPECIFIED UNSPECIFIED UNSPECIFIED Schmidt, Hartmut UNSPECIFIED UNSPECIFIED UNSPECIFIED Strassburg, Christian P. UNSPECIFIED UNSPECIFIED UNSPECIFIED Guba, Markus UNSPECIFIED UNSPECIFIED UNSPECIFIED van Rosmalen, Marieke UNSPECIFIED UNSPECIFIED UNSPECIFIED Rogiers, Xavier UNSPECIFIED UNSPECIFIED UNSPECIFIED Samuel, Undine UNSPECIFIED UNSPECIFIED UNSPECIFIED Schoen, Gerhard MSc UNSPECIFIED UNSPECIFIED UNSPECIFIED Nashan, Bjoern UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-139421
DOI:	10.1155/2019/8747438
Journal or Publication Title:	Can. J. Gastroenterol. Hepatol.
Volume:	2019
Date:	2019
Publisher:	HINDAWI LTD
Place of Publication:	LONDON
ISSN:	2291-2797
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language LIVER-TRANSPLANTATION; RECURRENCE; HCC; CRITERIA; IMPACT; MILAN; SIZE Multiple languages Gastroenterology & Hepatology Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/13942