The aMAP score predicts long-term outcomes after resection of hepatocellular carcinoma: a multi-institutional analysis

Diamantis I Tsilimigras; Yutaka Endo; Francesca Ratti; Hugo P Marques; François Cauchy; Vincent Lam; George A Poultsides; Irinel Popescu; Sorin Alexandrescu; Guillaume Martel; Minoru Kitago; Alfredo Guglielmi; Tom Hugh; Luca Aldrighetti; Ana Gleisner; Feng Shen; Itaru Endo; Timothy M Pawlik

doi:10.1016/j.hpb.2024.01.001

The aMAP score predicts long-term outcomes after resection of hepatocellular carcinoma: a multi-institutional analysis

HPB (Oxford). 2024 Apr;26(4):541-547. doi: 10.1016/j.hpb.2024.01.001. Epub 2024 Jan 4.

Authors

Diamantis I Tsilimigras¹, Yutaka Endo¹, Francesca Ratti², Hugo P Marques³, François Cauchy⁴, Vincent Lam⁵, George A Poultsides⁶, Irinel Popescu⁷, Sorin Alexandrescu⁷, Guillaume Martel⁸, Minoru Kitago⁹, Alfredo Guglielmi¹⁰, Tom Hugh¹¹, Luca Aldrighetti², Ana Gleisner¹², Feng Shen¹³, Itaru Endo¹⁴, Timothy M Pawlik¹⁵

Affiliations

¹ Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, OH, USA.
² Department of Surgery, Ospedale San Raffaele, Milano, Italy.
³ Department of Surgery, Curry Cabral Hospital, Lisbon, Portugal.
⁴ Department of Hepatobiliopancreatic Surgery, APHP, Beaujon Hospital, Clichy, France.
⁵ Department of Surgery, Westmead Hospital, Sydney, Australia.
⁶ Department of Surgery, Stanford University, Stanford, CA, USA.
⁷ Department of Surgery, Fundeni Clinical Institute, Bucharest, Romania.
⁸ Department of Surgery, University of Ottawa, Ottawa, Canada.
⁹ Department of Surgery, Keio University, Tokyo, Japan.
¹⁰ Department of Surgery, University of Verona, Verona, Italy.
¹¹ Department of Surgery, The University of Sydney, School of Medicine, Sydney, Australia.
¹² Department of Surgery, University of Colorado, Denver, CO, USA.
¹³ Department of Hepatic Surgery IV, The Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, China.
¹⁴ Yokohama City University School of Medicine, Yokohama, Japan.
¹⁵ Department of Surgery, The Ohio State University Wexner Medical Center, Columbus, OH, USA. Electronic address: [email protected].

PMID: 38218690
DOI: 10.1016/j.hpb.2024.01.001

Abstract

Background: The aMAP score is a proposed model to predict the development of hepatocellular carcinoma (HCC) among high-risk patients with chronic hepatitis. The role of the aMAP score to predict long-term survival among patients following resection of HCC has not been determined.

Methods: Patients undergoing resection for HCC between 2000 and 2020 were identified using a multi-institutional database. The impact of the aMAP score on long-term outcomes following HCC resection was assessed.

Results: Among 1377 patients undergoing resection for HCC, a total of 972 (70.6 %) patients had a low aMAP score (≤63), whereas 405 (29.4 %) individuals had a high aMAP score (≥64). aMAP score was associated with 5-year OS in the entire cohort (low vs high aMAP score:66.5 % vs. 54.3 %, p < 0.001). aMAP score predicted 5-year OS following resection among patients with HBV-HCC (low vs. high aMAP:68.8 % vs. 55.6 %, p = 0.01) and NASH/other-HCC (64.7 % vs. 53.7, p = 0.04). aMAP score could sub-stratify 5-year OS among patients undergoing HCC resection within (low vs. high aMAP:81.5 % vs. 67.4 %, p < 0.001) and beyond (55.9 % vs. 38.8 %, p < 0.001) Milan criteria.

Discussion: The aMAP score predicted postoperative outcomes following resection of HCC within and beyond Milan criteria. Apart from a surveillance tool, the aMAP score can also be used as a prognostic tool among patients undergoing resection of HCC.

Publication types

Multicenter Study

MeSH terms

Carcinoma, Hepatocellular*
Hepatectomy / adverse effects
Humans
Liver Neoplasms*
Prognosis
Retrospective Studies