Yang et al reported a simple score for determining if a patient with hepatocellular carcinoma is a potential candidate for living donor liver transplantation. The authors are from Seoul National University in South Korea.
Patient selection: hepatocellular carcinoma, confined to liver
Parameters:
(1) number of tumor nodules
(2) diameter of the largest tumor nodule in cm
(3) serum alpha-fetoprotein (AFP) concentration in ng/mL
Parameter
Finding
Points
number of nodules
1
1
2 or 3
2
4 or 5
3
>= 6
4
diameter
<= 3 cm
1
3.01 to 5 cm
2
5.01 to 6.5
3
> 6.5 cm
4
serum AFP
<= 20 ng/mL
1
20.01 to 200
2
200.01 to 1,000
3
> 1,000 ng/mL
4
score =
= SUM(points for all 3 parameters)
Interpretation:
• minimum score: 3
• maximum score: 12
• The higher the score the worse the prognosis.
• A score from 3 to 6 ("within criteria") are considered candidates for living-donor liver transplantation. This group was 89% free of tumor recurrence at 3 years after transplant.
• A score from 7 to 12 ("beyond criteria") are considered nontransplantable. This group was 42% free of tumor recurrence at 3 years after liver transplant.
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