Savanna Monson, Pin-Jung Chen, Alexandra Gangi, Kevin Waters, Sandrine Billet, Andrew Hendifar, Shelly Lu, Jason A Zell, Jun Gong
{"title":"Chemopreventive strategies for sporadic colorectal cancer: a narrative review.","authors":"Savanna Monson, Pin-Jung Chen, Alexandra Gangi, Kevin Waters, Sandrine Billet, Andrew Hendifar, Shelly Lu, Jason A Zell, Jun Gong","doi":"10.21037/tgh-24-97","DOIUrl":"10.21037/tgh-24-97","url":null,"abstract":"<p><strong>Background and objective: </strong>Globally, colorectal cancer (CRC) is the third most commonly diagnosed cancer. CRC is known to arise from precancerous polyps known as adenomas. Although there are genetic syndromes (i.e., familial adenomatous polyposis syndrome) that carry a high lifetime risk of CRC, the majority of CRC cases are sporadic. Sporadic CRC develops via molecular events that occur early and frequently in the transformation of the normal colon epithelium to invasive cancer. Prevention of sporadic CRC (i.e., CRC chemoprevention) has been a topic of interest in the past decades due to its large public health burden. The objective of this study is to review various chemopreventive agents studied in randomized controlled trials (RCTs) to evaluate their effectiveness and safety in preventing sporadic CRC.</p><p><strong>Methods: </strong>This review focuses on recent RCTs using potential chemopreventive agents to prevent sporadic CRC formation, either directly or through reduction of its known precursors such as adenomas or aberrant crypt foci (ACF) through interventions including nonsteroidal anti-inflammatory drugs (NSAIDs), vitamins and minerals, and metabolic agents.</p><p><strong>Key content and findings: </strong>Multiple RCTs have been conducted in sporadic CRC chemoprevention. NSAIDs have proven promising in sporadic CRC chemoprevention but have been limited due to increased cardiovascular risk, particularly for celecoxib and rofecoxib.</p><p><strong>Conclusions: </strong>There is active investigation into establishing the first sporadic CRC chemoprevention strategy. Building from previous trials, the choice of study population, selection of endpoints, safety and tolerability, availability of surrogate biomarkers, and novel mechanisms of action targeting the adenoma-carcinoma sequence remain important points to consider for all future trials of sporadic CRC chemoprevention.</p>","PeriodicalId":94362,"journal":{"name":"Translational gastroenterology and hepatology","volume":"10 ","pages":"11"},"PeriodicalIF":3.8,"publicationDate":"2025-01-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11811562/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143412181","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The synthesis of the psychosocial and the physiological aspects of chronic digestive disease is at a crossroads.","authors":"Sara H Marchese, Tiffany H Taft","doi":"10.21037/tgh-24-102","DOIUrl":"10.21037/tgh-24-102","url":null,"abstract":"","PeriodicalId":94362,"journal":{"name":"Translational gastroenterology and hepatology","volume":"10 ","pages":"1"},"PeriodicalIF":3.8,"publicationDate":"2025-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11811560/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143411989","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ulrike Bauer, Cornelia Fütterer, Rickmer F Braren, Petia Trifonov, Roland M Schmid, Katrin Böttcher, Ursula Ehmer
{"title":"Decreased overall survival in patients with hepatocellular carcinoma during the COVID-19 pandemic.","authors":"Ulrike Bauer, Cornelia Fütterer, Rickmer F Braren, Petia Trifonov, Roland M Schmid, Katrin Böttcher, Ursula Ehmer","doi":"10.21037/tgh-24-54","DOIUrl":"10.21037/tgh-24-54","url":null,"abstract":"<p><strong>Background: </strong>The coronavirus disease-2019 (COVID-19) pandemic had a profound influence on screening, diagnosis and treatment of cancer patients worldwide. Due to overloaded health care facilities, screening and surveillance visits for early cancer detection were postponed or completely omitted. This included surveillance of patients with liver cirrhosis who are at risk for development of hepatocellular carcinoma (HCC) and resulted in a decrease in HCC diagnoses. We therefore aimed to analyze the impact of the COVID-19 pandemic on HCC diagnoses and survival of HCC patients in our tertiary care center in Germany.</p><p><strong>Methods: </strong>We conducted a monocentric retrospective study in which we analyzed data of 175 patients diagnosed with HCC before (March 2018 through February 2020) or during the COVID-19 pandemic (March 2020 through February 2022).