Pathological Score of Parfitt et al for Predicting Recurrent Hepatocellular Carcinoma Following Liver Transplantation

Description

Parfitt et al developed a score for predicting recurrence of hepatocellular carcinoma following liver transplantation. The score is based on the pathological examination of the explanted (native) liver. The authors are from London Health Sciences Centre and the University of Western Ontario in London, Ontario, Canada.

Examination: gross and microscopic examination of resected liver

Parameters:

(1) maximum diameter of the largest tumor nodule

(2) microvascular invasion

(3) microsatellitosis (microscopic tumor nodule separated from the main tumor by a distance greater than microscopic tumor nodule's diameter)

(4) giant or bizarre tumor cells visible at low microscopic power

Parameter	Finding	Points
maximum diameter of a tumor nodule	< 3 cm	0
	>= 3.5 cm	3.5
microvascular invasion	absent	0
	present	4.0
microsatellitosis	absent	0
	present	3.5
giant or bizarre tumor cells	<= 25%	0
	> 25%	3.5

total score =

= SUM(points for all 4 parameters)

Interpretation:

• minimum score: 0

• maximum score: 14.5

• The higher the score the greater the risk of recurrence. A patient with a intermediate or high risk of recurrence may benefit from more aggressive management including closer monitoring and/or adjuvant therapy.

Total Score	Rate of Recurrence
0 to 4	low (< 5%)
7 to 7.5	intermediate (40 or 65%)
10.5 to 14.5	high (> 95%)

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Description

Specialty

ICD-10