Survival outcomes of liver transplantation for hepatocellular carcinoma in patients with normal, high and very high preoperative alpha-fetoprotein levels

Table 1 Comparison of Group A, Group B and Group C

	Group A (n = 83)	Group B (n = 131)	Group C (n = 36)	P value
Age (yr)	56 (38-65)	55 (3-72)	51.5 (11-66)	0.037
Male/Female	67/16	113/18	29/7	0.492
Diagnosis:
Cirrhosis
Cryptogenic	2	2	1
Hepatitis B	67	89	25
Hepatitis C	4	22	3
Alcoholic	0	1	1
Hepatitis B + C	1	2	0
Alcoholic + hepatitis C	1	0	1
Alcoholic + hepatitis B	0	1	0
Autoimmune	1	0	0
Wilson's disease	0	0	0
Preoperative MELD score	13 (6-35)	12 (6-35)	12 (8-43)	0.745
Waiting time (d)	94 (1-2735)	31 ( 1-1874)	35 (1-1473)	0.001
Blood transfusion (units)	4.2 (0-32)	2 (0-56)	4 (0-31)	0.128
Fresh frozen plasma transfusion (units)	8 (0-24)	6 (0-30)	6 (0-22)	0.609
Platelet transfusion (units)	8 (0-26)	6 (0-32)	8 (0-22)	0.978
Operation time (min)	650 (370-1105)	678 (333-1110)	707 (300-1273)	0.598
Cold ischemic time (min)	182 (62-652)	125 (60-633)	133 (70-500)	0.206
Warm ischemic time (min)	49.5 (25-102)	52 (26-108)	55.5 (30-93)	0.209
Hospital stay (d)	1.7 (8-132)	15 (0-83)	15 (7-47)	0.251
Intensive care unit stay (d)	3 (1-42)	3 (0-30)	3 (2-16)	0.283
Follow-up (mo)	82.4 (0.59-204.9)	89.1 (0-210.82)	68.2 (5.95-204.24)	0.242
Hospital mortality	2 (2.4%)	2 (1.5%)	0	0.626
LDLT:DDLT	45:38	93:38	28:8	0.012
Explant Milan Within:Beyond	56:23	84:46	15:21	0.010
Explant UCSF Within:Beyond	63:16	98:32	23:13	0.188
No. of tumor in explant	1 (1-multiple)	2 (1-multiple)	1 (1-20)	0.272
Largest size of tumor in explant (cm)	2.5 (0.90-7.00)	3.0 (0.25-9.00)	4.0 (1.5-19.5)	0.003
Differentiation:				0.017
Well	26	41	3
Moderate	41	66	25
Poor	2	8	6
Undifferentiated	0	2	0
Unknown	10	13	2
Vascular permeation:				0.003
No	60	85	14
Yes	18	40	21
Unknown	1	5	1
Graft loss	18 (21.7%)	28 (21.4%)	15 (41.7%)	0.033
Patient status Alive:Dead	65:18	104:27	21:15	0.027
Graft survival, yr				0.038
1	96.40%	93.10%	97.20%
3	89.20%	84.70%	80.60%
5	85.50%	81.60%	66.00%
Patient survival, yr				0.029
1	96.40%	94.70%	97.20%
3	89.20%	85.50%	80.60%
5	85.50%	82.40%	66.00%
Disease-free survival, yr				0.007
1	92.80%	89.30%	80.60%
3	88.00%	81.70%	72.20%
5	84.30%	80.10%	61.10%
Postoperative early complication by Clavien grading:				0.702
No	40	68	20
I	19	24	9
II	5	13	2
IIIA	11	11	3
IIIB	6	6	2
IVA	1	7	0
IVB	0	0	0
V	1	2	0

Group A-AFP < 10 ng/mL; Group B-AFP ≥ 10 to < 400 ng/mL; Group C, AFP ≥ 400 ng/mL. MELD: Model for end-stage liver disease; DDLT: Deceased-donor liver transplant; LDLT: Living-donor liver transplant.

Table 2 Comparison of the two subgroups, Group D and Group E

	Group D (n = 180)	Group E (n = 70)	P value
Age (yr)	56 (38-67)	53.5 (3-72)	0.017
Male:Female	150:30	59:11	0.855
Diagnosis:
Cirrhosis
Cryptogenic	4	1
Hepatitis B	136	45
Hepatitis C	19	10
Alcoholic	1	1
Hepatitis B + C	1	2
Alcoholic + hepatitis C	1	1
Alcoholic + hepatitis B	1	0
Autoimmune	1	0
Wilson's disease	0	0
Preoperative MELD score	12 (6-35)	12 (6-43)	0.972
Waiting time (d)	58.5 (1-2735)	32 (1-1874)	0.183
Blood transfusion (units)	3 (0-56)	4(0-32)	0.988
Fresh frozen plasma transfusion (units)	6 (0-30)	6 (0-22)	0.798
Platelet transfusion (units)	6 (0-30)	8 (0-32)	0.708
Operation time (min)	654 (333-1110)	716.5 (300-1273)	0.151
Cold ischemic time (min)	137.5 (60-652)	127.5 (66-633)	0.195
Warm ischemic time (min)	51 (25-108)	53 (28-93)	0.308
Hospital stay (d)	15.5 (0-132)	16 (7-48)	0.497
Intensive care unit stay (d)	3 (0-42)	3 (2-30)	0.806
Follow-up (mo)	87.2 (0.0-210.8)	75.4 (3.8-206.8)	0.173
Hospital mortality	4 (2.2%)	0	0.486
LDLT: DDLT	112:68	54:16	0.025
Explant Milan Within:Beyond	116:60	39:30	0.170
Explant UCSF Within:Beyond	135:41	49:20	0.354
No. of tumor in explant	1.5 (1-multiple)	1 (1-20)	0.551
Largest size of tumor in explant (cm)	2.85 (0.90-7.00)	3.5 (0.25-19.5)	0.017
Differentiation			0.0001
Well	59	11
Moderate	91	41
Poor	6	10
Undifferentiated	0	2
Unknown	20	5
Vascular permeation			0.014
No	124	35
Yes	48	31
Unknown	4	3
Graft loss	37 (20.6%)	24 (34.3%)	0.023
Patient status Alive:Dead	143:37	47:23	0.041
Graft survival, yr			0.024
1	95.00%	94.30%
3	87.20%	81.40%
5	83.80%	72.30%
Patient survival, yr			0.045
1	95.60%	95.70%
3	87.20%	82.90%
5	83.80%	73.80%
Disease-free survival, yr			0.006
1	91.10%	84.30%
3	85.00%	75.70%
5	82.20%	70.00%
Postoperative early complication by Clavien grading			0.798
No	90	38
I	35	17
II	16	4
IIIA	19	6
IIIB	11	3
IVA	6	2
IVB	0	0
V	3	0