</p><p><strong>Results: </strong>Compared to patients diagnosed with HCC prior to the COVID-19 pandemic, a significantly higher percentage of patients was diagnosed with HCC in more advanced stages during the COVID-19 pandemic. This was associated with a significantly lower overall survival (OS) in patients diagnosed with HCC during the first year of the pandemic. Importantly, stage-dependent survival was not different between patients diagnosed before and during the COVID-19 pandemic, strongly indicating that diagnostic delay during the pandemic did not play a major role at our center.</p><p><strong>Conclusions: </strong>Taken together, our data indicate that the COVID-19 pandemic significantly impacted on HCC patient care. Specifically, our data suggests that HCC diagnosis was delayed during the pandemic in a relevant percentage of patients translating into reduced survival in our patient cohort.</p>","PeriodicalId":94362,"journal":{"name":"Translational gastroenterology and hepatology","volume":"10 ","pages":"9"},"PeriodicalIF":3.8,"publicationDate":"2024-12-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11811565/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143412163","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Current status of artificial intelligence analysis for the diagnosis of gallbladder diseases using ultrasonography: a scoping review.","authors":"Xiuming Wang, Huabin Zhang, Zhiyong Bai, Xia Xie, Yue Feng","doi":"10.21037/tgh-24-61","DOIUrl":"10.21037/tgh-24-61","url":null,"abstract":"<p><strong>Background: </strong>Ultrasound (US) is the first-line imaging method for gallbladder diseases (GBDs), with advantages of easy accessibility, real-time dynamic imaging, and no radiation. However, using only visual judgment from US images to stratify the risk of gallbladder (GB) lesions is challenging. In addition, the diagnostic ability of sonographers is highly correlated with their knowledge reserves, clinical experience, and proficiency in operation. Recently, the application of artificial intelligence (AI) in medical image recognition has attracted widespread attention. This review aims to provide a comprehensive summary and analysis of the application of US-based AI technology in various GBDs. In addition, the diagnostic ability of US-based AI technology in GBDs based on the findings of published articles was evaluated.</p><p><strong>Methods: </strong>We searched the PubMed and Wiley databases using predefined keywords for articles published over the past two decades (from January 2003 to December 2023) to evaluate research progress in this field. Articles were screened for relevant publications about US-based AI applications in GBDs. Then, we conducted a comprehensive summary and analysis of the application of US-based AI technology in various GBDs and evaluated its diagnostic performance.</p><p><strong>Results: </strong>Following PRISMA-ScR guidelines, 16 studies were included in this review. These studies involve a relatively narrow spectrum of GBDs, including GB polyps, gallbladder cancer (GBC), GB stones, and biliary atresia (BA). The most widely used applications of AI in GBDs are GB polyps and GBC. AI has achieved satisfactory sensitivity, specificity, or accuracy in the differential diagnosis of GB polypoid lesions. AI has certain application value in the GB stone measurement and auxiliary diagnosis of GBC and BA.</p><p><strong>Conclusions: </strong>The current status, limitations, and future perspectives of AI-assisted ultrasonography in GBDs were reported. In the near future, the AI has the potential to become a breakthrough in the diagnosis of GBDs, supporting doctors in improving the diagnostic ability of GBDs with ultrasonography.</p>","PeriodicalId":94362,"journal":{"name":"Translational gastroenterology and hepatology","volume":"10 ","pages":"12"},"PeriodicalIF":3.8,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11811555/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143412160","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nicolò Fabbri, Salvatore Greco, Antonio Pesce, Francesco Virgilio, Luca Bonazza, Luca Bagnoli, Carlo V Feo
