JAHA: Incidence, predictive indicators and mortality of liver cancer after Fontan surgery

After Fontan's surgery, liver cancer (LC) is a serious late-stage complication.
, however, its incidence, predictive factors and prognosms are still unknown.
, researchers aim to identify the clinical characteristics of these patients in a recent study published in JAHA, an authoritative journal in the field of cardiovascular disease.
researchers assessed liver function in 339 patients who underwent Fontan surgery between 2005 and 2019.
10 patients were histologically diagnosed with LC (range: 0.3-13.8; with a medium age of 29.9 years) during follow-up with a medium time of 2.9 years. 4.4-41.5 years; the median age of follow-up after Fontan surgery was 25.6 years (range: 13-32.1 years) and the annual incidence rate of LC was 0.89%.
the annual incidence of new LCs in the second, third and fourth decades was 0.14 per cent, 0.43 per cent and 8.83 per cent, respectively, throughout Fontan postoperative follow-up.
follow-up time was longer in patients with LC, AFP (A fetal protein) levels were higher, and liver fibrosis index was higher (P.lt;01-0.0001).
addition, all indicators can predict new LCs (P.lt;0.01-0.0001).
LC treatment includes surgical excision (n=3), arterial chemical embolism (n=3), RF ablation (n=2) and hospice care (n=2).
4 patients died during the 9.4-month mid-level follow-up period.
survival rate of 60% in 1 year and better survival rate in asymptomatic patients (P .lt;0.01).
shows that 30 years after Fontan surgery, the incidence of LC increased rapidly, and liver fibrosis index and AFP can be used as predictive indicators of new LC.
these LC predictive markers should be closely monitored to detect LC and improve patient prognostics as early as possible.