Newswise — UCLA transplantation researchers have developed a novel method that more accurately calculates the risk of disease recurrence in liver cancer patients who have undergone a liver transplant, providing a new tool to help physicians make treatment and surveillance decisions.
Dr. Ronald W. Busuttil, the William P. Longmire, Jr. Chair in Surgery and director of the Pfleger Liver Institute and Dumont-UCLA Transplant and Liver Cancer Centers, presented the study during the annual meeting of the Southern Surgical Association. The study appears in the early online edition of the peer-reviewed Journal of the American College of Surgeons.
The predictive calculator, also known as a nomogram, was developed after the research team analyzed data from UCLA’s 30 years of experience with liver transplantation for liver cancer. The retrospective study included 865 liver cancer patients who had transplants between 1984 and 2013, said study first author Dr. Vatche G. Agopian, an assistant professor of surgery in the division of liver transplantation at UCLA.
Prior to 1996, there were no criteria to guide which liver cancer patients might be good candidates for transplant, and patients with all sizes and numbers of tumors underwent transplantation, often times with early recurrence of disease. In 1996, radiologic criteria popularized as the “Milan criteria” were introduced and recommended transplantation be limited to patients with a single tumor of five centimeters or less or up to three tumors with not any single tumor larger than three centimeters.
However, the criteria didn’t take into account the aggressiveness of the tumor or other blood biomarkers that can help predict recurrence, Agopian said. UCLA’s nomogram used three groups of factors to predict recurrence and was more accurate than the Milan criteria and the existing American Joint Committee on Cancer pathologic TNM staging system, giving transplant physicians and oncologists more information to work with in deciding how often to monitor for recurrence and whether or not adjuvant treatment is necessary.
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