{"title":"Enhancing the management of acute and gangrenous cholecystitis: a systematic review supported by the TriNetX database.","authors":"Nicolò Fabbri, Salvatore Greco, Antonio Pesce, Francesco Virgilio, Luca Bonazza, Luca Bagnoli, Carlo V Feo","doi":"10.21037/tgh-24-27","DOIUrl":"10.21037/tgh-24-27","url":null,"abstract":"<p><strong>Background: </strong>Acute cholecystitis (AC) leads to emergency hospital admissions, and is categorized into mild, moderate, or severe grades, and affects hospital stay, surgery rates, costs, and prognosis. Gangrenous cholecystitis (GC) is the severe form and entails gallbladder wall necrosis and infection, possibly leading to emphysematous cholecystitis (EC), a life-threatening variant: early recognition of such a condition is crucial, since its symptoms may mimic uncomplicated AC. The current literature lacks comprehensive reviews on EC and GC due to their rarity and this study aims to bridge this gap by utilizing the TriNetX database, comparing clinical data of AC with GC outcomes.</p><p><strong>Methods: </strong>The study involved data retrieval from PubMed and Medline and the TriNetX database. Initially, 981 English articles were identified, focusing on emphysematous and GC and cholecystectomy. After filtering and reviewing, 73 articles were suitable for inclusion. We analyzed electronic medical records of adults diagnosed with AC, comparing demographics, comorbidities, and medications between medical and surgical intervention groups. Propensity score matching balanced cohorts, and Kaplan-Meier analysis estimated outcomes, while other statistical analyses, including risk ratios (RRs) and odds ratios (ORs), were conducted within TriNetX, with significance set at P<0.05. The study aimed to compare 5-year all-cause mortality in AC patients treated with or without surgery.</p><p><strong>Results: </strong>We found 9 retrospective studies and 3 prospective studies. Additionally, 70 patients from 62 case reports were utilized for descriptive analyses. From the TriNetX database, a total of 245,668 patients hospitalized for AC we identified. Despite, overweight/obesity was more frequent in the surgery group (24% <i>vs.</i> 14%, P<0.001), hypertension, diabetes mellitus, ischemic heart disease, chronic kidney disease and cerebrovascular diseases were more frequent in the non-operated patients (37% <i>vs.</i> 36%; 20% <i>vs.</i> 17%; 19% <i>vs.</i> 13%; 12% <i>vs.</i> 8%; 11% <i>vs.</i> 6%, respectively, all with P<0.001). The data concerning gastric medications are particularly eloquent, since 43% of operated patients were treated with such drugs versus 33% of non-operated subjects, before surgery (P<0.001). As for Kaplan-Meier analyses, patients who underwent surgery for AC presented generally lower mortality rates in the whole period of follow-up extended to 5 years (RR 0.415, 95% CI: 0.403-0.426; OR 0.364, 95% CI: 0.353-0.376; P<0.001) and this was particularly evident in the first 200 days of observation since index event.</p><p><strong>Conclusions: </strong>In GC, timely surgical intervention within 72-96 hours reduces complications, such as infections and hospital admissions. Laparoscopic surgery decreases intensive care unit (ICU) admissions and intra-abdominal abscesses. For AC, proton pump inhibitors (PPIs) seem to increase the ri","PeriodicalId":94362,"journal":{"name":"Translational gastroenterology and hepatology","volume":"10 ","pages":"16"},"PeriodicalIF":3.8,"publicationDate":"2024-11-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11811563/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143412174","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The current progress and futural prospects of ultrasound-targeted microbubble destruction for liver diseases: a narrative review.","authors":"Bing-Jie Yang, Hai-Feng Zhou, Yu Liu, Wei Yang, Jia Li, Wei-Zhong Zhou","doi":"10.21037/tgh-24-53","DOIUrl":"10.21037/tgh-24-53","url":null,"abstract":"<p><strong>Background and objective: </strong>Ultrasound (US)-targeted microbubble (MB) destruction (UTMD) involves the application of low-intensity US to MBs. This review is to illustrate the current progress and futural prospects of UTMD for liver diseases.</p><p><strong>Methods: </strong>A review of the most recent literature concerning the use of UTMD for liver diseases is presented from January 2000 to December 2023. A comprehensive search was conducted by two independent reviewers. In this review, we provide an overview of various preclinical applications of UTMD in the delivery of drugs and genes to target liver diseases, including liver cancer, liver fibrosis, and hepatic gene deficiency disorders, which have established the safety and effectiveness.</p><p><strong>Key content and findings: </strong>A total of 9 studies and 14 studies were identified about the preclinical applications for drug-loaded and gene-loaded UTMD for liver diseases, respectively. UTMD allows specific substances to bypass physiological barriers and reach target tissues or organs. It has been demonstrated to enhance hepatic disease drug delivery. UTMD still requires improvement in many areas, including sonographic parameters, drug-loading capacity, and range of treatable diseases.