4th Congress of the Spanish Society of TransplantationLiver transplantationOncological Evaluation by Positron-emission Tomography, Circulating Tumor Cells and Alpha Fetoprotein in Patients With Hepatocellular Carcinoma on the Waiting List for Liver Transp

•No data are available in the literaturre regarding the determination and especially the relationship between circulating tumor cell levels (CTCs) and time on the waintg list for an orthotopic liver transplantation in patients with hepatocellular carcinoma.•IsoFlux is a good method to detect CTCs with high sensibility.•Integration of CTCs, α-fetoprotein, and positron-emission tomography findings could be useful in creating a prognostic model to predict an early recurrence to exclude these high-risk patients from the waiting list for orthotopic liver transplantation.

IntroductionThe objectives of this study are the determination of the number of circulating tumor cells (CTCs), by means of the IsoFlux enrichment system (Fluxion Biosciences Inc, San Francisco, California, United States) in patients with hepatocellular carcinoma (HCC) in compliance with the Milan criteria and on the waiting list for hepatic transplantation, as well as the study of its relation with the of α-fetoprotein levels (AFP) and positron-emission tomography-computed tomography (PET-CT) findings.Patients and MethodsAn oncologycal evaluation with PET-CT, CTCs, and AFP was conducted in 24 consecutive patients with HCC eligible for orthotopic liver transplantation according to the Milan criteria. The diagnosis of HCC was made according to clinical, biological, and radiological findings.ResultsWe detected CTCs in peripheral blood in 21 of 24 patients (87.5%) before liver transplantation, with a mean number CTCs of 156 ± 370 (range, 2 to 1768) with statistically significant association between number of CTCs detected in peripheral blood and the time within the waiting list (P < .05), but not betwen AFP levels and standard uptake value and time to orthotopic liver transplantation (P > .05).ConclusionsPET-TC, CTCs, and AFP levels could be an essential key for the correct management of the patients with HCC on the waiting list for liver transplantation.