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Elevated Red Cell Distribution Width and Outcomes in Advanced Stage HCC at Liver Transplant
EP27023
Poster Title: Elevated Red Cell Distribution Width and Outcomes in Advanced Stage HCC at Liver Transplant
Submitted on 08 Feb 2018
Author(s): Dakota Becker-Greene, Michael Caire M.D., Ebonie Rogers B.S., Ambuj Kumar M.D., M.P.H., Jacentha Buggs M.D.
Affiliations: University of South Florida; Transplant Hepatology, Tampa General Medical Group; Transplant Research, Tampa General Hospital; Transplant Surgery, Tampa General Medical Group, Tampa, FL
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Poster Information
Abstract: Introduction: Hepatocellular carcinoma (HCC) has an increasing incidence and mortality rate. The current prognostic tools used to assess HCC severity pre-operatively have failed to mitigate the spread. Therefore, there is an urgent need to determine an accurate predictor of HCC prognosis. Hypothesis: We hypothesize that elevated red cell distribution width (RDW) can be predictive of advanced HCC stage at time of liver transplantation.


Methods: We performed a retrospective cohort study of all consecutive adult orthotopic liver transplant (OLT) patients from January 1st, 2012 through December 31st, 2016. Only patients who were diagnosed with incidental or pre-operative HCC were studied.


Results: Our transplant center performed 389 OLT of which 32.4% recipients were diagnosed with HCC (N=126). There was a statistically significant correlation between pre-OLT RDW and explant HCC (p=.026). Patients with pre-OLT RDW of >=14.2 were significantly more likely to have HCC present in explant pathology compared with pre-OLT RDW of <14.2 (OR=3.8; 95% CI 1.28 to 11.05). The results remained statistically significant (p=.049) when pre-OLT treatment type was taken into consideration, with an odds ratio of 1.448 (95% CI 1.00-2.09). Overall patient survival when correlating pre-OLT RDW with explant HCC was not significant (p=.959).


Conclusions: This is the first research that demonstrates a positive correlation between pre-OLT RDW values and HCC outcomes. Our findings are retrospective from a single center, thus limited. Future multicenter collaborations are essential to further validate these conclusions.
Summary: Hepatocellular carcinoma (HCC) has an increasing incidence and mortality rate. The current prognostic tools used to assess HCC severity pre-operatively have failed to mitigate the spread. Therefore, there is an urgent need to determine an accurate predictor of HCC prognosis. References: 1. Howell J, Pinato DJ, Ramaswami R, et al. Integration of the cancer-related inflammatory response as a stratifying biomarker of survival in hepatocellular carcinoma treated with sorafenib. Oncotarget. Feb 14 2017.
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5. Furihata T, Sawada T, Kita J, et al. Serum alpha-fetoprotein level per tumor volume reflects prognosis in patients with hepatocellular carcinoma after curative hepatecto
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