The predictive value of the modified AFP model for liver transplantation outcomes in multinodular hepatocellular carcinoma patients Journal Articles uri icon

  • Overview
  • Research
  • Identity
  • Additional Document Info
  • View All


  • Abstract Background There is a lack of studies focusing on the benefit of liver transplantation (LT) in hepatocellular carcinoma (HCC) patients with > 3 tumors. This study aims to establish a model to effectively predict overall survival in Chinese HCC patients with multiple tumors (> 3 tumors) who undergo LT. Methods This retrospective study included 434 HCC liver transplant recipients from the China Liver Transplant Registry. All HCC patients had more than 3 tumor nodules. Three selection criteria systems (i.e., AFP, Metroticket 2.0, and Up-to-7) were compared regarding the prediction of HCC recurrence. The modified AFP model was established by univariate and multivariate competing risk analyses. Results The AFP score 2 and the AFP score ≥ 3 groups had 5-year recurrence rates of 19.6% and 40.5% in our cohort. The prediction of HCC recurrence based on the AFP model was associated with a c-statistic of 0.606, which was superior to the Up-to-7 and Metroticket 2.0 models. AFP level > 1000 ng/mL, largest tumor size ≥ 8 cm, vascular invasion, and MELD score ≥ 15 were associated with overall survival. The 5-year survival rate in the modified AFP score 0 group was 71.7%. Conclusions The AFP model is superior in predicting tumor recurrence in HCC patients with > 3 tumors prior to LT. With the modified AFP model, patients likely to derive sufficient benefit from LT can be identified.


  • Wang, Jingrui
  • Bao, Jiaqi
  • Wang, Rui
  • Hong, Jiachen
  • Zhang, Lincheng
  • Que, Qingyang
  • Xu, Shengjun
  • Wu, Yongfeng
  • Zhan, Qifan
  • Liu, Yuchen
  • Liu, Jimin (Nancy)
  • Zheng, Shusen
  • Ling, Sunbin
  • Xu, Xiao

publication date

  • March 27, 2023