Date of Award
C. Kristian Enestvedt
Liver -- Cancer -- Case studies, Liver -- Transplantation -- Case studies, Liver -- Cancer -- Pathogenesis
Hepatocellular carcinoma (HCC) is among the top ten most frequently diagnosed cancers in the United States, with liver transplantation widely accepted as the best treatment option for long term outcomes. The risk of HCC recurrence after liver transplantation is a growing concern among the medical community due to the scarcity of available organs for transplant. Scholars desire to understand HCC biology and risk factors associated with recurrence, for more accurate predictions of HCC recurrence in the future. A retrospective review from Oregon Health and Science University (OHSU) examined 69 HCC patients from February 27, 2002 to December 31, 2011. Data was collected and statistically analyzed for significant connections to incidence of HCC recurrence (p<0.05). No statistical difference was observed between ten of the eleven risk factors and incidence of recurrence: age, ethnicity, gender, initial imaging, explant pathology, AFP levels, MELD scores, ischemia time, diagnoses, and donor type. A statistically significant association was identified between Milan criteria and HCC recurrence (p=0.004). The incidence of HCC recurrence from the OHSU data set was 15.9%. The Milan findings support the nationwide acceptance of the risk factor, which underlies the MELD exception scores for transplantation. The other ten risk factors supported the lack of consensus among the research community and the idea that HCC biology is still not fully understood. This thesis determines how data from OHSU compares to nationally reported data, in terms of similarities, differences, and future focuses of research.
Hubsky, Ashlee, "Hepatocellular Carcinoma Recurrence After Liver Transplantation: an Analysis of Risk Factors and Incidence from Oregon Health & Science University" (2016). University Honors Theses. Paper 216.