Biases in the reporting of hepatocellular carcinoma tumor sizes on the liver transplant waiting list

• DOI: 10.1002/hep.29269
• Publication Date: 2017-05-18T12:44:23Z
• Authors: Mariya L. Samoylova; Mark J. Nigrini; Jennifer L. Dodge; John P. Roberts
• Keywords: Milan criteria

We investigated the possibility that patients with hepatocellular carcinoma (HCC) listed for liver transplant tumors just outside stage T2 size criteria may be inaccurately reported as meeting tumor transplant. The United Network Organ Sharing/Standard Transplant Analysis and Research database identified 12,958 transplants HCC exception points from 2006 to 2013, 9,168 of whom were one tumor. A logistic power peak function was fitted single‐tumor histogram, values representing unbiased expected values. difference between observed counts 2.0 cm 5.0 238 (22%) 66 (57%), respectively. This suggests up 304 (3.0%) had their measurements recorded at margins eligibility. risk‐adjusted Poisson model evaluated ratio recurrence by size. There 435 recurrences among 6,049 transplants. Only 2.0‐cm differing 1 (ratio 0.73, 95% confidence interval 0.57‐0.94), indicating a 27% lower than rate recurrence. Conclusion : Higher margin corroborated recurrence, suggesting sizes subject inaccurate reporting. (H epatology 2017;66:1144‐1150)