</p><p><strong>Conclusions: </strong>UTMD was shown in preclinical studies to enhance the therapeutic efficacy of drug delivery and gene therapy for liver cancer, liver fibrosis and hepatic gene defect diseases. Further clinical trials are emergent to evaluate the safety, effectiveness and long-term efficacy of UTMD in treating human liver diseases.</p>","PeriodicalId":94362,"journal":{"name":"Translational gastroenterology and hepatology","volume":"10 ","pages":"14"},"PeriodicalIF":3.8,"publicationDate":"2024-11-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11811551/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143411880","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"KEYNOTE-585: disappointing results for perioperative pembrolizumab in gastric cancer.","authors":"David H Ilson","doi":"10.21037/tgh-24-57","DOIUrl":"10.21037/tgh-24-57","url":null,"abstract":"","PeriodicalId":94362,"journal":{"name":"Translational gastroenterology and hepatology","volume":"10 ","pages":"18"},"PeriodicalIF":3.8,"publicationDate":"2024-10-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11811557/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143412196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Reproductive and sexual health concerns in gastrointestinal illness: a narrative review.","authors":"Katrina S Hacker, Alyse Bedell","doi":"10.21037/tgh-24-38","DOIUrl":"10.21037/tgh-24-38","url":null,"abstract":"<p><strong>Background and objective: </strong>Gastrointestinal (GI) disorders, including inflammatory bowel disease (IBD) and irritable bowel syndrome (IBS), can have a profound and widespread impact on quality of life, including on reproductive and sexual functioning. However, reproductive and sexual concerns are rarely addressed in GI appointments and patients desire more information and guidance related to these important aspects of quality of life. The purpose of this review is to provide a resource for providers seeing GI patients with these issues and to provide suggestions of resources and strategies to address these concerns.</p><p><strong>Methods: </strong>We conducted a non-systematic, narrative review of databases including PubMed and Google Scholar to identify English language research on reproductive and fertility concerns and sexual dysfunction (SD) in the setting of GI illness. We applied a biopsychosocial lens to highlight the complex, multifactorial nature of illness experience and quality of life.</p><p><strong>Key content and findings: </strong>GI illnesses, including IBD and IBS, contribute unique biopsychosocial risk factors to disruptions in reproductive and sexual functioning. GI patients have unique counseling needs that may shift throughout the reproductive lifespan. Research indicates that psychosocial outcomes improve when patients receive education and counseling, yet providers rarely address these topics.</p><p><strong>Conclusions: </strong>Multidisciplinary providers working with GI patients should routinely assess for reproductive and sexual concerns, and share accurate education with patients to reduce misinformation, shame, untreated symptoms, and emotional distress. Future research should continue to address these topics, as evidence remains inconclusive in several biopsychosocial domains of GI reproductive and sexual health.</p>","PeriodicalId":94362,"journal":{"name":"Translational gastroenterology and hepatology","volume":"10 ","pages":"15"},"PeriodicalIF":3.8,"publicationDate":"2024-10-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11811567/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143412207","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"REGγ deficiency ameliorates hepatic ischemia and reperfusion injury in a mitochondrial p66shc dependent manner in mice.","authors":"Long Guo, Qing Yang, Jiali Zhu, Jinbao Li","doi":"10.21037/tgh-24-46","DOIUrl":"10.21037/tgh-24-46","url":null,"abstract":"<p><strong>Background: </strong>Hepatic ischemia and reperfusion (I/R) injury is a common problem faced by patients undergoing clinical liver transplantation and hepatectomy, but the specific mechanism of liver I/R injury has not been fully elucidated. The protein degradation complex 11S proteasome is involved in apoptosis, proliferation and cell cycle regulation by regulating the 11S proteasome regulatory complex (REG)γ. The main objective of this study is to explore the role and specific mechanism of REGγ in liver I/R.</p><p><strong>Methods: </strong>By constructing a model of <i>in vivo</i> hepatic I/R injury in mice and a model of hypoxia and reoxygenation (H/R) in isolated hepatocytes. First, the REGγ expression were detected during hepatic I/R in mice. Second, to investigate the effects of REGγ knockout (KO) on liver necrosis, inflammatory response, apoptosis and mitochondrial function. Finally, mouse liver Src homology collagen (p66shc) mitochondrial translocation was detected.</p><p><strong>Results: </strong>The expression of REGγ was up-regulated during hepatic I/R. REGγ KO had significantly reduced liver tissue infarct size, liver transaminases, inflammatory cells infiltration, inflammatory cytokine and activation of nuclear factor kappa-B (NF-κB) signaling pathway and cell apoptosis. REGγ KO had significantly alleviated the mitochondrial damage, decreased the up-regulated level of cytochrome C, reactive oxygen species (ROS). REGγ KO had significantly reduced p66shc mitochondrial translocation in mice.</p><p><strong>Conclusions: </strong>The experimental results of this study indicated that REGγ has an important role in preventing liver I/R injury and may play a role through the mitochondrial p66shc signaling pathway.</p>","PeriodicalId":94362,"journal":{"name":"Translational gastroenterology and hepatology","volume":"9 ","pages":"62"},"PeriodicalIF":3.8,"publicationDate":"2024-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11535816/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142585320","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ning Jiao, Cheng Yan, Li He, Hai-Long Jin, Shuang Oiu, Chao Li, Zhi-Sheng Zheng, Bin Lu, Feng-Dong Wu, Yang Yang, Xin-Guo Chen, Qing Zhang
{"title":"Liver transplantation for hepatocellular carcinoma: a proposal for including preoperative serological indicators improves the Milan criteria expanded.","authors":"Ning Jiao, Cheng Yan, Li He, Hai-Long Jin, Shuang Oiu, Chao Li, Zhi-Sheng Zheng, Bin Lu, Feng-Dong Wu, Yang Yang, Xin-Guo Chen, Qing Zhang","doi":"10.21037/tgh-24-40","DOIUrl":"10.21037/tgh-24-40","url":null,"abstract":"<p><strong>Background: </strong>Liver transplantation (LT) is the most effective and radical treatment for hepatocellular carcinoma (HCC). Most LT criteria are based on the morphological characteristics of tumors, which are not enough to predict the risk of tumor recurrence. It is found that some serological biomarkers can predict tumor recurrence and may be a good indicator for selecting suitable HCC patients for LT. This article aims to evaluate the predictive effect of preoperative serological indicators on long-term overall survival (OS) and tumor recurrence-free survival (TFS) of patients with HCC after LT, and to explore its significance for expanding the Milan criteria.</p><p><strong>Methods: </strong>Clinical data of 253 patients after LT in HCC were collected retrospectively. The receiver operating characteristic curve was used to calculate the best cut-off value. χ<sup>2</sup> test was used to analyze the correlation between preoperative serological indicators and tumor pathological features. Univariate and multivariate analyses were used to analyze the risk factors affecting the OS and TFS rates and the predictive values of different LT criteria were compared. Nomogram model was used to predict the OS and TFS rates of patients exceeding Milan criteria.</p><p><strong>Results: </strong>Independent risk factors for poor OS and TFS rates were alpha-fetoprotein (AFP) >200 ng/mL, gamma-glutamyl transpeptidase (GGT) >80 IU/L, total tumor diameter (TTD) >8 cm and microsatellite lesions. Nomogram model showed patients beyond Milan criteria had better survival when AFP ≤200 ng/mL and GGT ≤80 IU/L or AFP >200 ng/mL, GGT ≤80 IU/L and TTD ≤8 cm. According to Milan criteria, AFP, GGT and TTD, Milan-AFP-GGT-TTD (M-AGT) criteria was established. There was no significant difference in OS and TFS rates among patients in M-AGT, Milan, Hangzhou, Malaya and the University of California at San Francisco (UCSF) criteria.</p><p><strong>Conclusions: </strong>Preoperative serological indicators AFP and GGT can effectively predict long-term OS and TFS in HCC patients after LT. Establishing M-AGT criteria based on serological indicators is helpful to supplement the Milan criteria.</p>","PeriodicalId":94362,"journal":{"name":"Translational gastroenterology and hepatology","volume":"9 ","pages":"63"},"PeriodicalIF":3.8,"publicationDate":"2024-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11535812/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142585313","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}